How Do You Know if Play Therapy Works?

I've been fascinated with the idea of play therapy themes, and what intrigued me even more was overhearing a judge in a court case question the validity of these themes. The judge asked a play therapist to explain how the play behaviors observed in a session were related to the client's issues. This question is crucial because if we, as play therapists, cannot clearly articulate the connections between play behaviors and therapeutic outcomes, it can undermine the credibility of play therapy.

What Are Play Themes?

In essence, play themes are the psychosocial content, both conscious and unconscious, that manifests through children's play. They are the issues children are working through, communicated through their play behaviors. This idea is fundamental to play therapy: children use play to express themselves in ways they might not be able to verbalize.

For instance, in adult therapy, therapists listen deeply to the spoken words, body language, and tone. Similarly, in play therapy, therapists observe play behaviors, the use of toys, statements made during play, and interactions to identify themes. These themes provide insight into what the child is experiencing and where they are in the therapeutic process.

Research on Play Therapy Themes

When creating courses or conducting training, I always look at what the research says. For me, there are three pillars to effective play therapy: the theoretical model, current research, and a strong therapeutic relationship. These elements work together to create a free and protected space for healing.

I recently came across a fascinating study that examined the recognition of play themes and their role in facilitating change. The study used both qualitative and quantitative measures to explore changes in play themes and corresponding behavior changes over six weeks for two case studies. This dual approach provided a deeper look into the therapeutic process.

Study Overview

The researchers trained therapists to use Helen Benedict's coding system for identifying play themes, based on object relations theory. They also used the Child Behavior Checklist to measure behavioral changes reported by parents. Data was collected at the first and sixth sessions to observe changes in play themes and behaviors.

The findings showed that changes in play themes were consistent with behavior changes reported on the Child Behavior Checklist. This supports the ability of play therapists to identify when change is occurring, validating the importance of being trained in a theoretical model.

Identifying and Interpreting Play Themes

Recognizing play themes is crucial for effective play therapy. These themes are consistent across different theoretical models, but their interpretation will depend on the specific model used. For example, themes of power and control or nurturing are common, but how these are understood and addressed will vary.

The study emphasized the importance of using both qualitative and quantitative methods to assess changes. This dual approach helps therapists validate their observations and ensure that the therapeutic process is effective.

Practical Implications

Understanding play themes allows therapists to make informed decisions about interventions and track progress. This process not only helps in creating effective treatment plans but also in writing detailed progress notes that reflect the therapeutic work done.


Research has shown that play therapy is effective in helping children overcome mental health challenges. By identifying and interpreting play themes, therapists can guide the therapeutic process and facilitate change. This approach underscores the importance of being grounded in a theoretical model and continuously updating one's knowledge through research.

For more in-depth learning on these topics, consider exploring my courses on case conceptualization, treatment planning, and play therapy foundations.


Snow, M. S., Hudspeth, E. F., Gore, B., and Seale, H. A. (2007). A comparison of behaviors and play themes over a six-week period: Two case studies in play therapy. International Journal of Play Therapy, 16(2), 147-159. doi.10.1037/1555-6824.16.2.147

Categories: : Case Conceptualization, Play Therapy, Play Therapy Model, Play Therapy Themes, Podcast, Progress Notes, treatmet plan