How to Use Neuroscience and Attachment Theory in Play Therapy to Heal Trauma

Over the last 30 years in the mental health field, I have been working closely with children and adolescents who have experienced trauma. One of the most transformative moments in my career came when I discovered the power of neuroscience and attachment theory in therapy, particularly in conjunction with play therapy. This discovery offered me a deeper understanding of how trauma impacts children, and how we can strategically use therapeutic models to facilitate healing.

The Foundation: Family Systems Theory

When I first began practicing, family systems theory resonated deeply with me because it emphasized understanding a child within the broader context of their family and generational history. In particular, Bowen family systems theory helped me recognize how issues in one family member often stem from dynamics across generations.

I used this foundational understanding as I ventured into play therapy with children and adolescents. By then, however, a new frontier had emerged—neuroscience and attachment theory—which opened up new pathways for helping children recover from trauma.

The Neuroscience Revelation

Around the early 2000s, figures like Daniel Siegel started gaining recognition for work that integrated neuroscience into psychotherapy, particularly through Mindsight and interpersonal neurobiology. Siegel's work drew on Allan Schore's research, which explored how early brain development, particularly the right hemisphere, affects emotional regulation and attachment.

A game-changer for me was reading Schore’s characterization of attachment theory as an emotion regulation theory. It became clear that, in play therapy, focusing on a child’s attachment patterns can significantly aid their ability to regulate emotions, particularly when trauma has disrupted early bonding.

Grounding Play Therapy in Neuroscience and Attachment Theory

In the world of play therapy, it is crucial to ground the work in a theoretical model that drives the application and helps children access the therapeutic powers of play. For me, this meant integrating my newfound knowledge of neuroscience and attachment theory with play therapy techniques.

In practice, grounding play therapy in these frameworks involves assessing the child’s trauma history, understanding its developmental impact, and considering attachment disruptions. Neuroscience explains the brain’s response to trauma, while attachment theory helps to repair emotional regulation by re-establishing secure attachment relationships.

Applying the Right Play Therapy Model

One question I frequently get from play therapists is, "Which model should I use for children with trauma?"

Here are three key considerations:

Age of the Child: Some play therapy models work better with younger children, such as child-centered play therapy (CCPT), which I’ve found particularly effective for children aged eight and under. Older children may respond better to more cognitively-oriented approaches, such as Cognitive Behavioral Therapy (CBT).
Severity and Duration of Trauma: For children with more severe or prolonged trauma, a prescriptive play therapy approach is often needed. Some children may require a higher level of care, such as intensive home-based services or even residential treatment.
Caregiver Involvement: The capacity of caregivers to support the child in healing from trauma is critical. Attachment-based parenting interventions can greatly enhance the therapeutic process.

Integrating Neuroscience and Attachment in Play Therapy

While there isn’t yet a fully established neuroscience-based play therapy model, the integration of neuroscience and attachment theory has become widely recognized as an evidence-based approach to treating trauma. Research in interpersonal neurobiology and polyvagal theory supports the idea that trauma can be healed by repairing attachment and regulating the brain’s threat response system.

By combining these insights with play therapy models like prescriptive play therapy, therapists can apply interventions that help children work through trauma using neuroscience-informed techniques.

Prescriptive Play Therapy: A Neuroscience-Based Approach

Prescriptive play therapy offers an excellent framework for integrating neuroscience and attachment theory. Developed by Dr. Charles Schaefer and others, this approach tailors interventions to each child’s needs, considering factors like developmental stage, personality, family system, and culture. In prescriptive play therapy, clinical decisions are based on case conceptualization and the therapeutic methods best suited to each unique child.

There are four key tenets to prescriptive play therapy:

Differential Therapeutics: Not all interventions work for every child, so therapists must carefully match interventions to the child’s specific needs.
Eclecticism: Therapists draw on a wide range of models and techniques to broaden their toolbox.
Integration: Theories and techniques are combined to strengthen the intervention, but always with intention, not trial and error.
Prescriptive Matching: Evidence-based practices are matched with the child’s unique trauma symptoms and therapeutic needs.

Final Thoughts

Incorporating neuroscience and attachment theory into play therapy can make a significant difference in helping children heal from trauma. Whether through child-centered play therapy or a more structured model like prescriptive play therapy, integrating these theories allows therapists to provide a strategic, evidence-based approach to trauma treatment.

By grounding play therapy in a theoretical model that aligns with neuroscience and attachment principles, therapists can help children rebuild emotional regulation, repair attachment bonds, and ultimately recover from trauma.

If you’d like to dive deeper into this topic, I offer training programs on play therapy for trauma. Visit RH Play Therapy Training to explore upcoming webinars and courses.

Categories: : Case Conceptualization, Neuroscience of attachment, Play Therapy, Play Therapy Model, Podcast, Progress Notes, Trauma