Play Therapy Not Working? 4 Ways to Get Unstuck

Feeling stuck with a play therapy case? Explore four ways to assess progress, adjust expectations, and make more confident clinical decisions.

Have you ever finished a play therapy session and wondered, “Is this actually working?”

Maybe you've been seeing a child for several months, and you're not noticing the progress you expected. The parents are still reporting challenges at home, the child seems to be doing the same things in the playroom, and you're beginning to second-guess your clinical decisions.

So what do you do? You start searching for another play therapy activity. You pull out your training materials, look through Pinterest or Etsy, or revisit an activity book hoping you'll find something that finally moves things forward.

Sound familiar?

Here's the thing: feeling stuck doesn't necessarily mean play therapy isn't working. Sometimes it means we need to take another look at how we're understanding the client, what we're expecting from the therapeutic process, and whether we're getting the support we need.

I've been working in the mental health field for almost 35 years, and I still get stuck sometimes. In fact, I recently reached out to a trusted colleague for consultation on a particularly challenging case.

Getting stuck is part of clinical work. What matters is knowing how to work through it.

So if you're wondering whether play therapy is working for your client, here are four things I encourage you to consider before searching for another intervention.

1. Revisit Your Case Conceptualization and Play Therapy Model

Whenever I'm feeling stuck with a client, one of the first things I do is return to my case conceptualization.

Case conceptualization is really just a way of making sense of what's happening with your client. You're using your theoretical model to understand the underlying problem, identify patterns that may be maintaining it, and develop a working hypothesis about what your client needs.

And I want to emphasize the word working because your case conceptualization isn't something you complete at the beginning of treatment and never look at again.

It's an ongoing process.

As you work with a child and their family, you're constantly gathering new information. You're learning more about their relationships, emotional responses, experiences, and patterns of behavior. That information should continue shaping your understanding of what's happening.

When I revisit my case conceptualization, I ask myself a few questions. What have I learned about this child and their family since our first session? What's changed, and what hasn't? Am I still working from the same understanding of the problem, or is there new information I need to consider?

Then I return to my play therapy model.

Whether you're using child-centered play therapy, Adlerian play therapy, Gestalt play therapy, or an integrative approach, your model should help you understand what stage of treatment you're in and what your clinical goals are during that stage.

Your play therapy model is your GPS. It helps you figure out what to do, when to do it, and how to do it.

Sometimes, when we feel stuck, we're actually trying to accomplish something that doesn't fit where the child is in the therapeutic process. Revisiting our case conceptualization and model can help us recognize that disconnect and make more intentional decisions.

2. Check Your Expectations About Progress

This is a big one, and it's something we talk about frequently inside Play Therapy Academy.

I'll hear play therapists say things like, “We've had 15 sessions. I feel like things should be better by now.”

Somewhere along the way, there's been an expectation that play therapy should take a certain number of sessions. Maybe you've heard that 20 sessions should be enough.

And for some children, that may be true. But when you're working with more complex cases involving trauma, attachment disruptions, or challenging family dynamics, the therapeutic process may take significantly longer.

One of the questions I encourage play therapists to ask themselves is whether they're expecting progress to happen in a straight line.

Because healing rarely works that way.

A child may make progress, experience a stressful event at home, and temporarily return to earlier patterns. A family may need more time to develop trust. Or perhaps the child is still working on feeling safe enough to explore difficult experiences.

Slow isn't the same as stuck.

Before deciding that play therapy isn't working, ask yourself whether you've established a strong therapeutic relationship with the child and their caregivers.

Are you expecting the child to gain insight before they feel safe? Are you asking them to talk about overwhelming experiences before they've developed enough trust? Are you expecting them to explain why they're struggling when their nervous system isn't regulated enough to do that?

Sometimes we unintentionally move faster than the child is ready to go.

For example, if you're asking questions and repeatedly hearing, “I don't know,” I want you to consider whether the pacing may be too fast. Maybe the child isn't ready to explore what you're asking, or maybe they need more time to feel comfortable in the therapeutic relationship.

Parents may have similar expectations. They might remind their child to tell you about something that happened at school and then ask afterward whether the child talked about it.

But if we're still developing safety and trust, expecting the child to immediately discuss something vulnerable may not be realistic.

When we understand what our play therapy model tells us about each stage of treatment, it becomes easier to tolerate the uncertainty that comes with the process.

And that's an important clinical skill. We don't necessarily become better therapists because uncertainty disappears. We become more confident because we learn how to navigate it.

3. Get Feedback Instead of Guessing

Another way to get unstuck is to gather more information.

Sometimes we're so focused on what's happening during our individual play therapy sessions that we forget how valuable feedback from caregivers can be.

This is one of the reasons I place so much importance on parent-only sessions. In my practice, I typically meet with caregivers at least once a month because I want to develop a partnership with them.

I need to understand what's happening outside the playroom. Are there changes at home or school? Have there been new stressors in the family? How are parents responding when their child becomes dysregulated? Are they developing the attachment-based parenting skills we've been working on?

That information helps me understand the child's progress and whether something in their environment may be influencing what I'm seeing during sessions.

It also gives me opportunities to support caregivers. After all, children usually spend far more time with their families than they spend with us in the playroom.

Depending on your play therapy model, you may also be able to gather feedback directly from your client.

If you're using a directive or integrative approach, you might use curiosity to explore what the child is experiencing or make connections between what's happening in the playroom and what's happening in their life.

However, if you're practicing child-centered play therapy with fidelity, you wouldn't directly ask the child for feedback in a way that leads or directs the process. Instead, you can gather information from caregivers and use your observations of the child's play to inform your ongoing assessment.

The key is to remain grounded in your model while gathering information that helps you understand the bigger picture.

You don't have to guess whether something is changing. You can use feedback and ongoing assessment to make more informed clinical decisions.

4. Get Consultation From Other Play Therapists

I think ongoing consultation is one of the most valuable resources we have as play therapists, and sometimes we underestimate just how helpful it can be.

Early in my private practice career, I was part of a small consultation group with several other therapists. We met monthly, discussed challenging cases, and supported each other through the ups and downs of clinical work.

It was wonderful to have that support. But there was one challenge: they weren't play therapists.

So while their feedback was helpful, I often had to figure out how to translate their suggestions into my play therapy approach.

Later, I connected with another play therapist, and having someone who understood the language, models, and process of play therapy made an enormous difference.

Here's something I remind myself of often: you can't see what you can't see, and you don't know what you don't know.

Sometimes we're simply too close to a case to recognize something important. That doesn't mean we're doing anything wrong. It means we're human.

When we bring a challenging case to trusted colleagues who understand play therapy, we gain different perspectives. Someone might notice a pattern we missed, ask a question that changes how we're thinking, or share an experience that helps us consider another approach.

And consultation isn't only valuable for finding solutions.

Sometimes it's reassuring to hear another experienced therapist say, “I've had that happen too.”

I experienced that myself recently when I consulted with a colleague about a challenging case. Hearing that they'd encountered similar difficulties helped me feel supported, and their feedback gave me additional ideas about how to move forward.

That's one of the reasons I created Play Therapy Academy and Play Therapy Elevation Circle. I wanted play therapists to have opportunities for ongoing consultation with people who understand the work they're doing.

Instead of walking away with one possible solution, you can leave with several options. You might have Plan A, B, C, and D, so if one approach isn't effective, you have other clinically grounded strategies to consider.

And you don't have to figure everything out alone.

Sometimes You Need a Different Perspective, Not Another Activity

When play therapy feels stuck, it's easy to assume we need to do something different in the playroom. We start looking for new interventions, activities, or techniques, hoping the next one will create the breakthrough we've been waiting for.

But sometimes what we really need is to understand the process more clearly.

Maybe our case conceptualization needs updating. Maybe our expectations don't match the child's stage of treatment. Maybe there's important information we haven't gathered from caregivers, or maybe we need another play therapist to help us see something we've been missing.

Before you reach for another activity, return to your clinical foundation.

Revisit your case conceptualization. Ground yourself in your play therapy model. Check your expectations, gather feedback, and seek consultation when you need it.

Feeling stuck doesn't automatically mean play therapy isn't working. Sometimes it's an invitation to look at the case from a different perspective.

And when you have a framework and a supportive community to help you navigate those moments, you can approach even your most challenging cases with greater clarity and confidence.

Want to Stop Second-Guessing Your Play Therapy Decisions?

If you've ever found yourself wondering whether you're making the right clinical decisions, I'd love to invite you to my upcoming free webinar:

How to Provide Play Therapy Without Second-Guessing Yourself, Even With Complex Cases

Join me on Sunday, October 25, 2026, at 4:00 PM Pacific / 7:00 PM Eastern for this 90-minute training. We'll take a deeper look at how to approach complex cases with a clearer clinical framework so you can feel more confident about what to do next.

You can register here.

And if you're looking for ongoing support and deeper clinical skill-building, I'd also love for you to explore Play Therapy Academy.

Inside PTA, we use structured case presentations, small-group consultation, and play therapy-specific training to strengthen your case conceptualization and clinical decision-making skills. Our cohorts are intentionally small so we can take a deeper dive into the cases you're working on and help you develop practical strategies grounded in your play therapy model.

I currently have a few openings in Play Therapy Academy. If you're interested, visit the supervision page on my website and schedule a 30-minute video call with me. We'll talk about what you're looking for and whether PTA—or Play Therapy Elevation CIRCLE—would be the better fit.

Because you don't need to have all the answers to become a more confident play therapist. You need a solid clinical framework, opportunities to keep learning, and people who can help you think through the challenging cases.

And you don't have to do that alone.

Categories: : Case Conceptualization, Play Therapy Academy, Podcast, Progress Notes