Tips for Using Sand Tray Therapy with Children and Teens Effectively and Ethically

Using sand tray in the treatment process with children and teens requires child/adolescent therapists to have a good understanding

of the common themes and patterns of your young clients because of their unique developmental processes and needs using this expressive arts modality. Having a clinical framework helps you understand and process your client’s sand tray which requires child/adolescent therapists to have a solid grounding in a theory model because theory drives the application. This blog post discusses what you need to develop proficiency using sand tray confidently, ethically, and effectively with your child and adolescent clients in the treatment process.

Sand tray therapy is an expressive arts modality which means it’s projective in nature. Since it’s projective in nature, training and consultation are key to use it ethically and effectively within a grounded framework – theory drives application when you’re using an integrated approach. There are some basic principles that apply across the board when using expressive arts modalities and how you “clinically interpret” meaning. This requires you to have a foundational idea of how to understand the developmental aspects of using sand tray therapy with children so you know what is typical and what may represent that your client is “stuck” in an earlier social-emotional stage/issue. Recognizing where clients are socially and emotionally stuck provides so much helpful clinical information and informs your clinical decision-making process. When using sand tray therapy, child/adolescent therapists need to know how to recognize common patterns seen in sand trays created by children so you know what is typical and what is not as well as helping you to recognize clinically relevant themes in your young client’s sand trays. Children and adolescents engage differently in the sand tray therapy process which makes sense when you think about their developmental differences, so child/adolescent therapists need to know how to introduce and process your client’s sand trays based on these developmental differences. Child/adolescent therapists need to know how to identify clinically relevant themes in the sand tray and then know what to do with that information, which requires a framework.

Since it’s projective in nature, training and consultation are key to use it ethically and effectively within a grounded framework – theory drives application when you’re using an integrated approach.

As a child/adolescent therapist you need to know how to clinically “hold” sand trays without “stepping all over” their projective content in the sand tray, which will bring the therapeutic process to a screeching halt, not to mention ruining the ability to maintain a safe therapeutic space for your client. Even if you’re using directive prompts within an integrative approach with your child and adolescent clients, you still need to have a framework for “holding” and “processing” the sand tray. I LOVE a good framework because it helps me to navigate the clinical decision-making process that’s necessary to help my clients successfully resolve their challenges – those issues bringing them to my office for therapy in the first place. It’s like have GPS for therapy. If I get stuck or there’s “an accident” halting movement, then my framework, or clinical GPS, helps me figure out another way to get to the same place, or maybe we just need to “stay where we are in traffic” and wait for the “lane to open back up.”

I LOVE a good framework because it helps me to navigate the clinical decision-making process that’s necessary to help my clients successfully resolve their challenges – those issues bringing them to my office for therapy in the first place. It’s like have GPS for therapy.

Using sand tray therapy without getting training and supervision can be detrimental because you need to have a framework for using it ethically, and that takes an investment in your time and money. The benefit making that investment of time and money is that you know you’re using sand tray therapy ethically as well as knowing how to use it confidently and effectively. There’s nothing worse than getting “lost” in the treatment process and having no clue what’s going on for your client. As mental health professionals, we need to be lifelong learners because the more we learn the more we realize there is more to learn. So, if you’re brand new to sand tray therapy or just starting your journey using sand tray, here’s my advice to getting the right kind of training to get you started with a solid foundation from which you can continue to build your skills:

Training needs to include experience creating your own sand trays so you understand the power of this projective modality
Training needs to ground you in a theoretical model to guide how you apply the principles of sand tray, including when you are using an integrated approach to play therapy and expressive arts
Invest in ongoing consultation to help you identify clinically relevant themes and case conceptualization using sand tray therapy to help with your clinical decision-making process for each client.

Here’s a recap:

Sand tray therapy is a projective modality (like any other expressive arts modality) and there are fundamental principles of sand tray therapy that are important to know at the very least to ground you in this projective modality.
Being grounded in a clinical framework and a theoretical model ensures sand tray therapy application is effective, ethical, and appropriate.
The basic principles of sand tray therapy (and other expressive arts modalities) are:
- understanding the developmental aspects of using sand tray therapy with children so you know what is typical and what may represent that’s your client is “stuck” in an earlier social emotional stage/issue
- recognizing common patterns seen in sand trays created by children
- knowing how to engage children and adolescents because they engage differently
- identifing clinically relevant themes in the sand tray and then knowing what to do with that information
- “holding” sand trays without “stepping all over” their projective content in the sand tray

If you’re interested in learning how to use sand tray therapy with your child and adolescent clients in the treatment process, contact me.

Categories: : Neuroscience of attachment