How to Use an Integrative Play Therapy Model with Traumatized Children & Teens

If you’ve ever found yourself cycling through a million play therapy activities hoping one of them finally sticks with your trauma clients, you’re not alone. I’ve been there. That overwhelming feeling of “Is this even working?” while flipping through activity books or scrolling therapist forums can really wear you down. That’s exactly why I wanted to dive into this topic today—what does it actually mean to use an integrative model in play therapy, especially when working with children and teens who’ve experienced trauma?

Let’s talk about what works, what doesn’t, and how to move away from what I call the “spaghetti-against-the-wall” method of treatment planning.

What Is an Integrative Play Therapy Model?

Back in the day, we used to call it “eclectic therapy.” Now we refer to it as an integrative model—but the core idea is the same: blending two or more theoretical models to best support each unique client.

An integrative approach views mental health concerns as multi-layered, because human beings are multi-layered. So, your theoretical model should reflect that complexity. Whether you're combining Child-Centered Play Therapy (CCPT) with Adlerian principles, or blending cognitive-behavioral strategies with somatic or IFS-inspired techniques, the key is that your models are driving your clinical decisions—not just the next fun activity you found online.

Why I Don’t Believe There’s “One Right Way”

I’ve been in this field nearly 35 years, and I’ve seen trends come and go. What’s stayed constant is the importance of choosing models that align with your values, personality, and beliefs about the therapy process.

For younger kids—especially under age 8—I lean heavily into Child-Centered Play Therapy. But by around age 9, I start integrating more directive models, often moving into an integrated framework that still holds onto the therapeutic presence, congruence, and empathy from CCPT while incorporating tools from trauma-focused models.

Blending Theory Without Losing Direction

When you use an integrative approach effectively, you avoid that frantic search for the “perfect” activity. Instead, you’re guided by theory, and you have a map for where your client is in the change process.

Here’s what that looks like:

Your models shape your understanding of what's going on with your client (case conceptualization).
You know where you are in the treatment process—early rapport building, deep trauma work, or integration.
You choose your interventions accordingly.

Without that grounding? You’re probably bouncing from one activity to another, hoping for breakthroughs. And eventually, you burn out.

An Example from My Work

When I’m working with a trauma client and using an integrative approach rooted in neuroscience and attachment theory, I consider things like:

What’s going on with their window of tolerance?
How are implicit memories showing up through their play?
Are they hypo- or hyper-aroused?
What stage of treatment are we in, and what does my model say to do here?

I might blend CCPT with components of IFS, somatic experiencing, or trauma-specific models. I also bring in neurobiological frameworks, like Daniel Siegel’s interpersonal neurobiology or Stephen Porges’ polyvagal theory, to guide how I interpret behaviors and determine next steps.

Directive and Non-Directive: When to Lead, When to Follow

Outside of CCPT, most play therapy models allow for a balance of direction. Sometimes the therapist leads. Sometimes we follow the child’s lead. An integrative model helps us make informed choices about when to do which. The “how” always comes from the theory—not just from what worked with the last client.

Case Conceptualization: It’s Ongoing

Your initial assessment is just the beginning. As therapy unfolds, you’re constantly reevaluating:

What’s working?
What patterns are emerging?
How does this line up with my chosen theoretical framework?
What’s my next move, and why?

If you start feeling lost, return to your theory. That’s your North Star.

Avoiding the “Perfect Activity” Trap

When we start focusing too much on finding the perfect intervention, we lose sight of the therapeutic relationship, the model, and the stage of healing. It becomes about doing something that “works” right now, rather than being with the client and understanding what’s happening in the deeper layers of their healing process.

The result? Exhaustion. Frustration. Doubt. And eventually, burnout.

Final Thoughts (and an Invitation)

The beauty of an integrative approach is in the flexibility it offers when it’s grounded in theory. You’re not boxed into one method—you’re tailoring therapy to your client’s needs. But that flexibility must be anchored. Otherwise, it’s just chaos disguised as creativity.

And if you’re thinking, “I’d love more support with this,” I’ve got something for you.

💡 Join Me for a Training:

Healing Trauma Through Play Therapy: A Neuroscience and Attachment Approach
🗓️ May 17th | Attend in-person or virtually
🌐 Register at RHPlayTherapyTraining.com

We’ll explore how to conceptualize trauma through neuroscience and attachment theory, identify what’s happening in the playroom, and walk through a clear stage-by-stage model for integrative play therapy. You’ll leave with strategies, inspiration, and a deeper understanding of how to do this work without feeling lost.

As a bonus, you’ll also get 2 free months in my new membership group: Play Therapy Elevation Circle, where you’ll get community support, consultation, and extra resources.

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