What is Bias in Play Therapy?


Bias is an inherent part of human nature, and as play therapists, we must actively recognize and address it in our clinical decision-making. Bias can subtly shape our perceptions, diagnoses, and treatment plans, often without us realizing it. In this blog post, we’ll explore the role of bias in play therapy, the different types of bias that can influence our work, and strategies for recognizing and reducing its impact to provide high-quality, ethical, and effective therapy.

The Role of Bias in Play Therapy

As mental health professionals, we are trained in self-reflection to identify transference and countertransference in our therapeutic relationships. However, bias—both conscious and unconscious—is often overlooked in play therapy discussions. Over the past 15 years of providing supervision, I’ve noticed that while case conceptualization and clinical decision-making are foundational to play therapy, we don’t always integrate discussions on bias into these areas.

Bias influences how we understand our clients, their presenting symptoms, and the interventions we choose. It can impact everything from our initial case conceptualization to our diagnostic formulation and treatment planning. If left unchecked, bias can lead to misdiagnosis, ineffective interventions, and an overall failure to meet our clients' unique needs.


What is Bias?

Bias refers to unconscious or conscious beliefs and ways of perceiving information that can undermine accuracy. These biases shape our views of ourselves, others, and relationships. In play therapy, bias can affect:

  • How we conceptualize a child’s presenting concerns
  • The diagnoses we consider (or fail to consider)
  • The interventions and play therapy models we apply
  • Our interactions with both children and their caregivers

By acknowledging our biases, we can prevent them from negatively influencing the therapeutic process.


Common Biases in Play Therapy

Research highlights several types of cognitive biases that can affect clinical work. Below are some of the most common ones found in play therapy:

1. Overconfidence Bias

Overconfidence bias occurs when a therapist assumes they know what’s happening with a client without thoroughly assessing all possible contributing factors. This often affects experienced play therapists who have encountered similar cases over the years.

For example, a therapist might quickly diagnose a child with ADHD based on hyperactive behavior without fully exploring other possibilities like trauma, anxiety, or sensory processing issues. While experience provides valuable clinical insight, it’s essential to stay open to alternative explanations and conduct comprehensive assessments.

2. Representativeness Heuristic

This bias occurs when therapists rely on past experiences with similar clients to make assumptions about a current case. While pattern recognition is useful, it can lead to errors in diagnosis and treatment planning.

For instance, if a therapist assumes a 22-year-old client with a flat affect must have major depressive disorder without assessing for bipolar disorder, they may overlook critical symptoms that would change the course of treatment.

In play therapy, we must ensure that we’re not prematurely labeling children based on prior cases but instead conducting thorough, individualized assessments.

3. Affect Bias

Affect bias happens when a therapist’s emotional response to a client or caregiver influences their clinical decisions. For example:

  • If a therapist finds a caregiver difficult or rigid, they may unconsciously avoid involving them in treatment—even if parent involvement is crucial for the child’s progress.
  • If a therapist personally relates to a child’s struggles, they may over-identify with them and lose objectivity.

Self-awareness is key to managing affect bias. Regular self-reflection and supervision help therapists remain objective and client-centered.

4. Anchoring Bias

Anchoring bias occurs when a therapist places too much weight on one specific characteristic of a client, leading to tunnel vision in case conceptualization.

For example, if a therapist labels a child as "oppositional," they may focus only on defiance and overlook other contributing factors like anxiety, sensory sensitivities, or communication difficulties. Similarly, if they assume a parent is "borderline," it may cloud their judgment about how to engage that parent in treatment.

A simple shift in language—from saying a child "refused" to saying they "declined"—can reduce anchoring bias and promote a more neutral, exploratory stance.


Why Bias Matters in Play Therapy

Bias has real consequences in play therapy, as it can:

✅ Negatively impact our clinical decision-making
✅ Lead to inaccurate diagnoses
✅ Affect the treatment approaches we choose
✅ Influence the way we interact with children and their families

Because bias is often unconscious, we must actively engage in self-reflection to ensure it doesn’t compromise the effectiveness of our therapy.


How to Address Bias in Play Therapy

1. Practice Radical Acceptance

We all have biases—this is part of being human. Instead of denying or feeling ashamed of them, we must accept that they exist and commit to exploring them non-judgmentally.

2. Engage in Self-Reflection

Regularly ask yourself:

  • What assumptions am I making about this client?
  • How might my personal beliefs, experiences, or emotions be influencing my clinical decisions?
  • Have I fully explored all possible explanations for this child’s behaviors?

Self-reflection helps bring unconscious biases into conscious awareness, allowing us to course-correct when needed.

3. Seek Supervision and Consultation

Supervision is invaluable for identifying blind spots. Engaging with peers and mentors allows for diverse perspectives, helping you catch biases that might otherwise go unnoticed.

4. Use Research to Challenge Assumptions

Stay updated with research and best practices. Recognizing that even psychological assessments can have inherent biases helps us critically evaluate the tools we use in our practice.

5. Embrace Lifelong Learning

Being a play therapist requires continuous learning. Bias awareness is not a one-time task but an ongoing process that evolves with experience and education.


Final Thoughts

Bias exists in all of us, and as play therapists, we have an ethical responsibility to recognize and minimize its influence on our work. By engaging in self-reflection, seeking supervision, and continuously challenging our assumptions, we can provide more accurate, effective, and compassionate care to the children and families we serve.

Interested in Expanding Your Play Therapy Skills?

If you want to deepen your play therapy knowledge, check out my Getting Grounded in Play Therapy Excellence course series. 

If you're looking for ongoing supervision, my Play Therapy Academy provides group consultation and case discussions to help you refine your skills. You can book a free 30-minute consultation call to see if it’s the right fit for you.

Let’s continue growing together and providing the best possible care for our young clients! 

Categories: : Case Conceptualization, Play Therapy, Podcast, Supervision, treatmet plan