Why Play Therapy Works

Now that you know the research has established that play therapy works, the next question is how it works. What is it about playing within a therapeutic context that provides such clear benefits to clients? First, to answer the questions of how and why play therapy works, Drewes and Schaefer (2016) listed 20 therapeutic powers of play. They wrote:

These play powers appear to constitute or augment the healing process, rather than simply serving as a medium for the application of other treatment modalities that just use play as an adjunct to the protocol. In other words, play powers are the actual change agents, not just an aid in moderating treatment.

(p. 38)

According to the authors, play accomplishes four important healing actions: facilitating communication, fostering emotional wellness, enhancing social relationships, and increasing personal strengths. This happens through at least 20 mechanisms described in the Handbook of Play Therapy (Drewes & Schaefer, 2016).

• • Play facilitates communication through self-expression, access to the unconscious, direct teaching, and indirect teaching.
• • Play fosters emotional wellness through catharsis, abreaction (repressed memories brought into the consciousness and released), positive emotions, counterconditioning of fears, stress inoculation, and stress management.
• • Play enhances social relationships through therapeutic relationship, attachment, sense of self and empathy.
• • Play increases personal strengths through creative problem solving, resiliency, moral development, accelerated psychological development, self-regulation, and self-esteem.

While these play powers are healing, they do not occur in a vacuum. They occur within the context of a therapeutic relationship between the client and the therapist. The play powers explain why play is therapeutic, but it does not explain why some therapists are more effective at facilitating positive outcomes. Therefore, the second factor in understanding why play therapy works is the relationship between the therapist and the client. This emotional bond is the core to lasting and productive change (Green et al., 2013). Those therapists who are most adept at creating psychologically safe places and conveying unconditional acceptance allow clients to explore and initiate deeper change. The quality of the relationship is more important to clients than interventions or techniques, and the client’s experience of feeling empathi- cally understood is considered the best predictor of a successful outcome (Mancillas, 2006).

The third consideration in understanding why play therapy works is the externalization of the issue, but within the perspective of the present time. When playing, the client is able to experience, as Etzi (2004) described, the paradox of the play being real and not real at the same time. This means that the client can “entertain a provisional reality with the optimal distance from reality constraints” (p. 243).

Clients can, in a sense, take out the issue or core need, look at it from a third person perspective, use the resources available to them in the present that may have been absent in the past, and test out what change might look like. The distance creates the safety to risk doing this. Etzi (2004) wrote: “Playful enactments of inner emotional conflicts in therapy allow oneself and the other to be acknowledged and accepted as separate and valuable persons in an experiential and immediate sense” (p. 247).

The answer, then, to how play therapy works is three-fold. It includes the inherent power in play, within the context of a safe therapeutic relationship, and from a perspective where the client is able to explore through a provisional reality. Creative Play Therapy also uses the powers of play, the safety of the therapeutic relationship, and the space to explore past, present and future realities with adolescents and adults.