I. Definition: A form of action therapy that uses sand play, fairy tales, art, and puppetry to encourage communication in children who have inadequate or immature verbalization skills or who verbalize excessively due to defensiveness1 .
 

 II. Purpose:

  a. to enable children to indirectly express inner thoughts, fears, anxieties, and feelings of rage and guilt

  b. to help children accomplish developmental tasks through a protected modality in which they can learn to deal with difficulties in the here and now (playroom as sanctuary)

  c. to help children reduce anxiety and resolve conflict
 

 III. The Process:  Metaphorical expression of distressing events allows children to externalize and fantasize their pain so that they can more effectively control it and learn adaptive ways to cope with it.

 IV. The Role of Play: Play is the currency of children. Play

 is  pleasurable
 is spontaneous
 is voluntary
 is noninstrumental
 has no goal, purpose, or task orientation
 is a natural way for children to communicate, act out sensitive material, gain security (imaginary friend), and develop self-confidence    (mastery)
 allows children to experiment with new ways of thinking and behaving

 V. Criteria for Play:

  a. Nonliterality
  b. Pleasure
  c. Intrinsic Motivation
  d. Flexibility

 VI. Stages of Play:

  1. Functional (Sensorimotor): Repetition and exploration [0 - 2].

  2. Constructive/Productive (Creative) [2-4]

  3. Dramatic/Reproductive (Realistic) [4-7]

  4. Games with Rules [7-12]
 

 VII. Types of Materials:

  a. Real-life toys: doll house, telephone, etc.
 
  b. Acting Out/Aggressive Release Toys: handcuffs, toy guns and knives, drums, etc.

  c. Creative Expression/Emotional Release Toys: chalk, magic markers, scissors, paper, blocks, hand puppets, Play-Doh, etc.
 
 
 VIII. Stages of the Therapeutic Process:

  1. Open and permissive atmosphere for relationship building, focusing on the feelings that play behavior evokes, open-ended questions, developing hypotheses

  2. More directive play, testing hypotheses, exploration of feelings and behavior - active probing

  3. Engagement of the child in more systematically structured play sequences related to the conflict; use of systematic desensitization
 

 IX. Techniques:

 Art Therapy
 Bibliotherapy
 Dance and Movement Therapy
 Fantasy and Guided Imagery
 Games
 Magic
 Music
 Nondirective
 Puppets
 Role Playing/Drama Therapy
 Theater of the Oppressed
 Sand Play
 Self-Esteem Activities
 Storytelling
 Writing