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What is 'Play Therapy', and could it be integrated into preschools?

What is ‘Play Therapy’, and could it be integrated into preschools?

My name is Riddhi, and I am currently doing the MSc in Developmental Psychology and Psychopathology at King’s College London. My interests surround aspects of child development and child psychology, involving the emergence of attachment, and psychological therapies in children and adolescents. I am particularly interested in learning about the first 1001 days of life, and understanding how aspects of the perinatal environment impact dimensions of child development. I find the concept of play therapy intriguing and hope to understand its role within a preschool curriculum.


Every day, emerging statistics portray the increasing number of young children experiencing mental health problems, and these numbers are likely to rise in the context of COVID-19. For example, 1 out of every 6 children in the age range of 2-8 years has a developmental, behavioural, or mental disorder. Mental health problems in early childhood impact a number of areas, and a lack of timely intervention is known to affect a child’s productivity in school. That’s why, from a mental health perspective, it’s important to consider integrating developmentally appropriate and inclusive therapeutic interventions into preschool as a part of the educational curriculum. And one of these therapeutic interventions is ‘Play Therapy’.

The concept of play as part of an educational curriculum has been seen before, through methods such as Montessori, which has been an important aspect of kindergarten for a few decades. However, play therapy, though sounds synonymous, is a distinct concept that has recently sparked my interest for a number of reasons. The idea that therapeutic help can be provided through something as simple as play intrigued me, and I sought to understand more about it.

Source: Egger & Angold (2006). Credit: Center on the Developing Child

I’ve grown up hearing about the concept of Montessori teaching and always assumed that it was simply teaching through play. As I grew older and realised that I want to someday be a Child Psychologist, I attempted to better understand the difference between Montessori and Play Therapy.

Maria Montessori, the founder of the Montessori method described play as the “work of the child”. Montessori is essentially an educational aspect, in comparison to Play Therapy which has a mental health and psychological perspective. Montessori teaching takes place in a classroom with multiple children, whereas a playroom for play therapy would often have just one child, or a few children if it was being conducted for a group. Play therapy is often used as an intervention for children who have been exposed to neglect, abuse, or have emotional, social, or behavioural difficulties.

The current definition of Play Therapy as defined by the British Association of Play Therapists is “… the dynamic process between child and Play Therapist in which the child explores at his or her own pace and with his or her own agenda those issues … that are affecting the child’s life in the present. … Play therapy is child-centred, in which play is the primary medium and speech is the secondary medium.”

As I sat at my desk, highlighters and post-its ready for a relaxing evening of reading, I learned that there are several forms of play therapy, but Child-Centred Play Therapy (CCPT) is among the oldest and most well-known, dating back to the 1940s. CCPT is conducted in a playroom consisting of categories of toys including real-life toys, acting out toys, and toys for creative expression, each of which can be used by the child to express their emotions and experiences.

I thought about applications of CCPT as a part of a preschool day and how it could be integrated into the daily schedule for children who require it, by setting up a playroom with specially selected toys and developing a timetable with the play therapist wherein the child can attend sessions a few days a week as a part of their school day. A playroom within a school setting provides a familiar and safe environment for the child and is accessible to all children.

Photo by Paige Cody on Unsplash

Previous studies have found support for using CCPT for children referred due to disruptive behaviour in school settings. Researchers from America conducted a study among 54 low-income preschool children who presented clinically significant disruptive behaviours and were assigned to a CCPT or an active control group. Results of this study portrayed that CCPT was an effective early intervention to reduce disruptive behaviours in the classroom, and the researchers concluded that CCPT is an intervention that can be used by mental health professionals in preschools, where children can easily access it.

Play therapy within kindergarten settings can also be an intervention for children with autism. Conducting the session in an environment in which the child is familiar, with a school-based therapist they know can provide a safe environment where the child will feel comfortable.

I recently came across a concept known as LEGO®-Based Therapy (LBT), an intervention developed for children on the autism spectrum. While the intervention has been seen in primary and secondary schools, there is limited research on its application in preschool.

A primary school in East Sussex conducted a group based pilot project for children with autism and found that among the positive outcomes observed, listening skills and problem-solving had significant developments, length of spoken sentences improved, and children had a greater awareness of social expectations. The intervention consisted of a team of three students, wherein each child assumed a different role, as a “Supplier”, a “Builder, and an “Engineer”. LBT can be adapted for preschool-aged children on the autism spectrum with the use of LEGO DUPLO®, a form of the toy designed for younger children, and can be integrated as a group play activity within a designated time in their school day.

Photo by cottonbro from Pexels

One of the assumptions I always held about play therapy was that a typical session would use typical toys such as blocks, or puzzles. With further reading, I’ve come to understand that play therapy is not restricted to the mainstream definition of toys, but also includes sand and water-based play, art-based play, as well as roleplay and stories. While electronic games have started being included in play therapy, these wouldn’t be appropriate for preschool-aged children. In a school setting, a playroom designated for play therapy can consist of a wide range of play therapy tools not restricted to just toys. Having materials such as sand, and clay can be beneficial to work on different aspects of a child’s mental health, be it emotional regulation or helping deal with trauma or anxiety.

All my reading on play therapy has led me to understand that most school-based play therapy interventions exist in primary and secondary schools, but there are a limited number of play therapy interventions in preschools. Given that the preschool age is one that often underpins mental wellbeing in later childhood, play therapeutic approaches have a wide scope for young children who have been exposed to trauma, neglect or are portraying neurodevelopmental disorder symptomology. It’s time to understand more about the topic and conduct future research in this field.


Header image by Xavi Cabrera on Unsplash


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