Play is an integral part of development for children and can help them develop valuable life skills, including problem-solving, emotion regulation, communication, and establishing boundaries. Children who have experienced adverse childhood experiences and psychological distress may not have the skills needed to engage in traditional therapy and counseling services. Keep reading to learn 10 Play Therapy activities and exercises you can do with your clients in sessions.
Play therapy is an age-appropriate treatment method commonly used with children and adolescents who are experiencing a range of mental health concerns. Therapists can use play therapy to help clients prevent or resolve current mental health concerns that are hurting their development or overall emotional well-being.
With play therapy, mental health professionals can tailor their use of language and body language in a way that is meaningful to their clients. You may find yourself encouraging your client to explore, understand, and accept their emotions through the act of play and the use of various toys.
Several professionals had an integral role in the development of play therapy. This includes Jean Piaget, Anna Freud, Melanie Klein, and more. Jean Piaget classified play into three types: practice, symbolic, and social play. Practice play begins in the first few months of life, while symbolic play generally begins around age two. Social play takes place between the ages of seven and eleven. His research found that children under the age of ten often did not have the mental capacity to understand complex issues, motivations, and feelings because this part of their development had not taken place. Play therapy is a way to provide children with the support they need for their mental health concerns, while meeting them where they are developmentally.
While there are many variations of how play therapy can be incorporated into your work, the main categories of play therapy include construction toys, toys that promote hand coordination, mimetic play, and play of pretense. Energetic play can include exploration play and physical activities that have rules, such as sports.
For more valuable resources, view our Play Therapy Tools and Resources hub
Mental Health Concerns That Can Benefit From Play Therapy Activities
Play therapy can be an effective treatment option for children who are experiencing a range of mental health concerns and conditions. This can include difficulties with life transitions such as a divorce, loss, arrival of new family members, or a move of their home or school environment. Play therapy can also be helpful for children who have difficulties managing their emotions and those who experience behavioral concerns like aggression and frequent tantrums.
Play therapy is commonly used for children who have witnessed or experienced trauma. This can include domestic violence, sexual abuse, emotional abuse, physical abuse, and neglect. Children who have medical concerns or require medical procedures may benefit from play therapy to address the fear and anxiety that they’re experiencing. Lastly, play therapy can be used with children who are living with developmental disorders like autism spectrum disorder and Attention Deficit/Hyperactivity Disorder (ADHD).
Research has supported the use of play therapy in many of these cases. As an example, a study assessing the effectiveness of play therapy with preschool children found that participants had a noticeable improvement in their communication and problem-solving skills. Another study evaluating the use of play therapy with children who have Type 1 diabetes showed that participants experienced a decrease in anxiety surrounding their physical health symptoms.
Play Therapy Activities for Trauma
Child-Centered Play Therapy (CCPT) is commonly used with children who have experienced a trauma or have been diagnosed with a trauma-related condition like Post Traumatic Stress Disorder (PTSD). With CCPT, sessions take place in a playroom that has specific toys that are used to help children communicate their experiences and views. Examples of play therapy activities for trauma that could be used include:
1. Guided Imagery
Guided imagery is a therapeutic intervention that can be used to promote emotional expression among clients. The Play Therapy Guided Imagery Worksheet offered by TherapyByPro is tailored to the developmental stages of children by incorporating creative play and storytelling. Additionally, visualization can be used as a health coping mechanism for clients who find themselves experiencing psychological distress stemming from a traumatic event or memory.
What Is It: Guided imagery is a therapeutic intervention using creative storytelling and visualization to help children express emotions and process trauma.
How It Helps Clients: It encourages emotional expression in a safe, non-threatening way, allowing children to process distressing experiences indirectly.
How To Do It: Lead the child through a guided visualization using age-appropriate imagery. Use the TherapyByPro Guided Imagery Worksheet to incorporate symbols or storytelling elements, and discuss feelings that arise during or after the exercise.
2. Sand Tray Therapy
Sand tray therapy can be used with children experiencing intrusive memories, nightmares, hypervigilance, and more. This intervention can be used with children four and over. Sand tray therapy includes the use of objects and miniature figures to create scenes that reflect their thoughts, emotions, and experiences. This is a form of non-verbal expression that allows children to remain in control and use symbolic play to express themselves.
What Is It: Sand tray therapy allows children to use miniature figures and objects to create symbolic representations of thoughts, feelings, and experiences.
How It Helps Clients: It provides a non-verbal method for expressing trauma and intrusive experiences, giving children a sense of control and safety.
How To Do It: Invite the child to create a scene in the sand tray representing their experiences or emotions. Observe and reflect on the child’s choices, providing validation and facilitating discussion as appropriate.
3. Emotion/Thought Box
Children can work with their therapist to create a box that can hold the emotions and thoughts that cause distress. This play therapy activity is ideal for older children who can identify the thoughts and emotions that overwhelm them. You can encourage your client to use this box as a way to separate their struggles from themselves, promoting emotional boundaries and increasing their sense of self-control.
What Is It: A box is used as a symbolic container for overwhelming thoughts or emotions, externalizing internal experiences.
How It Helps Clients: Separating distressing emotions from themselves promotes self-regulation, emotional boundaries, and a sense of self-control.
How To Do It: Work with the child to decorate a box and instruct them to place upsetting thoughts or feelings inside. Encourage the child to revisit and explore the contents with therapist guidance.
Play Therapy Activities for Depression
Child-centered play therapy has also been found to show statistically significant improvement for children who are living with depressive symptoms. One study found that improvements were noticeable to parents as well as blind observers. Examples of play therapy activities for depression include:
4. Worry Jar
TherapyByPro has a Play Therapy Worry Jar Worksheet that can be used to help your clients externalize their persistent fear, anxiety, or worry. This worksheet can help children visualize their difficulties outside themselves, which can help reduce the emotional charge that your client is experiencing. Depending on your client’s needs, you may use this worksheet as a bridge to a conversation focusing on effective coping skills for their psychological concerns.
What Is It: The worry jar is an externalization tool that allows children to “deposit” anxious or depressive thoughts visually.
How It Helps Clients: It reduces the intensity of persistent worry or anxiety by creating psychological distance from distressing thoughts.
How To Do It: Have the child write or draw worries on slips of paper and place them in the jar. Review and discuss the worries with the child, linking to coping strategies and emotion regulation.
5. Clay Sculpting
Play therapy can include a range of creative arts interventions, including clay sculpting. You can encourage your client to use clay to create objects or shapes that represent their feelings and experiences. This approach is ideal for clients who have some insight into their emotional experiences. You may use this with children who are struggling with fatigue, loss of interest, and hopelessness. Clay can be an engaging activity that provides children with a non-verbal way to express and release their emotions.
What Is It: Clay sculpting allows children to express emotions and experiences through tactile, creative play.
How It Helps Clients: Non-verbal expression of feelings can reduce internalized distress, enhance emotional awareness, and promote self-expression.
How To Do It: Invite the child to model objects, shapes, or scenes representing their current feelings. Reflect on the creation with open-ended questions to explore emotional meaning.
6. Emotional Thermometer
Creating an emotional thermometer is a creative activity that can help children express their emotional experiences. This includes identifying how they go from “cold” to “hot”. This activity can help children who are struggling with emotional numbness and those who struggle to recognize their emotional experiences, often connected to depression and depressive symptoms. Children may find that they’re better able to identify and communicate their emotional experiences, which can improve self-awareness.
What Is It: An emotional thermometer is a visual tool for children to track and identify the intensity of their emotions.
How It Helps Clients: Helps children recognize and communicate emotional experiences, improving self-awareness and emotion regulation.
How To Do It: Have the child label a thermometer from “cold” to “hot” with their feelings. Ask them to indicate where they feel their current emotions, and discuss patterns or triggers.
Play Therapy Activities For Attention Deficit/Hyperactivity Disorder (ADHD
ADHD is a behavioral health condition that can create educational and social challenges for children. While medications can be used to improve a child’s functioning, play therapy and storytelling can be used to address developmental needs like socialization. Studies have indicated that the use of play therapy and storytelling in a clinical setting can lead to improvements in self-expression, impulse control, responsibility, and cooperation among school-aged children. Continue reading for examples of play therapy activities that can be used with clients living with ADHD.
7. Impulse Control Games
Impulse control games, like “Red light, green light,” are an example of energetic play that can be incorporated into sessions with clients struggling with impulse control and hyperactivity. This game can be used with children ranging from four years old and older. These games can help children strengthen their self-regulation, improve focus, and provide a fun outlet to practice following directions.
What Is It: Energetic games like “Red Light, Green Light” encourage children to practice controlling impulses while engaging in movement-based play.
How It Helps Clients: Strengthens self-regulation, attention, and behavioral inhibition in a structured, enjoyable context.
How To Do It: Play the game in session, establishing clear rules and consequences. Encourage practice of stopping and starting on cue, gradually increasing challenge.
8. Emotion Matching Games
To help improve socialization skills, you may find it helpful to use a matching card game for emotions. These games allow children to practice matching facial expressions and body language to specific feelings and situations. This can be impactful for children who experience social difficulties regarding picking up on others’ emotions, as well as recognizing their own emotional experiences. This can lead to improved emotion recognition, empathy, and social interactions with others.
What Is It: Matching facial expressions or body language to emotions through games improves recognition and understanding of emotional cues.
How It Helps Clients: Enhances empathy, social awareness, and the ability to interpret others’ emotions, supporting social skills development.
How To Do It: Provide cards or images of different emotions. Have the child match expressions to emotions or scenarios, discussing each choice and reinforcing understanding.
9. Role-Playing Daily Routines
Role playing is another intervention that can be helpful for children living with ADHD who struggle with transitions and organization. You can use role-playing to act out daily routines that children struggle with, using dolls or figurines. This can help them learn and practice problem-solving skills. Additionally, this can reinforce structure and help your client recognize patterns within the routine. Many find that this helps them in real-life situations that their symptoms make challenging.
What Is It: Role-playing uses dolls or figurines to simulate daily routines and problem-solving scenarios.
How It Helps Clients: Helps children with ADHD practice organizational skills, transitions, and adaptive problem-solving in a controlled, playful environment.
How To Do It: Identify a challenging routine (e.g., morning preparation). Use figurines to act out the steps, discuss solutions, and rehearse alternative strategies.
Bonus Play Therapy Activity
This bonus activity gives children a safe and creative way to express their feelings, explore personal experiences, and practice problem-solving through imagination.
10. Storytelling/Creative Play
This activity allows children to explore their thoughts, feelings, and experiences in a safe and imaginative way. Through storytelling or creating scenes with toys, props, or art materials, children can express emotions and experiences they may not have the words to describe. This approach encourages them to externalize their inner world, make sense of complex situations, and practice problem-solving. By observing and guiding their narratives, clinicians can gain insight into the child’s perspective while helping them build coping skills and emotional awareness.
What Is It: Storytelling and creative play allow children to create narratives that represent personal experiences, thoughts, and feelings.
How It Helps Clients: Encourages self-expression, meaning-making, and processing of emotional or traumatic experiences. Improves narrative skills and emotional literacy.
How To Do It: Invite the child to tell a story or create a scene with toys, art, or props. Guide reflection by asking how the characters feel, what challenges they face, and how the child relates to the story.
Frequently Asked Clinical Questions
Below are FAQs clinicians are asking:
How does a clinician differentiate between standard symbolic play and a child’s externalization of trauma in play therapy sessions?
Evaluate the affective intensity, repetitive loops, and behavioral rigidity shown across multiple clinical encounters rather than reviewing single isolated scenes. Standard symbolic play allows for creative flexibility and smooth transitions between roles or themes, whereas trauma externalization involves highly disorganized, distressing re-enactments of threat, physical abuse, or neglect where the child appears somatically dysregulated and unable to reach a safe, adaptive narrative resolution.
What is the recommended clinical protocol if an expressive arts intervention like clay sculpting triggers acute emotional flooding?
Cease the tactile creative task immediately, remove the modeling materials from their direct line of sight, and transition the child into structured co-regulation. Avoid asking the child to analyze or verbalize the meaning behind their clay object or scene while their autonomic nervous system is operating outside its window of tolerance; instead, utilize a sensory grounding tool like a glitter jar, bubble breathing, or freeze dance to safely anchor them back to present-moment safeness.
How should a Child-Centered Play Therapy (CCPT) practitioner address parents who demand clear verbal progress reports and show skepticism toward non-directive play?
Provide intentional, attachment-focused parent training to explain the developmental neuroscience of symbolic play and the limits of pediatric cognitive capacity. Demystify the clinical framework by explaining that children under the age of ten lack the mental development to verbalize complex motivations or feelings, and show them how construction toys and mimetic play serve as the child’s natural language for communicating underlying psychological stressors.
When is it clinically appropriate to transition a depressed child from solitary worry jar externalization to interactive group therapy settings?
Introduce structured group play and interactive emotion matching games once the child demonstrates stable baseline emotion regulation and can reliably identify their internal states using an emotional thermometer. Attempting to place a child who suffers from severe lethargy, social isolation, or hopelessness into active peer group environments too early can overwhelm their tracking skills, backfire into behavioral tantrums, and worsen peer isolation.
Can an independent outpatient therapist safely manage an adolescent presenting with severe, acute PTSD symptoms through standalone creative play activities?
No, an independent outpatient counseling frame must be paired with comprehensive care coordination and potentially higher crisis containment services. While mild situational stress from life transitions like moving can be managed in standard weekly sessions, treating advanced trauma, nightmares, or hypervigilance requires an integrated treatment plan with medical providers, school psychologists, and regular behavioral classroom interventions to maintain absolute physical safety.
Final Thoughts On Choosing Play Therapy Activities For Your Clients
Play therapy activities can be a powerful tool for clinicians working with children. It can be hard for children to engage in traditional treatment activities for several reasons. Play therapy can help clients express themselves when they struggle to find the words to match their thoughts, emotions, or experiences. Expressing these things is a learned skill that children may not have mastered when you begin working with them.
Play therapy can be used with clients experiencing a range of mental health concerns and helps them develop needed coping skills and insights to improve their quality of life and overall mental wellness. Clinicians and other mental health professionals who are interested in learning more about how play therapy can enhance their sessions are encouraged to explore continuing education and other training opportunities within their niche.
TherapyByPro is a trusted resource for mental health professionals worldwide. Our therapy tools are designed with one mission in mind: to save you time and help you focus on what truly matters-your clients. Every worksheet, counseling script, and therapy poster in our shop is professionally crafted to simplify your workflow, enhance your sessions, reduce stress, and most of all, help your clients.
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View all of our Play Therapy Worksheets
Resources:
- Burgin, E.E., Ray, D.C. Child-Centered Play Therapy and Childhood Depression: An Effectiveness Study in Schools. J Child Fam Stud 31, 293–307 (2022). https://doi.org/10.1007/s10826-021-02198-6
- Humble JJ, Summers NL, Villarreal V, Styck KM, Sullivan JR, Hechler JM, Warren BS. Child-Centered Play Therapy for Youths Who Have Experienced Trauma: a Systematic Literature Review. J Child Adolesc Trauma. 2018 Nov 9;12(3):365-375. doi: 10.1007/s40653-018-0235-7. PMID: 32318206; PMCID: PMC7163898.
- Koukourikos K, Tsaloglidou A, Tzeha L, Iliadis C, Frantzana A, Katsimbeli A, Kourkouta L. An Overview of Play Therapy. Mater Sociomed. 2021 Dec;33(4):293-297. doi: 10.5455/msm.2021.33.293-297. PMID: 35210953; PMCID: PMC8812369.