What Is Play Therapy? A Plano Parent's Guide

What is play therapy?

Play therapy is a form of counseling where children work through their feelings by playing, alongside a trained therapist who understands what that play is saying. Play is how kids communicate what they do not yet have the words for.

Garry Landreth, one of the founders of child-centered play therapy, describes it as a relationship. A trained therapist provides carefully chosen play materials and builds a safe relationship, so a child can fully express and explore their feelings, thoughts, experiences, and behaviors through play, which he calls the child's "natural medium of communication" (Landreth, Play Therapy: The Art of the Relationship).

In my own words: play therapy is a place where kids get to play out their feelings with a professional who can interpret them. From there, I help children build self-esteem, tolerance for frustration and anger, and independence, among other things.

How does play therapy help a child?

Play therapy helps by giving children a safe way to process emotions they do not yet have the self-knowledge or vocabulary to talk about. So instead of talking it out, they play it out.

A child who is afraid of the doctor will often play doctor, because running the scenario gives them a sense of control and agency. A child struggling with anger outbursts may play more aggressively, throwing, kicking, or overpowering toys, because it lets them feel powerful.

The playroom is one of the only spaces, maybe the only one, where a child is not being told what to do or how to be. That freedom lets them play out their feelings safely, with an adult whose sole focus is them. Here is what that looks like in practice:

Self-esteem grows because their play is noticed and affirmed.

Confidence grows because they are encouraged to do things they would normally feel uncomfortable doing, like beating me at every card or board game.

Self-control grows because they learn to handle big feelings in productive ways, like hitting a bop bag or screaming into a pillow.

When does a child need play therapy?

Signs a child may benefit from play therapy include frequent anger outbursts, pulling away from friends, a negative trend in self-talk or self-esteem, recovering from abuse or neglect, and fear of or resistance to ordinary things like school or the doctor.

That said, I firmly believe play therapy can help a child even when it does not look like they "need" it. In a review of 42 studies, children who received play therapy scored on average 25 percentile points higher on outcome measures than children who did not (LeBlanc & Ritchie, 2001).

If you are trying to tell a phase from a pattern, signs your child needs play therapy (and signs they don't) goes deeper.

What age is best for play therapy?

There is no single best age, but play therapy is generally most helpful for children between 3 and 11. A good rule of thumb: once your child can play imaginatively, play therapy can be a great resource for your family.

For older kids who have outgrown the playroom, teen therapy is usually a better fit.

Does play therapy work for anxiety?

Yes, play therapy works well for kids with anxiety. When a child plays out their fears with an adult who acknowledges those fears through the play, the child feels safe and secure, and the anxiety often eases significantly.

If worry is at the root of what you are seeing at home, learn more about therapy for childhood anxiety.

What happens in a play therapy session?

What happens depends on the child. Some kids want to play with dolls, some want to battle with figurines, and some head straight for the sand.

But nothing in the playroom is there by accident. Landreth teaches that toys should be chosen to serve six purposes: helping children express a wide range of feelings, explore real-life experiences, test limits, build a positive self-image, understand themselves, and practice self-control. The toys give kids expressive outlets that match what they feel, so they can process those emotions and grow as little human beings.

Many of the boys I work with gravitate toward more aggressive play. I love doing tea parties with my female clients. But for a lot of boys, it is really healthy to have a male adult who can play with them in a way that leaves them feeling seen, valued, and encouraged. That is a big part of why I focus on offering play therapy for boys.

What are the stages of play therapy?

I break play therapy into three stages: relationship building, the working phase, and maintenance. Relationship building usually takes 4 to 5 sessions. Maintenance varies the most, anywhere from 5 to 10 sessions. It really depends on the kid.

Stage 1: Relationship building

It generally takes 4 to 5 sessions before a child feels comfortable in a room with a new person. I often see small changes within 2 to 3 sessions, but the relationship takes a little longer to form. For many parents, this is the hardest phase, because it can look like nothing is changing. But I believe it is the most important phase, because it is the relationship that causes change in people, not the techniques.

Stage 2: The working phase

This is where patterns start to emerge. I work with parents on what they are seeing at home and we refine the goals for therapy, often building self-esteem, frustration tolerance, and desired independence. Then I work with your child on those areas directly in the room.

Stage 3: Maintenance

Maintenance begins once your child has made enough progress to start spacing out visits, from once a week to every other week or once a month. This phase can last anywhere from 5 to 10 sessions, depending on the child. Your child keeps a safe outlet where they can go and be vulnerable.

For a closer look at timelines, read how long play therapy takes before you see changes.

Do parents sit in on play therapy?

No, parents typically do not sit in on play therapy sessions. If a child feels afraid or unable to separate during the first session, I will invite the parent to sit with us until the child feels comfortable being alone with me.

After that, parents stay outside. The playroom has to be a safe place for the child, where they feel free to act and play without worrying about a parent stepping in. You are still very much part of the work, though. We meet regularly to talk about what you are seeing at home and how to support your child's progress.

How to explain play therapy to your child

Keep it simple and positive. Here is what I suggest parents say:

"Mom and Dad want you to have a place where you can play and have fun for a whole hour, just for you. You'll get to play with Mr. Aaron, and you can paint, draw, and battle. I'll be right outside the whole time, so if you need me, I'll be right there."

When I bring a child into the playroom for the first time, I tell them: "This is our playroom. In here, you can play with all of these toys in lots of different ways that you like." Most kids light up, because there is so much to do.

Does play therapy really work?

Yes, play therapy really works. In my own practice, I generally start to see growth within 2 to 3 sessions. Kids get louder, freer, and more able to express themselves, which is a great sign they feel comfortable being their authentic selves.

Play therapy is also one of the most researched approaches in child counseling:

A review of 42 studies found that children in play therapy scored about 25 percentile points higher on outcome measures than children who did not receive it, and that parent involvement was linked to stronger results (LeBlanc & Ritchie, 2001).

A review of 93 studies found play therapy effective across a wide range of children, challenges, and situations (Bratton et al., 2005).

A review of 52 controlled studies of child-centered play therapy found moderate to strong improvement in problem behaviors and relationship stress (Lin & Bratton, 2015).

A 2020 study of second graders found that children who received play therapy made significant gains in reading, math, and language usage compared to peers (Perryman et al., 2020).

What are the downsides of play therapy?

The biggest downside is that play therapy is not quick. Many parents feel it is not moving fast enough, and that is very common and very understandable. Play therapy takes longer because it relies on the child growing at their own pace. In a culture that idolizes outcomes, it can be hard to feel like things are not progressing fast enough.

The second downside is that the work in the playroom has limited impact unless the family system changes too. I get roughly one hour a week with your child. Your child lives with you. If we are working on stress tolerance in the playroom but nothing changes in how the family operates at home, progress will be significantly slower than for a family willing to look at the system as a whole and put the therapist's insights into practice.

You are paying a play therapist for expert care and insight. Trust them.

How much does play therapy cost, and does insurance cover it?

Play therapy with me is $110 per 45-minute session. I do not accept insurance, though I can provide superbills, and HSA and FSA cards are accepted.

Here is why. Insurance reimbursement rates would require me to take on more clients to stay afloat, which would make my work less focused. I never want the quality of care I give your child to slip because I need to pay the bills.

There is another reason many parents appreciate. To bill insurance, I would have to give your child a diagnosis, and that diagnosis becomes part of their health record with that insurance company. Many parents would rather that not happen. You can find more details on my services and fees page.

How to choose a play therapist in Plano

Most parents arrive at this question after they have already decided play therapy makes sense. Here is what to look for before you book.

Training beyond the license. Every licensed counselor can call themselves a child therapist. A Registered Play Therapist (RPT) has completed specific graduate coursework in play therapy, supervised clinical hours in a playroom, and continuing education in the modality. The credential is not required to do good work with kids, but it is a signal that the therapist chose this specialty rather than fell into it. I am currently not an RPT but am pursuing this credential.

A playroom, not a couch. Ask where sessions happen. If the answer is a general office with a bin of toys in the corner, that tells you something. A dedicated playroom has a sand tray, expressive art materials, aggressive play materials like bop bags, and toys chosen on purpose. The room is part of the treatment.

Someone who will talk to you. A good play therapist meets with parents regularly, not just when something goes wrong. Ask how often you will get updates and what those conversations look like. If the answer is vague, keep looking.

A fit for your child specifically. Ask how the therapist handles a child who is anxious about separating, a child who shuts down, or a child who is aggressive in the playroom. The answers will tell you more about the therapist than any credential.

A clear answer on money. Ask about the fee, the cancellation policy, and whether they take insurance, before the first session. A therapist who is uncomfortable talking about cost will be uncomfortable talking about other hard things.

How it feels on the consultation call. You are not looking for chemistry with your child, because your child will not be on the call. You are looking for whether this person listens, whether they answer your questions directly, and whether they seem genuinely interested in your kid. Trust that.

If a therapist you contact is a poor fit or does not have openings, ask them for a referral. In Plano, most of us know each other and would rather point you toward the right person than have you give up on the search.

Play therapy in Plano

I love doing play therapy. It truly is a dream job, helping kids grow into their full potential. I also see how great the need is for play therapists in Plano. There are only a handful of male therapists doing play therapy in the area, and I am proud to be one of them. A lot of therapists do not want to work with kids, because it is hard and takes a lot of patience. I count it as a privilege.

As your friendly neighborhood therapist, I would love to work with your child in Plano and the surrounding area. Play therapy is in person only, at my office in Plano. If you are ready to take the next step, schedule a free 15-minute consultation.

About the author

Aaron Helm, LPC Associate, supervised by Katherine Dunham, MS, LPC-Supervisor, is a therapist at Connect to Thrive in Plano, TX. He works with kids, teens, adults, couples, and creatives. Aaron offers in-person sessions in Plano and online therapy anywhere in Texas. Play therapy is in person only.

References

Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, 36(4), 376–390.

Landreth, G. L. (2023). Play therapy: The art of the relationship (4th ed.). Routledge. (Original work published 1991)

LeBlanc, M., & Ritchie, M. (2001). A meta-analysis of play therapy outcomes. Counselling Psychology Quarterly, 14(2), 149–163.

Lin, Y.-W., & Bratton, S. C. (2015). A meta-analytic review of child-centered play therapy approaches. Journal of Counseling & Development, 93(1), 45–58.

Perryman, K. L., Moss, R., & Anderson, L. (2020). Play therapy and academic achievement in second-grade students. International Journal of Play Therapy, 29(2), 77–87.