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Kids experiencing emotional distress need professional help beyond their parents and teachers.

Black boy in profile

Childhood development experts agree that the time to seek out support and treatment for your child is when struggles are frequent, intense, and/or when they have a significant, detrimental impact on daily functioning. 

These struggles can be:

  • behavioral (hitting, crying, sudden withdrawal, or isolation); 
  • verbal (cursing or incessant complaints and whining); or 
  • functional (bedwetting, failure to make academic gains or grasp skills). 

Parents can also seek treatment and support for their kids because of situational circumstances. This can mean traumatic loss, drastic changes like death or divorce, or concerns that your child isn’t ready for a new life stage.

Having a hard time knowing where to start? These four commonly used therapy modalities help kids process their feelings. 

Play Therapy 

Play therapy encourages children to play out their fears, worries, and conflicts. It helps children develop self-confidence as well as social, relationship, and problem-solving skills. Kids can also learn how to express emotions and take responsibility for their behaviors. 

How Does Play Therapy Work?

Parents are actively involved in play therapy. Play therapists meet with parents first so they can understand their young client’s current challenges, as well as provide adults with a brief overview of what to expect along the journey. 

At my practice, I see children individually once a week for about 45 minutes. After every four to six sessions, I consult with parents to review goals, offer supportive strategies for home and school, and make any necessary recommendations. 

Children explore a playroom and engage with their therapist at their comfort level. Over each session, the therapist models self-regulation and uses encouraging and self-esteem-building language. 

For a child who can’t self-regulate and is having multiple tantrums at home, the therapist will name all the things the child can do successfully like building towers or remembering songs from the radio. This makes connections for the child that things like singing or using their creativity are ways to self-soothe when they’re feeling intense emotions. 

Yes, we are “playing,” but a play therapist is highly trained in responding to play and children’s behavior. The ultimate goal is improving function. Play therapists permit “bad” behavior as long as everyone can stay physically and emotionally safe. Over time, kids acquire new coping tools and rewire their previous patterns.

Who Is The Best Candidate For Play Therapy?

Play therapy is developmentally appropriate for children ages 3-12. Play is the language of children: The prefrontal cortex (our wise mind) isn’t fully online until the later adolescent years—and even then complete development doesn’t round out until age 25. Talk therapy for kids 13 and under can take quite a bit longer for parents to see positive results. 

Teenagers can benefit from play therapy, too. I have done play therapy successfully with minors as old as 17 and 18! They love being able to let down their guard and take a break from their “cool” image. Teens love to explore a sandbox, blow bubbles, or cry just like a little kid without being shamed or shut down.

How Do I Find A Play Therapist?

Pediatricians can usually recommend great, local therapists, as well as asking your school social workers and psychologists. Facebook groups can yield some great referrals as well.

If you’re looking for a play therapist for your teenager, ask them if they’d like to talk to someone other than you. Teenagers like to be included in decision making—it makes them feel empowered. Frame the appointment as a reverse interview; the teen can identify if the therapist is a good fit for them. 

You can find more information and therapist contact pages through Association for Play Therapy.

black girl

Theraplay

The relatively new field of neuroscience has unpacked that parent/caregiver attention and attachment are crucial to the well-being of a child. Theraplay® can help build (or rebuild) the attachment bonds that are necessary for healthy relationships, learning, and general well-being. It’s a form of child and family therapy focused on building and enhancing attachment, self-esteem, and trust.

How Does Theraplay Work?

Despite its name, Theraplay is NOT play therapy. Instead the therapist is teaching the parent / caregiver and child skills. There are toys to help the child engage, but they are secondary to what’s going on during the session.

In Theraplay, a child experiencing anxiety or distress at home or school has a session with their caregiver and the practitioner. The practitioner gives targeted feedback, which the parent then implements at home. Using those demonstrated skills will increase parent-child connection and reduce challenging behaviors.

Who Is The Best Candidate For Theraplay?

Theraplay can be a good option for foster or adoptive families who want professional help in building connection with their children as they transition into their home. 

It could also be a helpful modality for reuniting parents and children (e.g. Mom was deployed overseas for some time, or Dad was experiencing a deep clinical depression during a child’s first few years). 

How Do I Find A Theraplay Specialist?

Theraplay.org has a directory of Theraplay Certified Practitioners.

Photo credit: jim gade on Unsplash

Sand Tray/Play Therapy 

Although many therapists who work with children incorporate sandboxes for a sensory and playful experience, sand Tray/Play Therapy is a specialized practice.

Sand tray therapy is a very powerful tool that can be used in addition to talk therapy. (Bessel van der kolk, the leading trauma expert and author of The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, supports Sandplay as a treatment for healing.) 

Sand tray helps the left side of the brain—which is responsible for language—process emotions that are stuck in the right side of the brain. It creates a meditative state that allows clients to express those difficult experiences with or without words. 

How Does Sand Tray Therapy Work?

The client uses a tray and small figurines to create a scene. This helps their body and subconscious mind “show” the therapist what is happening in their internal world. 

Instead of “talking it out,” the client can take a step back, protect their vulnerable side, and still address what’s causing them pain. The therapist then uses specific prompts and lines of questions to elicit more information and move the client towards healing.

Who Is The Best Candidate for Sand Tray Therapy?

Sand tray therapy can be an excellent option for tweens (kids ages 11-13) who are a little too old or resistant to play. As mentioned above, talk therapy with this age will take a long time, but isn’t totally out of the question. A good therapist will blend modalities to support the client’s journey. 

How Do I Find a Sand Tray Therapist?

Many therapists who work with children have sandboxes or trays in their offices (I do!). But there is a specific certification and credentialing process to be called a sand tray/play therapist. 

If you are expressly looking for this, make sure to ask about the therapist’s training during your consultation. You’ll want to ask if the therapist will be interpreting or analyzing sand tray scenes and if this mode of engagement is successful with the issues you’d like to be addressed with your child in sessions. 

Tween Black boy wearing large noise-blocking headphones

Eye Movement Desensitization and Reprocessing (EMDR)

While EMDR can be used for smaller issues, it’s most notably used for traumatic events like accidents and abuse.

After a traumatic event, children can display a host of symptoms including panic, difficulty sleeping, and regression in developmental milestones. Implementing EMDR can help them recover from these setbacks.

“When yucky things happen, the brain has a hard time putting all the pieces together and as a result, things that people say or do—or things that kids see, hear, smell, or touch—can bring up the yucky memories, the mixed-up thoughts, feelings and body feelings connected to those yucky things,” writes Ana Gomez, a psychotherapist and expert in EMDR.

“EMDR helps the brain put all the pieces together so the yucky stuff can leave us and the good stuff or the things we learned from it can stay so we get stronger,” she continues. “Then, the brain can chew up and digest all the mixed-up feelings and thoughts as well as the yucky feelings we may have in the body.” 

How Does EMDR Work?

EMDR uses bilateral stimulation (either through sight, sound, or touch) to help clients heal from disturbing or traumatic life events. 

The therapist gives the client various prompts while also discussing the upsetting event and incorporating soothing cues for their nervous system.

This type of therapy fosters a deeper form of therapeutic healing. Clients using EMDR see a decrease in symptoms that is seven times faster than traditional talk therapy.

Who Is The Best Candidate For EMDR?

EMDR is helpful for kids who are experiencing emotional distress as a result of challenging life events. (Some examples: being bullied by peers, being in a near-death event, or having an ill parent.)

Since some children may have a hard time staying engaged for a full session of EMDR, it’s best for children 8 and up.

Some other limitations to be aware of are that symptoms may be increased for 24-48 hours after an EMDR session. In addition, this type of therapy would not be beneficial to a child whose symptoms are severe. 

How Do I Find An EDMR Therapist for Kids?

The credentialing body EMDRIA, has a Find a Therapist Directory to find EMDRIA members providing EMDR therapy in your area. The directory includes searches by location, name, and other criteria.

Black woman holding daughter in bed
Photo credit: Nneka Salmon for mater mea

Moving Forward With Getting Professional Help For Your Child

These four therapies are just a few geared toward children’s mental health. There are several treatment options out there for kids and families who are struggling, including art therapy, speech therapy, occupational therapy, and neurological testing. A professional can refer you to the right resource if they aren’t a match for you and your child’s needs. 

If you’re not sure where to begin, try thinking about the “end.” What would life look and feel like at the end of successful treatment? What is the goal you want to achieve? School support? Increased confidence? Less tantrums? These prompts will help you and your chosen professional make the best choices for your child and your family. 

Children benefit from having a place and space that’s just for them to talk, play, and share their feelings. As a school social worker, many children have told me that they like knowing there’s a place within the school building that there is no pressure to perform or “be” any specific way. They can show up fully as themselves and not be judged. 

And what a gift: to be honored and seen for who you are and who you’d like to become.

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Malia L. Segal is a licensed clinical social worker and registered play therapist based in New Jersey. Malia specializes in working with children ages 4-18.

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