How Theraplay® Differs from Non-Directive,
or Child-Centered, Play Therapy

Theraplay is a dyadic psychotherapy for two individuals: the child and her caregiver. The main focus of the therapy is to improve the relationship between adult and child through direct interactions between the two individuals.

In Theraplay there are no materials that mediate the development of feelings. It is the therapist and parent who are the “play objects”, the most enticing things in the room. In Theraplay the parent, with guidance from the therapist, plays engaging, exciting, attuned and nurturing activities that use the parents’ facial expression, voice, rhythm, touch and physical presence as the modalities by which to elicit feelings from the child. Theraplay, gets right to the heart of the child’s issues vis-à-vis himself, his caregiver, and the world. The child’s feelings are then attuned to by the parent so that the parent can provide the most appropriate response--one that responds to the underlying need that is motivating the child’s behavior. Theraplay, then, is an intervention which has an immediate impact on the parent-child dyad, and progress can be made quickly.

Another aspect of Theraplay that sets it apart from non-directive play therapy is that the therapist explicitly guides the parent in the activities: to notice the child’s expressions; to go slower or faster in a game to match the child’s need; to touch the child in a way that’s nurturing but not overstimulating. In other words, Theraplay therapists act as in-vivo coaches for parents to point out ways to improve interaction patterns. Not only is this done in the therapeutic moment, but also, each session is taped so that the therapist can go over the session with the parent at a later date and point out an interaction sequence from which the parent can learn new behaviors.

An additional unique feature of Theraplay is its focus on non-verbal communication. The use of voice, facial expressions, gestures, posture, eye contact, and rhythm communicates directly with a child’s right brain, that part of the brain which processes relational information, but which is non-verbal. It is accurate to say that Theraplay works on a “gut” level, imbuing safety and meaning into relationships through non-verbal communication sequences.

Because Theraplay works in the “here and now” at the pre-verbal, pre-symbolic level, it benefits children who are not developmentally or emotionally prepared for non-directive play therapy. For example, Theraplay can help children with Autistic Spectrum Disorders because the child is not expected to be able to comprehend the therapist’s comments and interpretations. Rather, the Theraplay activities help the child with autism to engage more actively with the world around him or respond more appropriately to structured situations.

For children who have undergone severe relational trauma, Theraplay can have more impact than non-directive play therapy. This is because some traumatized children perseverate on the traumatic acts in non-directive play therapy and are severely resistant to accepting new and healthier resolutions to their play scenarios. Because the Theraplay therapist directly provides intensive, personal interactions during the session, traumatized children can often integrate new, more positive experiences of themselves more readily than in non-directive therapy.

Theraplay helps children with oppositional behavior or very strong repressed anger as well. In Theraplay the adult is in charge--structuring the treatment, attuning and adjusting to the needs of the child, providing nurture and challenge. In this way, the child who is accustomed to being bossy and controlling has her familiar defense mechanisms challenged. An oppositional child usually believes that the world is an unsafe place, and he cannot count on anyone to take care of him. Theraplay’s directive model challenges these assumptions. The therapist maintains control, gently but assertively using Theraplay activities to change the child’s view of himself and the world. In non-directive play therapy, the therapist would not usually make as direct of a challenge to the child’s defense mechanisms.