Document Type : Review Article
Author
Department of General Psychology, Semnan Azad University, Semnan, Iran
Abstract
Objective: To provide a comprehensive, evidence-based review of the role, mechanisms, and efficacy of play therapy as an intervention for trauma in children aged 3-12 years. This review synthesizes contemporary research to inform clinical practice and future directions.
Methods: A narrative review methodology was employed. Literature searches were conducted across PubMed, PsycINFO, and Web of Science databases for the period 2000-2025, using keywords including "play therapy," "child trauma," "post-traumatic stress disorder," "PTSD," "expressive therapy," and "trauma-focused intervention." Included studies encompassed systematic reviews, meta-analyses, randomized controlled trials (RCTs), quasi-experimental designs, and seminal theoretical works. A total of 40 key references were selected based on relevance, methodological rigor, and impact.
Results: Play therapy demonstrates significant efficacy in reducing core trauma symptoms (PTSD, anxiety, depression) and improving behavioral regulation, social competence, and caregiver-child attachment. Neurobiological evidence suggests play therapy can contribute to the regulation of stress-response systems. Modalities such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) with play elements, Child-Centered Play Therapy (CCPT), and attachment-based Theraplay® show strong empirical support. Critical mechanisms of change include the establishment of safety, non-verbal processing, emotional/physiological regulation, and the restoration of a sense of mastery.
Conclusion: Play therapy is a developmentally sensitive, evidence-informed, and essential modality for treating childhood trauma. Its strength lies in leveraging children’s natural communicative language—play—to access and process experiences that evade verbal articulation. Integration into multi-tiered, trauma-informed systems of care is warranted. Future research should prioritize neurophysiological outcome measures, cultural adaptations, and long-term follow-up studies.
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