What is play therapy, and how is it different from just playing?

Play therapy is a form of psychological therapy for children, usually between about 3 and 11, in which a trained clinician uses play to help a child understand and work through feelings and experiences they can't yet put into words. It looks like play because it is. What makes it therapy is what the clinician is doing.

Is play therapy just playing?

To a child, yes, and that's why it works. Ask a six-year-old to explain why they've been hitting their brother since the baby arrived and you'll get a shrug. Give the same child a dolls' house, a family of small figures and an adult who is paying close attention, and the story tends to come out on its own.

During that hour, we choose what's in the room and why. We track what a child returns to, what they avoid, and what changes from week to week. We reflect back what we notice in language the child can hear ("that baby keeps getting buried in the sand"), without steering them towards an answer. And we're working towards goals agreed with you at the start, and checking progress against them.

What play therapy can help with

The children who do best in play therapy are the ones whose difficulty is a feeling or an experience, rather than a skill that needs teaching. In practice that covers a lot:

• Anxiety and worry, including separation anxiety and school refusal.
• Big feelings that come out as meltdowns, aggression or shutting down.
• Adjusting to change: a new sibling, a move, a new school, parents separating.
• Grief, after a death in the family or the loss of a pet.
• Low confidence and a child who's decided they're "the naughty one".
• Frightening experiences, including medical procedures, accidents and bullying.
• Behaviour that's landed a child in trouble at school and nobody can work out why.

A meta-analysis of 93 outcome studies (Bratton, Ray, Rhine and Jones, 2005) found that the average child who had play therapy was functioning about 0.8 standard deviations better than children who hadn't, which is a large effect for a psychological treatment. The Association for Play Therapy's evidence summary lists randomised trials showing gains in disruptive behaviour, anxiety, self-concept and recovery from trauma.

Two findings from that research shape how we work. Children whose parents were involved in the therapy improved the most. And child-led approaches, where the clinician follows rather than directs, produced larger effects than approaches where the adult sets the agenda.

What it's not the right tool for

Speech and language delay, learning difficulties, and attention and hyperactivity as the main concern all need something else first: speech therapy, a learning assessment, an ADHD assessment. Play therapy can sit alongside those, and often helps with the frustration and low confidence that come with them, but it won't fix the underlying skill. If you come to us with one of these, we'll say so rather than take the booking. Our article on what happens in an assessment explains that route.

What a play therapy session at 2Bloom looks like

It starts with you. Before your child comes in, we meet you to hear the story and agree what we're working on. The goals are yours: "fewer mornings that end in tears", "sleeping in his own bed again", "she's stopped saying she's stupid".

The room. A warm, uncluttered space with a sand tray, a dolls' house, small figures and animals, puppets, art materials, dress-up and a few things to knock down. There is no screen and nothing that needs batteries.

The sessions. Weekly, 45 to 50 minutes, same day, same time, same room. Children settle faster when they know what's coming. Your child chooses what to do. We start with a block of eight to twelve sessions and review with you halfway.

What we tell your child. In their own words, at the first session: this is a room where they can play however they like, we won't tell anyone the details of what they play, and if we're ever worried about their safety we'll talk to their parents. Children handle this better than adults expect.

What we tell you. A parent meeting every four to six sessions, where we describe what we're seeing, what's shifting and what might help at home. You won't get a blow-by-blow of each session, because the room has to stay your child's, but you will never be in the dark.

How it ends. Gradually, with your child told in advance, and with a written summary of what changed and what to watch for.

Play therapy in Malaysia

Play therapy is a recognised profession here. Play Therapy Malaysia is the national association, and a master's in practice-based play therapy is taught in Kuala Lumpur. At 2Bloom, play therapy is delivered by our clinical psychologists and counsellor, in dedicated play therapy rooms at our centre in Solaris Mont Kiara. If you're wondering whether it's the right starting point for your child, a short conversation with us will usually settle it.