Summer 2026 Issue

Play Therapy: A Child-Centered Approach
to Mental Health
By Elizabeth S. Goar
Social Work Today
Vol. 26 No. 3 P. 8

With origins tracing back to ancient cultures’ use of play, drama, and storytelling as emotional expression and healing practices, play therapy has evolved into a research-supported discipline used in schools, clinics, hospitals, and trauma treatment settings. It continues to evolve, incorporating digital tools, virtual environments, and integrative methods, while remaining grounded in the belief that play is a child’s natural language.

“When you’re looking for mental health therapy, you’re going to go to a psychotherapist, someone you can talk to, someone who’s going to make you feel safe, seen, and secure. For children, the developmentally appropriate way they process their environment and learn is through play,” says Megan Curtis, MA, LPCC, NCC, clinical coordinator with the Association for Play Therapy, Inc. “Play therapy is that controlled therapeutic space where children are able to explore, process, do whatever they need to do, and work through difficult emotions in a way that matches their cognitive development.”

Social work is also embracing the modality, says Rebecca Vannest. PhD, LPC, RPT-S, NCC, CFLE, an assistant professor in the Department of Counseling at Oakland University, which offers a Graduate Certificate in Child & Adolescent Play Therapy.

“It’s really exciting how well-received this is within social work [because] they’re doing such important things,” she says, adding that “because this credential is interdisciplinary, we can collaborate between the professions more than we normally might, which is enriching for all of us.”

Play Therapy Evolution Timeline
Modern play therapy emerged in the early 20th century as psychologists began recognizing that children communicate their inner worlds through play more naturally than through words. Early pioneers such as Sigmund Freud, Melanie Klein, and Anna Freud used play to observe children’s emotional conflicts and developmental needs, laying the psychoanalytic foundation for the field. In the mid-1930s, Margaret Lowenfeld introduced innovative methods such as the “world technique,” which influenced later therapies and helped establish play as a legitimate therapeutic medium.

A major turning point happened in the mid 20th century, as humanistic psychology reshaped the field. Carl Rogers’ client-centered principles inspired Virginia Axline to develop nondirective, child-centered play therapy, which emphasized empathy, acceptance, and the child’s innate capacity for growth. Her 1964 seminal book Dibs in Search of Self is credited with helping propel play therapy into mainstream practice.1

“There are some fundamental problems with traditional talk therapy being used with adolescents and children because talk therapy is reliant on two adults from fairly similar cognitive and verbalization abilities interacting,” Vannest says. “This is a huge problem [with children] because there’s a natural power differential between childhood and adulthood, and there are differences in cognitive and verbalization ability … Play therapy, or principles of play, is like the therapist taking all their knowledge about therapy and bringing it into the place where the child is the more successful and more powerful person.”

The field expanded with structured models such as filial therapy, ecosystemic, and cognitive behavioral play therapy (CBPT) approaches, maturing into a diverse, research-supported discipline used in schools, clinics, hospitals, and trauma treatment settings. Then, in 1982, APT was established to promote the value of play therapy and credentialed play therapists.

“The modality itself has really evolved from just that basic idea that children do need play to develop in a healthy way to the very formal, evidence-based, clinical practice that we have now,” Curtis says.

Play Therapy Today
Modern play therapy is not a single modality but a family of approaches. The most common are humanistic or nondirective approaches that emphasize a child’s innate capacity for healing. In general, nondirective play therapy is child-led and most useful for trauma, anxiety, and adjustment issues. Of these, Child-Centered Play Therapy (CCPT) is the most widely used. It taps into children’s natural ability to play, offers a safe space to understand their feelings and experiences, and emphasizes the healing power of play with the therapist acting as a supportive companion.2

CCPT is the “idea that the child is not broken, and we as adults don’t need to fix them,” Vannest says. “We are taking the perspective that the child is our teacher. We are trying to attune to and learn from them and support them, rather than imposing on them our ideas of who they should be.”

Other modalities include the following:

• Cognitive behavioral and skills-based models are structured and goal-oriented. CBPT integrates CBT with play and focuses on thoughts, feelings, behaviors, and coping skills. Trauma-Focused CBT with play adaptations is appropriate for trauma processing. Solution-Focused Play Therapy emphasizes strengths and solutions over problems.

• Psychodynamic and insight-oriented models are focused on unconscious processes and emotional conflicts. Psychodynamic Play Therapy utilizes symbolic play to uncover inner conflicts. Jungian Play Therapy focuses on the psyche’s role in personality development.

• Relationship and attachment-based modalities include Filial Therapy, which trains parents to conduct therapeutic play sessions to improve attachment and parent-child relationship. Theraplay is a structured, attachment-focused dyadic play, and Parent-Child Interaction Therapy is an evidence-based behavioral and play therapy for young children with disruptive behaviors.3

• Experiential or expressive modalities are often used in combination rather than as stand-alone theories and are particularly useful for younger or neurodivergent children.4

• Systems and integrative models include Adlerian Play Therapy, which focuses on belonging, social interest, and goals. Gestalt Play Therapy emphasizes awareness and present experience. Ecosystemic Play Therapy incorporates family, school, and broader systems. Prescriptive Play Therapy tailors interventions to child characteristics and needs.5

Play therapy is most appropriate for children aged 2 to 12 because “it speaks to the developing brain,” Curtis says. “That’s the age range where we know that talk might help, but it’s not the way we’re designed, neurologically. It’s not quite the way children are designed to process big emotions and the world.”

Credentials to Safeguard the Practice
APT introduced the Registered Play Therapist (RTP) credential in 1992, followed by the Registered Play Therapist–Supervisor (RPT‑S), which qualifies clinicians to supervise other play therapists and provide supervision hours toward RPT certification. School-Based Registered Play Therapist (SB‑RPT) focuses on the application of play therapy in educational settings.

Credentialing protects the integrity of a practice that has fought to be recognized as an evidence-based mode of therapy, one that appeals to a broad audience seeking to incorporate aspects of play therapy into their counseling practices—often without proper training or scientific support.

“We love seeing the world waking up to this very important modality,” Curtis says. “But we are also making sure that we’re safeguarding it and gatekeeping where we need to.”

Prospective RPT applicants must have a graduate degree in psychology, psychiatry, social work, marriage and family therapy, or clinical counseling, and their coursework must meet APT’s foundational core content requirements. This can be tricky for those social workers who took advantage of degree programs offering an “Advanced Standing” undergraduate status option for an expedited or more specialized graduate experience, which do not count toward APT requirements.6,7

For that reason, Curtis recommends using APT’s Transcript Review service to determine if coursework meets requirements prior to applying.8

“We’re looking for graduate coursework in child development, theories of counseling, and general skills and methods like a psychotherapy class,” she says. “Then we’re looking for a clinical diagnosis course—that’s the psychopathology core content area—a social and cultural diversity course, which would cover a multicultural lens, and finally an ethics course.”

While it sounds like a lot, Curtis emphasizes that anyone with a clinical license will most likely meet this requirement, “APT typically just needs to verify that you learned it at the graduate level.”

Once the education requirement has been met, prospects must earn, at minimum:

• 150 training hours;
• 350 (RPT) or 600 (SB-RPT) direct-experience hours; and
• 35 (RPT) or 50 (SB-RPT) supervised hours (See sidebar).

Centering the Child
Play therapy is an evidence-based approach to closing a serious gap in childhood mental health. By centering the child, it creates a safe space where children feel seen and supported as they work through emotional challenges.

“Just like for adult talk therapy, a safe, secure therapeutic space exists [with play therapy], so that kids within that [aged 2 to 12] developmental period of their life can come in and process big emotions,” Curtis says. “This is a clinical mental health practice. It’s not a behavioral approach. It’s not a super strict solution-focused type of modality. It’s something that is creating a natural environment for processing and exploring” emotions.

— Elizabeth S. Goar is a freelance health care writer based in Wisconsin.

APT CREDENTIAL REQUIREMENTS

Registered Play Therapist (RPT)
• 150 hours of APT-approved play therapy instruction, at least 75 of which must be in-person (contact) training.
• Minimum of 350 hours working directly with clients.
• Minimum of 35 hours of play therapy supervised by an RPT-S.
• Minimum of five observations by an RPT-S.
• Additional requirements (nonhour) include:
- Master’s or higher mental health degree;
- active clinical license; and
- integration of training, experience, and supervision over time.

Registered Play Therapist–Supervisor (RPT-S)
• Prerequisite: Must already hold the RPT credential in good standing for three consecutive years.
• Hours: Includes all RPT requirements, plus:
- additional post-RPT clinical and play therapy experience;
- additional advanced training hours in play therapy and supervision; and
- formal supervision training.
• Exact hour totals for RPT-S are not a single fixed set like RPT, but instead require:
- demonstrated advanced competency; and
- documented clinical, play therapy, and supervision experience per APT standards.

School Based-Registered Play Therapist (SB-RPT)
• 150 hours of play therapy instruction.
• Minimum of 600 hours of direct play therapy services (typically in schools).
• Minimum of 50 hours of play therapy supervised by an RPT-S.
• Additional requirements (nonhour) include:
- school counselor or school psychologist credential; and
- at least two years of school-based work experience.

References
1. History of play therapy timeline. Preceden website. https://www.preceden.com/timeline/play-therapy.

2. Types of play therapy. Play Strong Institute website. https://playstronginstitute.com/play-therapy/complete-guide/theory/types-of-play-therapy.

3. About PCIT. PCIT International website. https://www.pcit.org/about.  

4. Homeyer LE, Sweeney DS. Play therapy with children. American Psychological Association website. https://www.apa.org/pubs/books/play-therapy-with-children-sample-chapter.pdf. Accessed June 8, 2026.

5. Exploring types of play therapy: techniques for emotional healing in children. Social Work Institute website. https://socialwork.institute/counselling-basics/exploring-types-of-play-therapy/. Updated May 9, 2025.

6. Association for Play Therapy. Credentialing standards for the Registered Play TherapistTM: APT professional credentialing program. https://cdn.ymaws.com/www.a4pt.org/resource/resmgr/credentials/
standards_&_applications/RPT_Standards.pdf. Published 2025.

7. Association for Play Therapy. Registered Play TherapistTM application: APT professional credentialing program. https://cdn.ymaws.com/www.a4pt.org/resource/resmgr/credentials/
standards_&_applications/rpt_application.pdf. Published 2025.

8. Submission of transcript review. Association for Play Therapy website. https://www.a4pt.org/page/TranscriptReview