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Sandplay therapy for trauma patients

sandplay therapy

sandplay therapy

Sandplay therapy can help patients suffering from trauma issues

Sandplay therapy or sand tray therapy refers to the therapeutic approach that uses sand to help those who suffer from trauma issues like PTSD, a traumatic past or a catastrophic incident that occurred in the past. Earlier the sand tray therapy was only used to help children. However, nowadays sand tray therapy is used to help adults as well as the children.

What is sandplay therapy?

Sand play or sand tray therapy is a therapeutic intervention which focuses on using a non verbal intervention to help the patients deal with their past trauma. Sand tray therapy uses toy figures, water and sand box for the purpose of creating scenes depicting miniature worlds which can be used to reflect the sufferers struggle, thoughts as well as concerns. Sand tray therapy is generally used along with talk therapy. The toy, sand and figures are used as accessory communication tools.

Sand tray therapy was initiated by Dora Kalff. Dora was extremely inspired by the work of Margaret Lowenfeld, a developer of World technique and a child psychiatrist.

Sandplay therapy primarily focuses on providing a safe space to the trauma patient. The purpose behind the therapy is that the client will be able to use the sand tray to find solutions to their problems on their own. Even thought sandplay therapy is primarily meant for use with individuals, it can be applied to groups as well as couples if needed

Sandplay therapy allows the client or the patient to design their world with the help of the miniature toys and sand. They mostly create scenes which reflect their own lives in some manner. Looking at a reflection of their own life laid out in front of them allows them to retrospect and resolve conflicts. It also helps to remove obstacles and gain the acceptance of oneself.

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Which type of patients is sandplay therapy used for?

Sandplay therapy is generally used to help patients who have previously suffered from abuse, trauma or severe neglect. Sand play is most often used to help young kids who find it hard to express their feelings verbally. It can also be used to help adults and teens who find it difficult to express themselves or who have suffered from extreme trauma.

Sand tray therapy vs sandplay therapy

Both the names, sand tray therapy and sandplay therapy are used to refer to the use of sand as a non verbal mode of communication. However, these have have subtle differences which set them apart from each other. Sand tray therapy incorporates many theoretical orientation of psychology while sandplay therapy is mainly based on Jungian psychology.

Sand tray therapy focuses on the persons feeling and emotions in real time. The primary focus is on what the person might be feeling at that very moment. The sand tray therapist focuses on their current experiences of growth and awareness in the person.

In case of Sand tray therapy, the relationship between the client and psychologist must be strong for the therapy to be effective since the treatment requires the client to open up emotionally about their trauma and their deepest feelings and thoughts.

However, in case of sandplay therapy, the therapist focused mainly on the unconscious side of the person and provide them with a safe and protected space where they can use nonverbal modes of communication. Sandplay therapists are not involved in interfering or interpreting the clients emotions or thought process in anyway.

Sandplay therapy techniques

Sand tray therapy techniques work by using the humanistic approach. In this therapeutic technique, therapists do not interfere with the clients thinking process. The clients are provided the sand box and miniature toy figures. They create the scene of their past experiences and trauma using the miniature toys and the sand. This creative mode of expression allows the person in therapy to manifest their feelings in the sandbox which would otherwise be impossible to express.

The work of the therapist is to treat the person as a whole and understand that the process of sand tray therapy will allow the person to find the answers which they are seeking on their own. In case of sand tray therapy the belief is that the answer is already within the person and a little bit of retrospection will help them figure it out.

Sandplay therapy techniques involve different techniques amongst it. One of the most common technique which is employed in case of sandplay therapy technique is the world technique. This uses miniatures, objects and figurines in the sand. The client arranges the sand objects, figurines and miniature toys in a way of their choosing. This enables a therapist to observe and analyze a persons interaction and emotional situation.

The client is allowed to add water to the sand and place the miniatures in any way they wish on the sand. The design in the sand is primarily guided by the persons imagination and their subconscious thought process.

This leads to the formation of the persons inner world on the sand. The sand scenes are interpreted by the use of metaphor and symbolism. It may or may not make an immediate sense to the client who is using the sand to depict his or her emotions.

Once the sand play is complete, the therapist and the client analyze the choices made by the client and decipher the metaphorical and symbolic meanings of the same. Once the discussion is over, the client chooses to change the world they have created in the sand. The sandplay therapy sessions may either consist of one single session or it may carry on for as long as a period of a few years.

However, the therapist who has been trained to understand the hints and meaning of what the person has made on the sand, starts to recognize the relationship between the scene that is created on the sand and the persons inner thoughts and feelings.

Sand tray therapy for trauma and abuse

People who have faced abuse, neglect or trauma find it very difficult to verbalize their emotions. The advantage of sand tray therapy is the nonverbal communication mode. The non-verbal communication mode and the familiar sand medium helps children feel comfortable and secure in presence of the therapist. The therapist gives the child a little bit of instructions and then the child is left to freely play with the sand. This allows the child to experience independence.

Soon the child starts to make behavioral changes and assumptions without any prompts or ques from the therapist. This type of therapy has been observed to act as a very powerful and valuable tool to help children access their past trauma without actually talking about it.

Sand tray therapy has also been observed to be extremely useful in case of children who have previously suffered from sexual abuse . Such children have been most often observed to stay silent because they’re afraid of being harmed by the abuser. Most often such children and patients and are in a heightened state of anxiousness when they come to the therapist. The first step is to calm the patient down and build trust before the therapy can actually begin. Sandplay therapy can be a useful asset for relaxing the kids and helping them build a trust with the therapist.

Sand tray therapy to help adults

Even though most often people think that sand tray therapy is only meant for children, it can be very helpful in treatment of adults as well. Sand tray therapy is a multi dimensional therapeutic approach which can help in emotional release of an adult as well. This therapy is especially effective for adults who have suffered from trauma in the past and show a limited response in case of other kinds of therapeutic approaches .

The environment of sand tray therapy helps to relax and build confidence in the patient. The client is allowed to change the position of the object and sand to represent past events and trauma. Sand tray therapy helps adults but by allowing them to realize that a change made at a fictitious level can also be made in their real lives. Even though in some cases sandplay therapy may take months or years to help the patient, sometimes changes can be observed only after one sand tray therapy session.
Sandplay therapy

Other problems which sand tray therapy can help with:

Sandplay therapy has been shown to help children suffering from the following problems

  • Attention deficit hyperactivity disorder ADHD
  • Aggression
  • Anxiety problems
  • Autism spectrum issues
  • Anger management
  • Parental divorce
  • Depression
  • Loss and grief
  • Low self-esteem
  • Learning and physical disabilities
  • School drop issues
  • Trauma and crisis
  • Social issues

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What are the limitations of the sand tray therapy?

Just like all other therapeutic interventions, sand tray therapy also has its own limitations. Some psychologists may say that this technique is confusing, frustrating, time-consuming or too dependent on the expertise of the therapist.

Adults may not like this technique because it needs a visually expressive approach. Furthermore if the client is not creative or lacks artistic skill, the treatment may not be effective because the therapist may not be able to interpret the scenes depicted on the sand properly. Furthermore, the interpretation of the figures, symbols or the scenes by the client or the therapist may present an alternative explanation and may not go in the right direction. There is also very less scientific research available with regards to the sand tray therapy which would validate it as a good approach for helping the client .

Benefits of Sand tray therapeutic technique

According to research, Sandra therapy has been observed to reduce symptoms in case of many types of mental health issues. Since sandplay therapy is basically unstructured it allows clients or patients to rid them selves of the negative emotions which are deep-seated because these inner thoughts can be expressed by the use of Sandplay therapy. Eventually the patients feel that their thoughts feelings and emotions are being accepted by the therapist and this triggers the healing process

Effectiveness of Sandplay therapy

Recent studies have shown that sandplay therapy is very effective in treating emotional and trauma issues in both children as well as adults

A study done in Korea found that when sand tray therapy was used as a part of the school counseling, it led to significant changes in the emotional problems and improvement in the self-esteem of the students who were in fourth and fifth grade.

Another study which was conducted on 4 to 5 year old kids showing behavioral issues observed that the children showed a reduction in the aggressive behavior after a 30 minute period of group and play session with sand.

Another study conducted in Korea on children who had suffered from domestic violence observed that music and imagery when combined with the sandplay therapy improved the behavioral and emotional outcome of the kids after six individual sessions

Researchers have observed that sandplay therapy may be a good fit for children who find it very difficult to express or talk about the trauma like very young kids. The study supporting this finding was conducted on a three-year-old orphan who was suffering from human immunodeficiency virus [HIV]. It was observed that sandplay therapy helped the child and provided emotional support.

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Training for sand tray therapy

Sand tray therapists are also referred to as witnesses on facilitators. Their primary role is to act as a guide to help the client during the sand tray exercise. The therapist is taught how to help the client engage with the world which they create on the sand. The client is always the primary focus of the therapy and the therapist is there to support, encourage and guide the client as the client depicts images from their inner world into the sand. Sand play therapists have also started to include yoga, narratives, meditation as well as music into the therapeutic approach.

What to look for if you are looking for a sand tray therapist?

Even though no certification is required for a psychologist to become a sand play therapist, there are certain certification programs available. If you are looking for a sand tray therapist, look for an experienced and licensed mental health professional, counsellor or therapist who has an advanced training in sandplay therapy. However, when looking for a therapist for your child, the most important thing to check is that your child be comfortable in the presence of the therapist and in talking to him or her.

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Even though sand tray therapy can be of great help for children suffering from past trauma or abuse, it can also help kids suffering from aggression, ADHD, anger issues and a variety of other psychological issues.
Have you ever tried sandplay therapy for yourself or your child? What are your view on this therapeutic technique? If you have any queries pertaining to this blog post or any other, feel free to contact me on any of my social media channels or fell free to leave your queries in the comment section. I will be happy to help you out.
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Frequently asked questions

What type of therapy is sandplay therapy?
Sandplay or sand tray therapy is considered to be an expressive counselling, hands on and psychotherapy modality. Sand play therapy has been used for over 70 years now. This form of therapy is basically used to form a bridge between the expressive therapies and verbal therapy while combining bits of both.
How is sand play therapy used in case of a therapeutic setting?
Sand play therapy provides both children as well as the adult a chance to portray their inner feelings and experiences which are difficult to portray verbally or say out loud. Sandplay therapy acts as a balance between the inner world and the outer focused every day world.
Who developed sandplay therapy?
Sand play therapy was developed by Donna Klaff. She was one of Carl Jung students.

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