What Is Sand Tray Therapy?

Although it may look like play, sand trays are quite therapeutic

Sand tray therapy (which is also referred to as sandplay therapy) is often used with individuals who have experienced a traumatic event such as abuse. It’s most often used with children but it can also help teens and adults.

Psychotherapists may use sand trays to assess, diagnose, or treat a variety of mental illnesses. Research shows that sand tray therapy can help increase emotional expression while also reducing psychological distress in many populations.

What It Involves

Sand tray therapy is a combination of play therapy and art therapy. The therapist provides a tray or box filled with sand. The client is given miniature toys to create a play world. Toys may include anything from farm animals and dinosaurs to people and cars. Trees, fences, gates, doors, and buildings are common as well.

The client is free to choose which toys to incorporate into the tray and then the toys are arranged in any way that the client wants.

The therapist mainly serves as an observer and rarely interrupts. It’s thought that the client is able to create a world that represents their internal struggles or conflicts. After the sandplay is complete, the therapist and the client often discuss what was observed—the toys that were chosen, how they were arranged, and any symbolic or metaphorical meanings.

The client may then choose to rearrange the toys based on the discussion. Sand tray therapy may also include verbal therapy, play therapy, art therapy, or other types of treatment.

How It Helps

Sand tray therapy was developed by Dora Kalff and is derived from Margaret Lowenfeld’s “Worldtechnik,” Jungian theory and Buddhist contemplative practices.

It’s based on the notion that if a therapist provides the client with a safe space, the client will use the sand tray to create solutions to their problems on their own. Research shows that sand tray therapy reduces symptoms of many mental health issues and increases resilience.

Sand tray therapy is unstructured. It allows clients to experience healing through the therapeutic process. It provides the opportunity for clients to free themselves of deep-seated negative emotions by allowing them to express their inner thoughts and feel accepted by the therapist.

Sandplay can also be a pleasurable sensory experience. It facilitates the natural expression of emotions. It may be used as part of an individual, group, or family therapy.

What the Research Says

Studies show sand trays are an effective means of treatment for a variety of problems and can be used in many different populations.

A study conducted on four and five-year-old children with externalizing behavior problems resulted in the children showing less aggressive behavior after receiving 30 minutes of group sandplay therapy twice a week for 16 sessions.

Another small study in Korea that consisted of three children who had witnessed domestic violence found that supportive music and imagery combined with sandplay therapy improved emotional and behavioral adaptability after six individual sessions. Additionally, a study of migrant women in Korea found that group sandplay therapy produced positive self-expression and reduced negative self-expression.

In China, a study involving boys with Asperger syndrome found that sandplay therapy helped develop their psychological well-being and interpersonal communication skills when it was combined with other forms of treatment.

Researchers theorize that sandplay therapy may help vulnerable children with pre-verbal trauma, making it a good strategy for children who are too young to talk about their traumatic experience.

A study supporting this theory was conducted on a 3-year-old orphan with HIV. Researchers found that sandplay therapy provided the child with emotional support.

What to Expect

If you or your child attends sandplay therapy, you may wonder how using miniature toys in the sand is helping to resolve any issues. If you have questions about the effectiveness of your treatment, it’s important to ask the therapist.

When it’s used as part of an assessment, the therapist may provide a sand tray and then look for common themes that indicate insecurities or aggressive behavior or resilience and positive emotional expression.

If it’s used as part of treatment, sessions may be 30 to 60 minutes in length and they may be scheduled weekly or bi-weekly. Your therapist may greet you and then provide you with an empty sand tray and miniatures so you can get to work.

The therapist may ask to photograph your sand trays so that the changes in the scenes you create can be reviewed over time.

The therapist may take time to talk about your sand tray at the end of each session. For example, what might it mean if the domesticated animals are caged while the more dangerous animals (like tigers or dinosaurs) get to roam free? Together, you may find some meaning in the sand tray.

But, it’s also possible that there will be little discussion at all. Instead, the therapist may simply give you a safe space to work.

How to Find a Sand Play Therapist

While any psychotherapist may be able to provide sandplay therapy, some therapists are specifically certified in sandplay therapy. Sandplay Therapists of America offers a directory of certified sandplay therapists.

If you think that you or a loved one might benefit from sand tray therapy, a good place to start is by talking to your physician. Your physician may be able to refer you to a local therapist.

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Article Sources

  • Cao H, Shan W, Xu Y, Xu R. Eastern sandplay as a safe container for a combined intervention for a child with Asperger syndrome: A case study. The Arts in Psychotherapy. 2013;40(1):134-142. DOI: 10.1016/j.aip.2012.12.008

  • Ferreira R, Eloff I, Kukard C, Kriegler S. Using sandplay therapy to bridge a language barrier in emotionally supporting a young vulnerable child. The Arts in Psychotherapy. 2014;41(1):107-114. DOI: 10.1016/j.aip.2013.11.009

  • Han Y, Lee Y, Suh JH. Effects of a sandplay therapy program at a childcare center on children with externalizing behavioral problems. The Arts in Psychotherapy. 2017;52:24-31. DOI: 10.1016/j.aip.2016.09.008

  • Jang M, Kim Y-H. The effect of group sandplay therapy on the social anxiety, loneliness and self-expression of migrant women in international marriages in South Korea. The Arts in Psychotherapy. 2012;39(1):38-41. DOI: 10.1016/j.aip.2011.11.008

  • Kang H-J. Supportive music and imagery with sandplay for child witnesses of domestic violence: A pilot study report. The Arts in Psychotherapy. 2017;53:72-79. DOI: 10.1016/j.aip.2017.01.009