Therapy is more likely to be beneficial when children and adolescents are willing participants. Many children and adolescents are reluctant, at-least initially, to attend and be involved in therapy. Either they don’t know what to expect, which causes anxiety, or they think that they have to attend because they have been “bad”. However, almost all children and adolescents enjoy playing and engaging in fun activities with a lively adult. So, incorporating fun activities into psychotherapy is a good way to help children and adolescents feel relaxed about attending therapy and, indeed, increases their motivation to attend.
Making and maintaining a connection
Research has found that the heart rates of mothers and children parallel each other during play. Heart rate is a sign of the level of activity of the nervous system, which is commonly referred to as arousal. Arousal is one of the two components of emotion. So, during play, adults and children are emotionally-connected to each other.
Most children and adolescents who are referred for therapy have trouble controlling their emotions, their behaviour, or both. The ability to self-regulate emotions and behaviour is thought to develop from adult caregivers providing a range of emotional experiences and intervening to ensure that children do not become overly excited or overly distressed during their early development. So, therapists can utilise play and the emotional connection associated with play to develop the child or adolescent’s capacity for self-regulation by facilitating the experience of a range of emotions of varying intensity and returning them to a state of calm.
Children and adolescents who are referred for therapy hold beliefs about themselves, about others and about the world in which they live. Often, one or more of these areas of belief is negative. That is, they might see themselves as bad and helpless, others as mean and uncaring, and/or the world as a harsh place. Simply telling children that they are good, that others are caring and understanding, and that the world is a safe place is rarely effective in changing children’s beliefs. Rather, they need to experience themselves, others and their social world differently. During therapeutic play, children and adolescents experience themselves as likeable and capable, experience others as fun and “nice”, and their world as safe and a source of happy experiences. This facilitates trust in others and the perception that therapy is a safe place for conversation about the reasons for their emotional distress and/or maladjusted behaviour.
Play is an important and natural approach for promoting the emotional wellbeing and positive adjustment of children and adolescents
 Reite, M., & Field, T (1985). The psychobiology of attachment and separation. Orlando: Academic Press