Play Therapy for Anxiety: Helping Children Find Calm Through Play

Play Therapy for Anxiety: Helping Children Find Calm Through Play

Anxiety is a common and often misunderstood issue that affects many children and has a significant impact upon their daily lives affecting school, home and social life. Anxiety in childhood looks different from adult anxiety. While some children will identify chronic worry, others will show this worry in different ways. They may refuse school, develop stomach aches, nausea or headaches with no medical cause, cling to caregivers, have difficulty concentrating or sleeping or have meltdowns that seem out of proportion to the situation. For parents, watching this unfold is distressing and reassurance alone rarely helps. Anxiety can interfere with a child’s ability to engage in everyday activities.

Play therapy offers an approach specifically suited to how children experience and express anxiety. As young children cannot yet think their way out of anxious feelings, they need an approach that meets them where they are. Play therapy uses play — the child’s natural language — to help them express and process anxiety in a safe and supported way.

Play Therapy UK (PTUK) maintains the professional register for qualified play therapists in the UK. All practitioners on the PTUK register have completed accredited postgraduate training and work within ongoing clinical supervision.

What Does Anxiety Look Like in Children?

Common signs include:

  • Persistent worry the child cannot control or shake off
  • Physical complaints such as headache, nausea or stomach aches with no medical cause
  • Avoidance of activities, people or places that previously caused no difficulty
  • Difficulty sleeping, nightmares or reluctance to sleep alone
  • Clinginess with caregivers, separation anxiety or fear of being left
  • Angry outbursts or emotional meltdowns that seem disproportionate to the situation
  • Irritability or mood swings
  • Withdrawal from social interactions
  • Emotionally based school avoidance

Some anxiety is developmentally normal such as separation anxiety in young children, nervousness before a new school year. Clinical anxiety is different: it is more intense, persists beyond the expected phase and meaningfully affects the child’s everyday functioning. When a child’s world is shrinking because of fear — fewer activities, fewer friendships, more avoidance — professional support is worth considering.

A young child drawing with felt-tip pens

Why Play Therapy Works for Anxious Children

Talk-based therapies rely on verbal, rational processing. That is often difficult, especially for children. Anxiety is driven by deeper emotional and physical responses — the body’s threat system. These responses do not switch off in response to logical reassurance, and in children the brain structures that support verbal self-reflection are still developing.

Through play, children can better understand their worries and gain a sense of control over their emotions. They can explore their feelings at their own pace.

Play therapy works precisely because it does not depend on verbal expression. When a child plays out a scary scenario with puppets, uses art to express something they cannot name, or buries a figure in the sand and then carefully uncovers it, they are doing therapeutic work. The play is the medium through which feelings are accessed, expressed and gradually processed.

Play therapy is child-centred: the child leads the process and the therapist provides attuned support without directing or rushing. For anxious children, who are often highly sensitive to the expectations of adults around them, this experience of unconditional acceptance is itself therapeutic.

Specifically, play therapy supports anxious children by:

  • Providing symbolic distance — a child fearful of something can play with it, controlling the interaction entirely on their own terms
  • Restoring a sense of agency and control, which anxiety systematically erodes
  • Offering a genuinely safe space for emotional expression without judgement or pressure to feel differently
  • Building the child’s sense of security through a consistent, predictable therapeutic relationship
  • Developing the child’s emotional literacy — their capacity to recognise and name what they feel

Play therapy works precisely because it does not depend on verbal expression.

What Happens in Play Therapy Sessions?

Sessions are held in a consistent space, at a consistent time, with the same therapist. This predictability is itself important for anxious children, whose difficulties are often rooted in a sense that the world is unpredictable or unsafe.

The child is free to explore the playroom and use the available materials — sand tray, art materials, puppets, clay, dolls, musical instruments — in whatever way feels right to them. The therapist follows the child’s lead, reflecting what they observe and creating a space in which the child feels genuinely accepted, whatever they bring.

Over time, the themes in a child’s play typically shift. The scenarios that were played with intensity and repetition — often reflecting the child’s anxiety — gradually become less charged. The child begins to find new solutions within the play, develops greater confidence and starts to carry this into their everyday life.

Parent involvement is an important part of the therapeutic process. Parents who understand what their child is working through and who can offer consistent support at home play a significant role in consolidating the work done in sessions. Most play therapists offer regular support to parents alongside the child’s therapy.

A young boy playing at a table in a playroom
A child arranging coloured paper shapes

Play Therapy and Other Approaches to Childhood Anxiety

Play therapy sits within a broader landscape of support for childhood anxiety. It is particularly well suited to younger children and to children whose anxiety has significant non-verbal or bodily dimensions — children for whom a purely verbal approach would place demands that exceed their current developmental capacity.

For older children and adolescents, play therapy can be adapted using creative arts modalities — art, music, drama, sand tray — that engage non-verbal expression while accommodating greater verbal capacity. A PTUK-registered therapist will discuss what approach is most appropriate for your child’s individual needs.

Play therapy can also run alongside other forms of support, including school-based provision and, where relevant, medical advice. A qualified therapist will discuss what is already in place and how best to coordinate the work.

Frequently Asked Questions

If your child’s anxiety is affecting their daily life — preventing school attendance, limiting friendships, disrupting sleep or family life, or causing significant distress — it is worth seeking a professional assessment. A PTUK-registered play therapist can help you understand whether play therapy is appropriate and what the process would involve.

School avoidance is a common presentation of childhood anxiety, and it’s important to recognise that it is not that the child will not attend school but that they cannot manage school. Play therapy can be an effective part of the support provided. A therapist will work to understand the underlying feelings and help the child develop the emotional resources to manage them. Work with parents and, where appropriate, the school may also be part of the approach.

This depends on the individual child and the nature and history of their anxiety. Research indicates that positive effects begin to emerge around 16 sessions, though the number of sessions needed will vary depending on the child’s individual circumstances. Your therapist will discuss expectations with you at the outset and review progress regularly throughout.

Not necessarily. Play therapy does not require children to talk about their feelings directly. The therapeutic work happens through play, and children are free to engage in whatever way feels comfortable to them. Many children find this a significant relief — particularly those who have felt pressured by previous attempts to make them articulate their worry.

Finding a Play Therapist

Play Therapy UK (PTUK) maintains the UK professional register for qualified play therapists. All practitioners on the register have completed accredited postgraduate training and work under ongoing clinical supervision. Use the Find a Play Therapist directory on this website to find a PTUK-registered therapist near you.

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