Play Therapy for Grief and Loss in Children

Play Therapy for Grief and Loss in Children

Children experience grief differently from adults. To a child, the loss of someone they love can be devastating. A child’s sense of security can be shattered and their whole world becomes a scary and unsafe place. The death or terminal illness of a friend or family member can affect their behaviour, emotional development and relationships with family, friends and education. A child may appear to play happily one moment and collapse into tears the next, or ask matter-of-fact questions about death and then avoid the subject for weeks. This is not a sign of coping better — it is how childhood grief works. When a child cannot find the words to express what they are carrying, play becomes their language.

Play Therapy for grief and loss gives children a structured, safe space to process bereavement and other significant losses through the natural medium of play. At Play Therapy UK (PTUK), registered therapists use evidence-informed, child-led approaches to help children at their own pace, without pressure to talk or explain their feelings.

How Children Experience Grief

Grief in childhood does not follow the linear stages familiar from adult models. Children revisit loss repeatedly as they develop — what they understood about a bereavement at age six will feel very different when they reach nine or twelve. Grief can need processed at different stages for the child across the lifespan, often at developmental milestones.

Common signs that a child may be grieving include changes in behaviour at school or home, withdrawal from friends, increased clinginess, physical complaints with no medical cause, sleep difficulties, regression to earlier behaviours, and sudden emotional outbursts. Not all grieving children show obvious distress — some appear to carry on as normal while the weight of the loss builds internally.

Loss takes many forms for children beyond bereavement. Parental separation, a serious illness in the family, the death of a pet, moving home or school, the loss of a friendship, or the arrival of a new sibling can all trigger genuine grief responses. Play Therapy recognises and works with all of these.

Children also grieve differently depending on their developmental stage. A toddler cannot understand permanence; a school-age child understands death but may struggle to manage the emotions that follow; an adolescent may oscillate between mature engagement and regression. A skilled play therapist tailors their approach to the child’s developmental understanding, not just their chronological age.

A young girl holding a teddy bear

What Happens in Play Therapy for Grief

Sessions take place in a carefully equipped play therapy room containing materials chosen to support the expression of a wide range of emotions: sand trays, art materials, puppets, figures, building materials, and objects that invite symbolic play. Children do not need to name their feelings or talk about what has happened. The play itself carries the work.

A child processing the death of a grandparent might spend sessions building and knocking down towers, burying figures in sand, drawing family portraits, or acting out scenarios with puppets that echo themes of absence and return. The therapist does not direct this, they follow the child, reflecting and gently witnessing without interpretation or pressure.

Some children approach their grief directly and symbolically from the very first session. Others spend many weeks establishing safety in the therapeutic relationship before the grief material emerges. Both patterns are normal. The therapist holds the pace set by the child, not by a predetermined therapeutic timeline.

The Role of Memory and Meaning

One important aspect of grief work in play therapy involves helping children develop a continuing bond with what or who they have lost. This supports children to hold memory in a way that is manageable and meaningful, through story, creative work, or ritual within the session.

Therapists trained in the Integrative Holistic Model (IHM), used by many PTUK-registered therapists, draw on a range of therapeutic approaches depending on what the child needs at each stage. This might include person-centred listening, creative arts approaches, or structured narrative work to help the child make sense of what has happened in age-appropriate terms.

The IHM recognises the child as a whole person, not just a collection of symptoms or a set of grief stages to move through. The work is guided by the child’s own process, always within a framework of clinical skill and professional oversight.

An old box of family photographs
An adult holding a young child in a hug

Involving Parents and Carers

Parental involvement is a consistent predictor of positive outcomes in child therapy. For grief work this is especially important — children need home environments that acknowledge their loss and allow them to ask questions and express emotion without anxiety about upsetting the adults around them.

Many PTUK-registered therapists offer guidance sessions for parents and carers alongside the child’s individual work. These are not therapy sessions for the adult, but practical conversations about how to respond to the child’s grief at home, what language to use, how to hold space for difficult questions, and how to maintain routine while allowing emotional flexibility.

Adults who are themselves grieving the same loss may find it hard to hold the child’s grief alongside their own. In these circumstances, the play therapist can offer specific guidance on managing the parallel grief process within the family, and may suggest additional adult support where appropriate.

Non-Death Losses

Play Therapy for grief is not limited to bereavement. Many children who are referred describe losses that are not deaths: a parent leaving the family home, the end of an important friendship, moving away from a school where they felt safe, the loss of a beloved pet, or the diagnosis of a family member with a long-term illness. These losses are real, and the grief that accompanies them is real.

In some cases, children grieve things they have never had — such as the absent parent they have never known, the family life they have not experienced. This disenfranchised grief, which is often not recognised or acknowledged by the adults around the child, can be particularly isolating. The play therapy space offers recognition and validation that may not be available elsewhere.

These losses are real, and the grief that accompanies them is real.

When to Seek Play Therapy for Grief

Not every bereaved child needs therapy. Many children process loss naturally within a supported family environment. Play Therapy becomes appropriate when grief is affecting daily functioning, when a child is showing signs of complicated or prolonged grief, when the loss was sudden or traumatic, when the child has experienced multiple losses within a short period, or when the adults in the child’s life are themselves too affected by the same loss to fully hold the child’s experience.

A GP, school counsellor, or CAMHS professional may also suggest play therapy as part of a wider support plan. PTUK-registered therapists work collaboratively with other professionals where this is in the child’s interest.

Frequently Asked Questions

No. Play Therapy does not require a child to discuss their loss directly. Many children process grief most effectively through symbolic and creative play rather than verbal conversation. The therapist follows the child’s lead entirely.

This varies depending on the nature and complexity of the loss, the child’s age and temperament, and their wider support environment. Some children benefit from a focused short-term piece of work; others with more complex or layered grief may work with a therapist for longer. The therapist will review progress with you at agreed intervals.

Yes. Grief does not resolve simply with the passage of time, and children often re-encounter losses at developmental transitions. Play Therapy can be effective whether a bereavement is recent or historical.

Children often minimise their distress, particularly if they sense that adults around them are also struggling. A willingness to engage in sessions, even when a child claims not to need help, is usually more informative than what they say. Your therapist can discuss any concerns about engagement at the outset.

Finding a Registered Play Therapist

PTUK (Play Therapy UK) is the UK’s professional register for play therapists. All practitioners listed hold recognised qualifications, work within a clear ethical framework, and are subject to continuing professional development requirements. To find a registered therapist for your child, visit the Find a Play Therapist directory at playtherapy.org.uk. You can search by location and filter by specialism, including therapists with experience in grief and bereavement work.

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