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Feature: ThotsnTots - Dealing with Anxiety through Play Therapy

Sometimes children are anxious or exhibit anti-social behaviour in school. It might hamper their academic development and they might be disruptive in class. Some schools may even suggest seeing a psychologist as they believe the child could be on the autism spectrum or have ADHD (Attention Deficit Hyperactivity Disorder).

But, this is not always the case. Sometimes the child may just be displaying some anxiety and need help dealing with emotions.

“I believe children behave that way for a reason. Sometimes it’s mum or dad’s anxiety that gets transferred to the child. The child doesn’t know how to deal with it so when he or she comes to school, that nervous behaviour surfaces,” says Rachel Ng, teacher and manager at Prep School by Trinity Kids.

She shares the story of a child who was reserved and didn’t really participate in class. After being involved in a water accident, the girl became extra anxious and constantly needed to be with an adult. She needed to know that she was safe and would cry when she was dropped off at school even though she had been going to school for a few years.

 “In such a case, it would be beneficial to go for play therapy to explore what she went through during the traumatic experience. Sometimes in play, children can act out their anxieties, and through play, they would find ways to manage their emotions. A lot of play therapy taps into their social emotional knowledge,” explains Ng. She is a certified Practitioner in Therapeutic Play Skills with Play Therapy International. Prep School by Trinity Kids now offers play therapy for those aged 4-16. The service is not just for Trinity students.

The certification allows Ng to conduct play therapy, but only for up to four people at a time and not complex cases. She is working towards gaining a certificate in therapy and play skills and then a diploma. Once she is done, she would be a certified play therapist and there would be no limit to how many children she can work with. In addition, she would then be able to work with more complex cases.

“Play therapy is very highly regulated. At the end of every session I have to write a report, and every two weeks, I need to bring all the documentation to my play therapy supervisor. She would go through all my cases and check that I’m adhering to the Play Therapy requirements. Everything has to be approved by her, even down to whether I can work with a child given his circumstances. At the end of every year, all these cases are sent to Play Therapy International for an audit,” explains Ng.

The therapy itself takes an hour, and part of that time is just the preparation of the room. It has to be private so that nobody can peek in to see what the child is playing with. During play therapy, the child is allowed to play with anything in the room. One of the principles is that the room must always look the same every time the child goes in because the child needs to know that no one came in when he or she wasn’t there. The room is supposed to be their private play space.

Typically, a child would go for 12 sessions. By the eighth session, there would be a review. This is where Ng would assess the child and talk to the parents and teachers to find out what progress has been made. If there is an improvement in the child’s behaviour, then the ninth to 12th sessions would be the winding down period to provide closure.

However, if at the review it is found that the child needs more time, the number of sessions would be extended.

Children going for play therapy would be given an introductory session where he or she would be brought into the room and told about the special play time.

“We don’t explain to them why they are going for play therapy, but we tell them they can do anything they want during this time. In play therapy, they also learn how to make choices and be responsible for those choices. For example, we give them boundaries and we tell them what happens when they cross those boundaries. Then it’s their choice if they want to breach those limits. It teaches children a lot of self-regulating behaviours as well as being responsible for themselves and their feelings,” says Ng.

According to her, small children sometimes don’t have coping strategies yet, and play helps them formulate strategies to deal with problems.

“It’s non-directive play. In play therapy, we believe that every child, or person, has the internal capacity and drive to want to resolve things within themselves. That is the play therapy modality. Human beings have an innate capacity and desire to resolve issues within themselves, even if it’s not conscious. So, you can say that play therapy works with the conscious and subconscious.

“For a child, playing with sand might help her. The sand tray is a very powerful tool where there is a selection of figurines, and children would subconsciously pick up whichever figure they want. Then they would play with the figure in the sand. Sometimes they might bury the character or take a whole load of toy snakes and bury them. It could signify them trying to bury whatever negativity they felt before, and it makes them feel better,” says Ng.

She cites the example of a child who experienced improvement through play therapy: The boy had delayed speech. At five he was still just vocalising words and not sentences. He had difficulty articulating his feelings and thoughts. Through play therapy, he was able to find his voice. He gained confidence and started speaking after going through play therapy.


“It’s not like counselling because we don’t talk it out. I’m there to support the child in the process of play. My main responsibility is to make sure that the room, space and process are supported so that the child can express what he or she needs to,” explains Ng.


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