Theraplay is a parenting intervention for families with a child between 7 to 9 years identified as being at risk of having emotional problems. It is delivered by a certified Theraplay practitioner to groups of children and their parents for eight weekly sessions, lasting about 40 minutes each.
The information above is as offered/supported by the intervention provider.
7 to 9 years old
Group
Theraplay is a therapeutic intervention for families with a primary school-aged child identified as having clinically significant emotional difficulties. Parents and their children attend eight sessions delivered by a Theraplay certified practitioner.
Each session lasts an hour or less and can be delivered over a period of three to six months. The session can be conducted with individual families or in group settings involving multiple children and families. During these sessions, the practitioner introduces play-based activities aimed at helping parents and children develop and maintain a positive parent–child relationship. Specifically, parents learn: 1) strategies that help them structure their child’s environment that increases physical safety and emotional security; 2) challenging strategies aimed at increasing child competence and self-confidence; 3) encouraging strategies aimed at increasing the child’s experience of themselves as an individual; and 4) nurturing behaviours, such as rocking, holding, and cuddling which help soothe and reassure the child.
Theraplay was developed specifically for children with additional emotional needs, including neurodiverse children and children who have experienced separations or loss – includes those who have been adopted, fostered, refugee children, and children affected by bereavement or divorce.
Primary school-aged children aged 7 to 9 years.
Children identified as being at risk of emotional difficulties.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Emotional security in early childhood helps children develop positive expectations about themselves and others as they mature.
Science-based assumption
Positive and fun parent–child interactions foster emotional security in children.
Science-based assumption
Children at risk of emotional difficulties at home and at school are particularly likely to benefit from activities aimed at supporting their emotional security.
Intervention
Parents learn strategies for improving the parent–child relationship and increasing children’s emotional security.
Short-term
Improved parent nurturing behaviours
Increases in the child’s experiences of safety and trust within the parent–child relationship.
Medium-term
Improved self-efficacy in managing emotions
Reduction in anxiety, aggression, and other symptoms of emotional distress.
Long-term
Development of secure, healthy attachments that persist over time
Improvements in emotional and social development
Reduced risk of mental health disorders such as anxiety, depression, and conduct disorders.
Targeted Indicated
Theraplay is delivered as weekly sessions of one hour or less duration by a Theraplay practitioner, to either individual families, or groups of children and families. The intervention typically lasts from three to six months.
Child and parent or children and group leader engage in fun, physical, and play activities chosen and led by the therapist to provide the level of structure, engagement, nurture, and challenge needed by the children to feel safe and secure to explore the world. These are supported by reflective feedback sessions for caregivers to make sense of their child’s needs.
A practitioner with experience in a helping profession, qualified as a Theraplay practitioner.
Practitioners are required to have received Theraplay Level 1 training (4 days) or Group training (2 days), and to have delivered 40 sessions, of which at least 8 must have been supervised, to become a certified practitioner. Booster training of practitioners is recommended.
It is recommended that practitioners are supervised by one Theraplay supervisor (certified in the model) who has practised Theraplay for 2 years and undertaken the Supervisors practicum.
Intervention fidelity is maintained through the following processes:
Email address: admin@theraplay.org.uk
Website: www.theraplay.org.uk
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
Theraplay’s most rigorous evidence comes from a single RCT conducted in Hong Kong consistent with Foundation’s Level 3 criteria.
This study identified statistically significant reductions in children’s internalising behaviours, including symptoms of anxiety, depression, and withdrawal.
Theraplay can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
Reduced internalising behaviour
Improvement index
Interpretation
Study
| Identified in search | 28 |
| Studies reviewed | 1 |
| Meeting the L2 threshold | 1 |
| Meeting the L3 threshold | 0 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 27 |
| Study design | RCT |
| Country | Hong Kong |
| Sample characteristics | 46 children within a single primary school identified as having clinically significant levels of internalising problems. The average age of the children in the Theraplay treatment group was 7.84 years, and 7.89 years in the control group. |
| Race, ethnicities, and nationalities | No ethnicity data was reported, but the study was conducted with pupils in a Hong Kong school. |
| Population risk factors | All children had clinically significant internalising behaviour problems, as identified by the Child Behaviour checklist (CBCL). |
| Timing |
|
| Child outcomes | Reduced internalising behaviours (Parent report) |
| Other outcomes | None |
| Study rating | 3 |
| Citations | Siu, A. F. (2009) Theraplay in the Chinese world: An intervention program for Hong Kong children with internalizing problems. International Journal of Play Therapy. 18 (1), 1. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Chang, Y., Kim, B. & Youn, M. (2021) Changes in children with autism spectrum disorder after Theraplay application. Journal of the Korean Academy of Child and Adolescent Psychiatry. 32 (3), 112.
Siu, A. F. (2014) Effectiveness of Group Theraplay® on enhancing social skills among children with developmental disabilities. International Journal of Play Therapy. 23 (4), 187.
Sundberg, B., Ollersjö, H. & Nilsson, K. (2020) Child psychiatric symptoms and parental stress before and after Theraplay treatment. Department of Clinical Sciences Child and Adolescent Psychiatry, Umeå University, Sweden.
Tucker, C., Schieffer, K., Wills, T. J., Hull, C. & Murphy, Q. (2017) Enhancing social-emotional skills in at-risk preschool students through Theraplay based groups: The Sunshine Circle Model. International Journal of Play Therapy. 26 (4), 185.
Weir, K. N., Pereyra, S., Crane, J., Greaves, M., Childs, T. S. & Weir, A. B. (2021) The effectiveness of Theraplay® as a counselling practice with mothers and their children in a substance abuse rehabilitation residential facility. The Family Journal. 29 (1), 115–123.
Wettig, H. H., Coleman, A. & Geider, F. J. (2011) Evaluating the effectiveness of Theraplay in treating shy, socially withdrawn children. International Journal of Play Therapy. 20 (1), 26.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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