Creative Therapies: How Art and Play Benefit Children's Mental Health

By Emily Watson MSW, LSW

It is an unfortunate fact that in the United States, rates of childhood behavioral problems continue to increase. In fact, according to the National Institute for Health and Clinical Excellence (NICE), behavioral disorders are the most common mental health disorders in children. It is common for caregivers to be bombarded with information about what might be going on inside their child, which may leave caregivers feeling confused or worried about how to help if their child is struggling. This blog will attempt to explore and simplify some common behavioral disorders and provide evidence based (which is a big term for proven practices) on how therapists and caregivers can help.  

You may be thinking that the term “behavioral disorder” sounds scary and serious. The good news is that a behavioral disorder is just a term that is meant to describe externalizing behaviors, or behaviors that happen on the outside and normally happen with others. The severity can range from difficulty following directions to yelling and hitting. These behaviors most typically include distractibility, difficulty complying with rules or norms, hyperactivity, and invading others' space without permission. Your child may struggle to regulate their feelings, misinterpret social cues, and may use aggression and anger to solve problems. These behaviors may impact your child’s ability to make friends, impact their school performance, and can lead to struggles as they grow up. 

As a clinician, I often hear from caregivers that they have tried to talk with their child about their behavior and feelings, but their child either can not or will not communicate with them, which leads to frustration between caregivers and children. As adults we find that by talking about our feelings with others we are better able to solve our problems, come up with next steps, and generally feel better, so why doesn’t this work with our children? Development and environment play a large role in answering this question. Research has shown that from 0-13 years of age, children are in different stages of emotional development and as children grow, they will move through these stages at their own unique pace which is impacted by their experiences, temperament, and relationship with their caregivers. All this is to say that it is completely normal for children to struggle to communicate their emotions. Children aren't born with coping mechanisms or an emotional vocabulary and must be taught to talk about and manage our feelings. 

So, how can we help our children express their feelings and grow their emotional development?  We play! While most children don’t often have the vocabulary to talk about their feelings, they are able to express themselves using the language of play and art. When working with children and play, the therapist takes a follower role and allows the child to lead the play through use of dolls, action figures, stuffed animals, costumes, toy cars, food toys, building toys, puppets, instruments, creative arts materials, books, sand trays, and more. As the child plays and creates, the therapist reflects what can be seen, such as the child's behavior, feelings, and themes seen in the play. This type of play exploration gives the child the chance to see their troubles from a new perspective, process difficult or upsetting events, and allows them a safe space to practice social behaviors. For example, a child who struggles to make friends or share can practice doing those things though play. The Association for Play Therapy states that the play done in therapy helps children:

• Become more responsible for behaviors

• Develop more successful strategies for behavior management

• Develop new and creative solutions to problems.

• Develop respect and acceptance of self and others.

• Learn to experience and express emotion.

• Cultivate empathy and respect for thoughts and feelings of others.

• Learn new social skills and relational skills with family.

• Develop self-efficacy and thus a better assuredness about their abilities.

You may be thinking to yourself “This all sounds great, but does it work?” It does! Play in therapy has been studied and positive outcomes have been seen across the board. Reviews of over 100 play therapy outcome studies have found that the overall treatment effect of play therapy “ranges from moderate to high positive effects. Play therapy has proven equally effective across age, gender, and presenting problems. Additionally, positive treatment effects were found to be greatest when there was a parent actively involved in the child's treatment.” (Lilly, J. O’Connor, K. & Krull, T.)

It’s important to remember that children are incredibly resilient and are more than capable of working through behavioral and emotional struggles. With the support of their caregivers and developmentally appropriate therapy involving play, both children and their families can learn how to cope with emotions, work on communication, and thrive together!

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