What is Sand Tray Therapy?

Most of us haven’t played in a sandbox in many years, and yet, playing with sand might just be a type of therapy that can help us even in adulthood. Sand tray therapy is rooted in art therapy and allows patients to resolve cognitive and emotional issues using a different medium. Let’s learn how this type of therapy uses the mind-body connection to work through distress in a safe environment.

What is Sand Tray Therapy, and How Does It Work?

Sand tray therapy is a form of non-verbal, expressive counseling where patients of all ages are invited to create three-dimensional pictures in sand trays. It is rooted in the “World Technique” developed by Margaret Lowenfeld, where miniature objects and sand are used to communicate.

In this creative approach, therapists or counselors encourage their clients to express themselves through the creation of an imaginary world using the sand tray. Patients can use a variety of props, toys, and figurines, such as miniature trees, people, houses, and animals, to build their sand trays. The toys are carefully selected and allow patients to create aspects of their inner world.

Sand tray therapy facilitates the healing process so the client can process any painful memories, whether conscious or unconscious. At the end of the session, the therapist and client will do some reflection and discuss the underlying meaning behind the sand tray creation.

Sand Tray Therapy for Kids and Teens

The childhood years are filled with many new experiences that can be exciting but also overwhelming for children. This is even more pronounced in the teenage years as a blend of emotions, such as anxiety, confusion, and the search for identity, runs high. Sand tray therapy provides kids and teens with a unique outlet to externalize emotions and inner conflicts that may be difficult to articulate. Arranging toys within the sand tray can help children and adolescents express their thoughts, fears, and desires in a safe way.

Sand Tray Therapy for Adults

Sand tray therapy is not just for children and teenagers. Adults can benefit from this type of therapy as well. It provides emotional release and leads to realizations during the therapeutic process. Since sand tray therapy provides an atmosphere that is free from threats, it can be very beneficial for adults who have experienced childhood trauma [*]. Therapists work with their clients to alter the positions of the toys or objects as representations of true people and events in their lives. Ultimately, sand tray therapy helps by facilitating change on a fictitious level until an individual gains the courage and ability to recognize that the same changes can be applied to their own life.

Sand Tray Therapy vs. Sand Play Therapy

While the terms “sand tray therapy” and “sand play therapy” are often used interchangeably, there are fundamental differences between the two.

Sand tray therapy places more emphasis on what the patient is experiencing in the current moment during therapy. As the patient builds their sand tray, the therapist uses directives to facilitate awareness and growth. There is some interpretation done on the therapist’s end, but most of it is based on the inner world the patient creates. To do sand tray therapy, a specialist must undergo 45 hours of training.

Sand tray therapy is considered an umbrella term under which sand play therapy falls. Sand play therapy is based on the ideas of psychoanalyst Carl Jung. In Jungian sand play therapy, the focus is on the unconscious mind. It involves using numerous trays over longer periods. Unlike sand tray therapy, no directives are used, and there is very little interpretation, if any. Professionals who wish to practice sand play therapy must undergo sand play therapy training and certification.

Sand Tray Therapy Techniques

Sand tray therapy is based on play therapy and art therapy. By using toys and small objects, therapists enable their patients to reflect on their world and express thoughts or emotions they might be unable to verbalize.

Therapists also anchor the therapeutic technique using the humanistic approach. It allows patients to use the sand as a tool for their healing. This then empowers them to find solutions to their problems. This approach helps individuals explore their feelings, discover themselves, and find meaning in their experiences.

What is Sand Tray Therapy Used For?

Sand tray therapy can be used for a number of challenges and conditions, including the following:

• Experiences of distress, neglect, abuse, or danger
• Inability to verbalize emotional states
• Grief and loss
• Aggression
• Anger management
• Low self-esteem
• Difficulty with social interactions
• Difficulty with school and/or work
• Depression
• Anxiety
• Having physical and learning disabilities
• Attention deficit hyperactivity disorder (ADHD)
• Autism

Sand tray therapy is especially helpful for those who have experienced trauma. For instance, there may be signs of childhood trauma in adults, such as hypervigilance and issues with emotional processing. Sand tray therapy can help with such issues.

Sand Tray Therapy Benefits

Numerous benefits come with undertaking sand tray therapy. You may experience:

• Increased resilience
• A reduction in anxiety and traumatic stress symptoms
• A boost in creativity
• Grief and loss processing
• The ability to express feelings without the need for words
• A sense of calm
• A boost in self-esteem
• Better anger management

How Effective is Sand Tray Therapy?

Plenty of research has supported the effectiveness of sand tray therapy in treating various health conditions and challenges.

A study done in 2017 found that a sand play therapy program reduced aggression and negative peer interactions in children [*]. Another study conducted in 2019 found that sand tray therapy reduced anxiety and challenging behaviors in kids with high-functioning autism [*].

More recent research found that sand tray therapy is effective in reducing sensitivity, anxiety, and apprehension in children with ADHD. This finding supports the hypothesis that sand therapy may be crucial for individuals who have difficulty understanding and expressing emotionally charged experiences [*].

Lastly, sand therapy was found to be effective at exploring the lived experiences of individuals with a terminal illness. A 2021 study allowed people with cancer to explore their resilience as well as understand themselves more deeply [*].

Frequently Asked Questions

Here are some commonly asked questions about sand tray therapy.

What should I expect in a sand tray therapy session?

In a sand tray therapy session, you can expect a calming and creative atmosphere. You'll be provided with a tray filled with sand and a variety of miniature figures, such as people, animals, buildings, and natural elements. Your therapist will guide you through the process and encourage you to create a scene that represents your thoughts, feelings, or experiences. As you interact with the sand and miniatures, your therapist may ask you questions or offer reflections to help you gain deeper insights into your emotions and experiences.

How is the meaning of the sand tray scenes interpreted?

Sand tray therapy interpretation is a collaborative process between the client and the therapist. The therapist uses psychological theories to better understand the client’s individual context and then analyze the meaning behind the composition of the sand tray. Some common themes that you might explore in a session are relationships, emotions, conflicts, and even fears and desires.

It's important to note that the interpretation of a sand tray scene is highly subjective and can vary depending on the individual client and their unique experiences. The therapist's role is to facilitate a safe and supportive space for the client to explore their thoughts and feelings through the sand tray.

How long does a sand tray therapy session last?

Sand tray therapy sessions are typically 30 to 90 minutes long.

How many sessions are needed to see results?

The number of sessions an individual will need can vary greatly depending on their mental health conditions (if any) and responsiveness to treatment. However, a case study found that nine weeks of 18 sessions (i.e., twice a week for at least one hour) was effective in reducing anxiety in an adult [*].

The Bottom Line

Sand tray therapy is a unique and creative approach that can help individuals explore their thoughts, feelings, and experiences. Engaging with the sand and miniatures can help patients gain deeper insights into themselves and their relationships. Sometimes, a non-traditional approach to therapy can be most helpful, whether a person is dealing with signs of repressed childhood trauma or has difficulties expressing their emotions effectively. To determine whether sand tray therapy will suit your needs, do not hesitate to consult a licensed mental health professional.

To supplement the emotional learning in sand tray therapy, try our feelings worksheets, which you can easily print at home.

References:

1. Schoonover T, Jha P, Romito M, et al. Sandtray Therapy’s Impact on Trauma Symptoms in Adults. 10 July 2024.
2. Han Y, Lee Y, Suh JH. Effects of a sandplay therapy program at a childcare center on children with externalizing behavioral problems. February 2017.
3. Daramadi P, Fathabadi R, Bakhtiarvand M, et al. Effectiveness of sand play therapy on challenging behaviors and anxiety in children with high-functioning autism disorder. August 2019.
4. Haghtalab T, Yaghobi A, Asadbeigi S. Effectiveness Sand Tray Therapy on Hyperactivity Attention Deficit and Evident Anxiety of Children with Attention Deficit / Hyperactivity Disorder. November 2021.
5. Liang Y, Hall K, Fedynich L, et al. Sandtray Therapy for Cancer Patients, Survivors, and Family Members. 2021.
6. Freedle F, Sani LR, Fonda G. The effect of sandplay therapy on the thalamus in the treatment of generalized anxiety disorder: A case report. 2020.