Theraplay
Theraplay is a parenting programme for parents with children aged 0 to 18 years. It can be delivered in the home, school or a community setting and aims to address behavioural, emotional, and developmental issues.
Theraplay aims to support the development of healthy attachments between the caregiver and child through practitioner-led activities. These activities guide parents and children to create playful and caring child-adult interactions. Through supporting the development of healthy attachments, Theraplay aims to improve children's mental health and well-being, including improving internalising behaviours. Theraplay can be delivered to all children, particularly including children with additional developmental needs or those that have experienced separations and loss e.g. neurodiverse children, adopted and fostered children, refugee children and those who have experienced bereavement or divorce in the family.
EIF Programme Assessment
Child outcomes
This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.
According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:
Supporting children's mental health and wellbeing
Decreased internalising behaviours
based on study 1
This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.
Who is it for?
The best available evidence for this programme relates to the following age-groups:
Primary school
How is it delivered?
The best available evidence for this programme relates to implementation through these delivery models:
- Group
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Targeted selective
Where has it been implemented?
- United Kingdom
- United States
- Hong Kong
- Ireland
Ireland provision
Ireland evaluation
About the programme
What happens during the delivery?
How is it delivered?
- Theraplay is delivered as weekly sessions of one hour or less duration by a Theraplay practitioner, to either individual families, or groups of children & families. The programme typically lasts from 3 to 6 months.
What happens during the intervention?
- 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.
What are the implementation requirements?
Who can deliver it?
- The practitioner who delivers this programme is a certified Theraplay practitioner with QCF-4/5 level qualifications.
What are the training requirements?
- 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.
How are the practitioners supervised?
- It is recommended that practitioners are supervised by one Theraplay supervisor (qualified to QCF- 4/5 level), who is a certified Theraplay practitioner who has practiced for 2 years and undertaken the Supervisors’ practicum.
What are the systems for maintaining fidelity?
Programme fidelity is maintained through the following processes:
- Training manual
- Other printed material
- Other online material
- Video or DVD training
- Face-to-face training
- Fidelity monitoring
Is there a licensing requirement?
There is no licence required to run this programme.
How does it work? (Theory of Change)
How does it work?
- Theraplay aims to support healthy child-caregiver attachment. Strong attachments between the child and the important adults in their life are believed to positively influence the child mental health and promote resilience.
- In treatment, the Theraplay Practitioner guides the parent and child through playful, fun games, developmentally challenging activities, and tender, nurturing activities. The act of engaging each other in this way helps the parent regulate the child's behaviour and communicate love, joy, and safety to the child. It helps the child feel cared for and more self-confident.
- When participating with a parent in Theraplay, the child increases their self-esteem, and sees the parent as trustworthy. This shift results in positive behaviour change in the short term which generalises to other relationships and situations.
- In the longer term, Theraplay allows children to enjoy higher quality caregiver-child interaction which decreases children's internalising and externalising symptoms of distress, reducing the risk of longer- term poor mental health.
Intended outcomes
Contact details
Theraplay
About the evidence
The most rigorous evidence for Group Theraplay comes from an RCT which was conducted in Hong Kong. This study identified a statistically significant positive impact on child outcomes. This programme is underpinned by one study with a Level 3 rating, hence the programme receives a Level 3 rating overall.
Study 1
| Citation: | Sui (2009) |
| Design: | RCT |
| Country: | Hong Kong |
| Sample: | 46 children from an elementary school in an urbanised area in Hong Kong |
| Timing: | Post-test |
| Child outcomes: |
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| Other outcomes: | |
| Study rating: | 3 |
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. Available at https://psycnet.apa.org/buy/2009-00564-001
Study design and sample
The first study is an RCT which assessed Group Theraplay.
This study involved random assignment of families to a Theraplay treatment group and a care as usual group.
This study was conducted in Hong Kong, with a sample of 46 children from one school who were experiencing internalising behavioural problems. The average age of the children in the Theraplay treatment group was 7.84 years, and 7.89 years in the control group. No ethnicity data was reported.
Measures
- Internalising behaviour was measured using the Child Behaviour Checklist (CBCL) (parent report)
Findings
This study identified a statistically significant positive impact on one child outcome. This includes improvements in internalising behaviour on the Child Behaviour Checklist (CBCL)