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Polyvagal Theory Principles and Play Therapy with Theraplay® Examples

October 3 @ 9:00 am - 12:15 pm CDT

CEs Available: 3    |     One Day Training      |     Virtual

Would you like to understand Polyvagal Theory (PVT) better and know how it can help you in your work with children and caregivers? Most presentations about PVT focus on adult treatment, despite the fact that it is early experiences that create the felt sense of safety or defense. It is critical for all play therapy child and caregiver clients to feel safe and to be able to co-regulate; this is especially true for clients who have sustained trauma. This presentation will clarify the main points of PVT, show you the impact of physiological state on the child and caregiver client and detail how PVT concepts can be used more intentionally to strengthen your play therapy practice. Video and literature clinical examples of clients with presenting issues of medical trauma, traumatic loss, orphanage care and adoption, dysregulation, autism, selective mutism, and parenting difficulties will illustrate Theraplay assessment, planning and treatment advice. This 2023 presentation has been updated with information about resources for child clinicians from the international polyvagal community and resources for working with dissociation in children.

PVT has been described as an important component in play therapy (Kestly, 2016, Daniel, Masters & Donovan, 2018). The play therapy model used in illustrations in this presentation is Theraplay®, one of nine clinical theories recognized as foundational to play therapy practice (Booth & Lindaman, 2019). Theraplay consists of four components:  Establishing safety and arousal regulation, Enhancing caregiver-child attachment, Working directly with the caregivers and the Practitioner’s use of self (Lindaman, Hong, Maxonight & Peacock, 2020). This combination of therapeutic actions has been shown to be effective in working with children and caregivers (Salo,, 2020). This presentation will focus on the first component of establishing safety and regulation. As noted above, it is critical for all Theraplay child and caregiver clients to feel safe and to be able to co-regulate. The actions suggested by PVT are consistent with the modifications of Theraplay already suggested for clients with trauma (Booth & Jernberg, 2010). The PVT concepts offer an additional, helpful lens through which to assess, plan and treat clients. There is a strong coherence between 1. the physiological safe states described in Polyvagal Theory: social engagement, polyvagal play, rest and digest, and movement between these states and 2. Theraplay’s focus on social engagement (Engagement), reciprocal and physical play (Challenge/Play), nurturing care (Nurture) and guided movements between play and care activities (Structure) (Lindaman & Makela, 2018). This presentation will fill in the details and value of this coherence, describing what  PVT means by “safety”; the development and action of the social engagement system; PVT’s recommended progression from social engagement to proximity to touch and then to trusting relationships; the value of states of “polyvagal play/dance” and “rest and digest/intimacy”; and the development of regulation and resilience.

Please note, our program registrations are transitioning to our Theraplay community on YourMembership! You’ll be able to log into your account to access your membership benefits, view your training history, certification progress, and much more!




Additional Information


This virtual training will take place October 3, 2023 from 9:00am-12:15pm Central Time. View detailed agenda.


Sandra Lindaman, MA, MSW, LCSW, LISW-CP – Sandra is a Certified Theraplay® Therapist, Supervisor and Trainer, and the Senior Training Advisor for The Theraplay® Institute. Sandra has worked at TTI since 1990 in treatment, management, training curriculum development, publication and research. She has a master’s degree in social work from Loyola University- Chicago. She also has a master’s degree in speech-language pathology from Northwestern University and worked in that field for many years.

  • The difference between safety and defensive states
  • The importance of the safe state for healthy development and healing
  • The signs of activation of the social engagement system (SES) and retraction of the SES
  • The combined power of the four components of Theraplay: establishing safety and arousal regulation, enhancing caregiver-child attachment, working with parents, and the practitioner’s use of self
  • The Theraplay dimensions as new ways for the child and parent to enter and stay in the safe state
  • The way the Theraplay session sequence improves regulation and resilience

Learning Objectives
  1. List six physiological states described in Polyvagal Theory and their significance for play therapy.
  2. Describe how the sequence of a play therapy session can be planned and carried out to maximize client safety, social engagement and regulation.
  3. Name the 4 components of the Theraplay model and how PVT concepts influence these Theraplay process components.
  4. Explain how the observations of dyadic Structure, Engagement, Nurture and Challenge routinely made in the Theraplay assessment of caregiver-child interaction (the Marschak Interaction Method) also correspond to PVT concepts of safety, social engagement, arousal status, proximity and contact, polyvagal play, soothing, and co-regulatory abilities.
  5. Identify PVT related responses to 4 possible problems in Theraplay treatment: retraction of the client’s social engagement system, client active or frozen mobilization, client shut down, client rejection of nurture.

Who Should Attend?

People who work with children and families in many different capacities will benefit from training programs offered by The Theraplay Institute. Visit our Who Should Attend page for more information. This course’s Content Level is Intermediate.


View this program’s bibliography for books and other materials referenced in the development of the content for this program.


For information about our CE process, cancellation policy, and how to contact us with questions and concerns visit our FAQ page. Attendance of the entirety of a program (in-person or virtual) is required in order to receive continuing education or a letter of completion.

This special program will be recorded and will be made available for viewing 2-3 weeks after the training.

There is no conflict of interest or commercial support for this program.

Registration Terms and Conditions


October 3
9:00 am - 12:15 pm CDT
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