Peer Review

Theraplay Treatment Outcome Research

Theraplay has evidence-based status. Theraplay has been accepted by the U.S. Substance Abuse and Mental Health Services Administrationfor inclusion on the National Registry for Evidence-based Programs and practices! Click here for more details

Theraplay is rated as Promising by California Evidence-Based Clearinghouse. Click here for more details

Published research in peer-reviewed journals: Controlled Studies

Hiles Howard, A. R., Lindaman, S., Copeland, R., & Cross, D. R. (2018). Theraplay impact on parents and children with autism spectrum disorder: Improvements in affect, joint attention, and social cooperation. International Journal of Play Therapy, 27(1), 56-68.
Siu, A.F.Y. (2009). Theraplay in the Chinese world: An intervention program for Hong Kong children with internalizing problems. International Journal of Play Therapy18(1), 1-12. (Download .pdf)

A primary objective of this study was to evaluate the effectiveness of Theraplay on reducing internalizing problems among children. Described as at-risk for developing internalizing disorders, 46 children in grades 2-4 were randomly allocated to either the Theraplay condition (weekly Group Theraplay for 8 weeks) or the wait-list control condition. A standardized measure of internalizing symptoms (CBCL) was completed before and after the 8-week period. Results showed that children from the Theraplay condition showed significantly fewer internalizing symptoms when compared to the waitlist group.


Siu, A.F.Y. (2014). Effectiveness of Group Theraplay® on enhancing social skills among children with developmental disabilities. International

Journal of Play Therapy23(4), 187-203.

Theraplay® is a play therapy approach that helps children form better relationships and attachments with others. It focuses on the nonverbal aspects of interaction. This study reports on a Group Theraplay program in a special school for children with developmental disabilities. Twenty-three students, arranged into four groups, participated in the year-long program that used Theraplay principles to enhance their social development. Results were compared with a group of 15 students who served as the comparison control. Data from the Social Responsiveness Scale showed that students from the Theraplay group had significant improvement in the subscale of “social communication” when compared with the comparison group. Feedback from teachers suggested new ideas in working with this group of children. A discussion of the rationale behind why Theraplay works for these children was presented. The limitations of this study and directions for future research are addressed.


Weir, K.N., Lee, S., Canosa, P., Rodrigues, N., McWilliams, M., & Parker, L. (2013). Whole Family Theraplay: Integrating Family

Systems Theory and Theraplay to Treat Adoptive Families Adoption Quarterly, 16 (3-4), 175-200.

http://www.tandfonline.com/doi/abs/10.1080/10926755.2013.844216#.UrnQJaUw1z9 (Article Link)

This article regarding the effectiveness of Theraplay for the clinical treatment of adoptive families both outlines a model for integrating family systems theory with Theraplay to create a new approach entitled Whole Family Theraplay (WFT), as well as provides a preliminary report of a pilot study demonstrating the efficacy of that model. WFT integrates Theraplay with family systems approaches (Structural and Experiential Family Therapies) to treat parents and all the siblings within adoptive families. The findings indicate that WFT treatment may lead to statistically significant benefits in regard to family communication, adults’ interpersonal relationships, and children’s overall behavioral functioning.


Wettig, H. G.; Coleman, A. R.; Geider, F. J. (2011). Evaluating the effectiveness of Theraplay in treating shy, socially withdrawn children. International Journal of Play Therapy, 20(1), 26-37.

This study assessed the efficacy for dually diagnosed children with language disorder and shyness/social anxiety. Study 1 was longitudinal, with 22 children treated at a single institution by 1 therapist. Study 2 incorporated 167 subjects and therapists across multiple centers to evaluate generalizability. Results showed that children improved significantly on assertiveness, self-confidence, and trust. Social withdrawal was reduced. Expressive and receptive communication improved. Improvements were maintained over a 2-year period with no cases of relapse.


Published research in peer-reviewed journals: Model Reviews

Tucker, C., Schieffer, K., Wills, T., Hull, C. and 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, Vol. 26, Number 4, 185-195 (View the full PDF here)


Catherine Tucker, Kay Schieffer, Stephen Lenz & Sondra Smith (2021) Sunshine Circles: Randomized Controlled Trial of an Attachment-Based Play Group with Preschool Students Who are At-Risk, Journal of Child and Adolescent Counseling, DOI: 10.1080/23727810.2021.1940658


Francis, Y., Bennion, K. & Humrich, S. (2017) Evaluating the outcomes of a school based Theraplay® project for looked after children, Educational Psychology in Practice, 33:3, 308-322

Read here: http://dx.doi.org/10.1080/02667363.2017.1324405


Bennett, L.R., Shiner, S.K. and Ryan, S. (2006). “Using Theraplay in Shelter Settings with Mothers and Children Who Have Experienced Violence in the Home”, Journal of Psychosocial Nursing and Mental Health Service, 44 (10), 38-47.


Finnish peer-reviewed medical journal: Comparison of Theraplay model to Circle of Security, Wait, Watch and Wonder, Reflective Functioning, Cognitive behavioral Therapy, Incredible Years, Parent Child Interaction Therapy, Positive Parenting Program.


Fuller, W. (1995). Theraplay as a treatment for autism in a school-based day treatment setting. Continuum The Journal of the American Association for Partial Hospitalization 2, 2, 89-93.


Makela, J. (2005). The Importance of Touch in the Development of Children. Finnish Medical Journal, 60,1543–9.

Published research in peer-reviewed journals: Case or Program Descriptions


Makela, J. & Salo, S. (2011) Theraplay –vanhemman ja lapsen välinen vuorovaikutushoito lasten mielenterveysongelmissa.

(Theraplay- Parent-child interaction treatment for children with mental health problems) Duodecim 127, 29-39.


Robison, M., Lindaman, S., Clemmons, M.P., Doyle-Buckwalter, K. & Ryan, M. (2009). “I Deserve a Family”: The Evolution of an Adolescent’s Behavior and Beliefs About Himself and Others When Treated with Theraplay in Residential Care. Child and

Adolescent Social Work Journal. Vol. 26, Number 4, 291-306.


Cort, L. & Rowley, E. (2015). A case study evaluation of a Group Theraplay intervention to support mothers and their preschool children following domestic abuse (Research in Brief). British Psychological Society, Debate 156.


Makela, J. & Vierikko, I. (2005) From heart to heart: Interactive therapy for children in care. Report on the Theraplay project in SOS Children’s Villages in Finland 2001-2004. The SOS Children’s Villages Association, Finland.


Salo, S., Lampi, L. & Lindaman, S. (2010) Use of the emotional availability scales to evaluate attachment-based intervention Theraplay- in substance abusing mother-infant dyads in Finland. Infant mental health Journal Supplement 2010: 32:77.


Tucker, C. & Smith, S. (2018)Using Play to Enhance Growth in Children who have Experienced Trauma: Theraplay Groups as Early Intervention., Young Exceptional Children Monograph, #17 Maltreatment and Toxic Stress, 72-81

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