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Bottom-Up Healing: Using Theraplay to Address Developmental Trauma in Young Clients

Theraplay provides a neurobiologically-informed approach for clinicians working with children affected by attachment wounds or developmental trauma. By engaging emotional and sensory systems through structured play, it promotes safety and co-regulation. Effective techniques like Hand Stacking and Cotton Ball Sensory Game assist children in therapy, extending healing into the home environment.

Ariana Wade
2–3 minutes

For clinicians working with children navigating attachment wounds or developmental trauma, Theraplay offers a neurobiologically-informed way to engage the emotional and sensory systems directly. Grounded in Dr. Amelia Taylor’s adaptations and Bruce Perry’s Neurosequential Model, Theraplay bypasses traditional resistance and invites regulation through rhythmic, relational experiences.

Theoretical Foundation
Theraplay’s strength lies in its ability to engage the parasympathetic nervous system, promoting felt safety and co-regulation through structured co-play (Way, 2000). Perry’s work reminds us that we must meet clients where they are neurodevelopmentally—particularly those “stuck” in earlier phases of emotional or sensory processing. Through play and touch, we access the regulatory brainstem and limbic systems before asking for cognitive processing.

Two Techniques in Practice

  1. Hand Stacking: A structure-based activity to rhythmically organize arousal states. Useful for children with fluctuating energy levels, this game reintroduces predictability and presence.
  2. Cotton Ball Sensory Game: A gentle nurture-based activity enhancing interoception, bodily autonomy, and sensory integration. Use clear consent language and narrate the experience to promote safety and awareness.

Clinical Application
These techniques are especially effective with children ages 3–12, including those who have experienced neglect, sensory processing issues, or early relational trauma. Because Theraplay is relational, its success depends not only on the activity but on the adult’s ability to attune, pace, and co-regulate. This calls for our own regulation and somatic awareness as clinicians.

Conclusion
Incorporating Theraplay into sessions—particularly for clients struggling with trust, engagement, or dysregulation—can offer a reparative space rooted in presence and touch. When paired with psychoeducation for caregivers, these interventions can extend healing beyond the therapy room and into the home environment.

References

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