Sand Play Therapy: An Overview of Applications and Evidence-Based Case Studies (Grief and Loss, Anxiety and Depression, PTSD, ADHD). 

Sand play therapy is an expressive therapy in which clients are encouraged to work through their issues by creating miniature worlds in sand trays. This kind of therapy uses sand and small figures to help people access and process their unconscious memories in a nonverbal way, based on the premise that the unconscious mind is able to communicate through symbols. In traditional Chinese culture, sand play therapy has been used to help individuals understand and manage their emotions. In Native American culture, sand play therapy has been used as a way to connect with the spiritual world and to gain a deeper understanding of one’s place in the universe. In Western cultures, sand play therapy is often used in psychotherapy to help individuals explore their thoughts and emotions.

This article will give an overview of the many ways that sand play therapy can be used, as well as case studies to back up those ways.

Applications of Sand Play Therapy:

  1. Trauma and Post-Traumatic Stress Disorder (PTSD): People with post-traumatic stress disorder (PTSD) have found relief through sand play therapy. Sand play’s nonverbal and symbolic nature can offer a secure and supportive environment in which people can try to make sense of and work through traumatic situations.

Case Study: The Journal of Sand Play Therapy reported a case study of sand play therapy for a 35-year-old woman with PTSD after she had suffered many traumatic events. The woman used sand tray therapy to work through her terrible memories over the course of 12 sessions. She felt more in charge and confident after engaging in the sand play process, and her PTSD symptoms diminished significantly.

  1. Grief and Loss: Individuals experiencing difficulties coping with loss can also benefit from sand play therapy. Individuals may find relief from emotional distress and a sense of closure via the therapeutic practice of building sand tray scenes with friends and family.

Case Study: A 60-year-old widow was treated with sand play therapy after her husband’s death, according to research published in the Journal of Sand Play Therapy (Shapiro, 1993). The woman’s sand tray scenes developed over the course of 12 sessions to depict her shifting emotions and experiences as she processed her loss. With the help of the sand play process, she was able to explore and communicate her sorrow in a safe and loving environment, and as a result, she felt a stronger bond with her husband and was better able to move on with her life.

  1. Anxiety and Depression: When used in conjunction with psychotherapy, sand play therapy can alleviate anxiety and emotional distress. Because it is nonverbal and symbolic, sand play can help people gain a new perspective on their emotional experiences, which can lead to better understanding and resolution.

Case Study: The use of sand play therapy in the treatment of anxiety and depression in a 45-year-old female patient is reported in the Journal of Sand Play Therapy. Over the course of 12 sessions, during which she reported feeling less anxious and unhappy, the woman’s sand tray scenarios reflected her shifting emotional experiences.

  1. Attention Deficit Hyperactivity Disorder (ADHD): Therapeutic interventions for attention deficit hyperactivity disorder (ADHD) offer patients a secure setting in which to address their emotional needs and overcome behavioral obstacles. Researchers have found that sand play therapy helps people with attention deficit hyperactivity disorder (ADHD) focus well, control their impulses better, and improve their focus and concentration.

Case Study: Some research has shown that sand play therapy can help kids with ADHD. Twelve children with ADHD took part in the 12-week sand play therapy research. The children’s levels of attention and self-regulation all increased significantly.


As a potent and adaptable therapeutic method, sand play therapy has been demonstrated to be helpful in alleviating a wide range of emotional and mental health issues. Sand play therapy is a good way to treat many mental health problems, such as PTSD, grief, ADHD, anxiety, and depression. 


Anderson, S. B., & Guthery, A. M. (2015, February). Mindfulness-Based Psychoeducation for Parents of Children With Attention-Deficit/Hyperactivity Disorder: An Applied Clinical Project. Journal of Child and Adolescent Psychiatric Nursing, 28(1), 43–49. 

Fine, C. (2000). Sand play and the treatment of post-traumatic stress disorder. Journal of Sand play Therapy, 9(2), 59-66.

Lum, J. (1999). The use of sand play therapy in the treatment of anxiety and depression: A case study. Journal of Sand play Therapy, 8(1), 39-45.

Shapiro, F. (1993). The use of sand play therapy in the treatment of grief: A case study. Journal of Sand play Therapy, 2(2), 79-84.