Play Therapy or Occupational Therapy: How to Know Which is Right for Your Child
Families’ search for resources and support when their child is struggling can lead them in many different directions. Many pediatric services use similar language, such as “play based” and “child-centered,” and most claim to be able to help children with social and emotional skills, self-confidence, and resilience. Depending on who you are asking, families will hear OT is exactly what their child needs or play therapy is the most appropriate. While friends, pediatricians, and school staff mean well, there is often little clarity on how these services actually differ.
This can make the process of choosing the most beneficial service for your child incredibly confusing. Let’s break down the differences between play therapy, play-based therapy, and occupational therapy (skip to the end for a cheat sheet).
Wait, There’s a Difference Between Play Therapy and Play-Based Therapy?
YES! There is a difference between play therapy and play-based therapy. Play therapy is an evidence-based therapeutic practice, meaning there is sufficient research to prove efficacy of play therapy interventions to treat mental health concerns across several populations.
There is a governing body, the Association for Play Therapy (APT), that ensures all clinicians offering play therapy services are in fact trained in play therapy, including but not limited to, cultural implications and considerations of play therapy, special populations, and foundational skills. There is a certification process that requires clinicians to have participated in extensive approved play therapy training, education, and experience with supervision from a registered play therapy supervisor. Clinicians must be fully licensed through their counseling governing body and have experience using play therapy for a minimum of two years. The letters RPT, standing for Registered Play Therapist, guarantee that a clinician has a thorough understanding and ability to use play therapy in practice. In order to offer “play therapy,” a clinician must have their RPT. The play therapy certification process is essentially a quality control process.
That being said, play-based therapy is not always a knock off or dupe of play therapy. It simply means the clinician is not certified with APT. Clinicians who offer play-based therapy services may be in the midst of their certification process and have gone through extensive play therapy training. However, there is no guarantee, so it is smart to inquire about a clinician’s experience and how they use play-based modalities. For example, a therapist who plays Uno while talking to an 6 year old about their fears is technically using a play-based modality to provide treatment, but a clinician trained in play therapy would know that talk therapy + games is not play therapy and is not the most developmentally appropriate treatment approach for a child of 6 years.
Play-based therapy can be offered by anyone offering therapeutic services that incorporate play. Play therapy can only be offered by fully licensed mental health clinicians. Pediatric occupational therapists can offer play-based therapy because of their use of occupational therapy interventions through a play modality that is appropriate for the child’s developmental level.
Play Therapy vs Occupational Therapy
In the simplest terms, play therapy treats the child from a mental health perspective and occupational therapy treats the child from a cognitive and physical perspective. They can both treat challenges with social skills, emotion regulation, transitioning, behavior, and executive functioning. Both can incorporate parents and caregivers. Both can help a child feel more capable and confident. However, the why behind treatment and the pathway to growth will differ.
Play therapy encourages growth through increased insight into and treatment of the child’s needs, beliefs, and attachment. Occupational therapy encourages growth through increased insight into and treatment of the child’s physical and cognitive capabilities.
Let’s consider this example situation:
Gemma is a 9 year old girl who is struggling to make friends at her new school. A play therapist will likely consider social anxiety and difficulty adjusting to change as the root cause of this challenge. An OT will likely consider a lack of social skills as the root cause. Note that social anxiety can appear due to a lack of social skills - kids know when they are not meeting expectations! If Gemma maintained close friendships at her old school, the problem is more likely to be mental health related. If she has always struggled with social skills and making friends, capability is likely the issue. In the latter, Gemma will benefit from OT. She can also benefit from play therapy. Other than overscheduling, there is very little to no risk in starting your child with a play therapist to supplement their OT treatment.
Here’s another example:
Jalen is a 6 year old boy who throws intense tantrums whenever it is time to brush his teeth. A play therapist will likely consider his need for control, power, and attachment as factors resulting in this behavior. An OT will likely consider Jalen’s actual ability to hold a toothbrush and functionally brush his teeth. Both will likely consider the possibility of sensory sensitivities. If the issue is emotional (i.e. need for control as a result of heightened anxiety), OT would not be appropriate. If the issue is motor skill related, play therapy would not be appropriate.
How Do I Know What the Root Cause is?
It can be tricky to determine why your child is struggling. Start by noticing patterns. Does your child only exhibit struggles during certain times/activities/around certain people? Do they resist certain textures and sounds? How do they describe their problem? Are you struggling to regulate yourself when your child struggles? What are your child’s strengths? What do teachers observe? The answers to these questions can help guide you towards an understanding of your child’s “why.”
Do not hesitate to reach out to a variety of professionals. It is always okay to get a second opinion or ask for a different evaluation. There are many factors that could be combined to create the challenge at hand. A neuropsych evaluation can provide extremely useful information regarding your child’s developmental level and cognitive capabilities. An OT assessment can provide helpful information regarding your child’s physical and cognitive capabilities.
Regardless of your child’s capabilities and challenges, a play therapist can provide much needed support as they process their experiences and create opinions about themselves, others, and the world around them. There is no harm in having an adult who completely accepts your child as they are, believes they are capable of positive growth, and values their unique strengths and qualities.
Cheat Sheet:
Play Therapy = play-based therapeutic mental health treatment offered by certified registered play therapists, who are fully licensed mental health professionals
Play-Based Therapy = any therapeutic service that incorporates play
Occupational Therapy = specialized practice that supports children’s cognitive, physical, and motor skills development