How I Support Children Through Anxiety, Depression, Trauma, and More in Play Therapy

One of the most common questions I get from parents and caregivers is:
“How do you work with different challenges and symptoms in kids?”

While every child’s therapy journey is unique and tailored to their needs, goals, and strengths, below is a general look at what play therapy sessions might look like based on common challenges. My approach is always neurodivergent-affirming, and I’m mindful of sensory needs and developmental appropriateness throughout our work.

Anxiety in Children

What it might look like:
Avoidance, frequent worrying, perfectionism, anger or aggression, and panic attacks.

What we do in sessions:
Anxiety is often rooted in the fight-or-flight response—a state of hyper-arousal in the nervous system. Many kids avoid situations that trigger these uncomfortable feelings, but this only reinforces the anxiety over time. In sessions, we practice building a kid’s tolerance to acknowledge, discuss, and feel anxiety so it becomes less activating in the future.

In therapy, we work together to:

• Build a child’s window of tolerance for anxiety and big feelings.

• Explore and name body sensations tied to worry or panic.

• Practice regulation strategies like movement, breath work, or using sensory tools.

• Use bibliotherapy, metaphors, or nervous system education depending on age and learning style.

• Identify and map personal triggers and coping strategies.

Caregiver sessions include:

• Nervous system education.

• Personalized strategies and visuals to use at home and school.

• Support with co-regulation and daily routines.

Depression

What it might look like:
Sadness, emotional numbness, lack of motivation, low energy, hopelessness, or withdrawal.

How we work together:
Depression often stems from hypo-arousal, or a shut-down response in the nervous system. Our first step is creating a felt sense of safety, allowing the child to begin feeling again—safely.

In therapy, we focus on:

• Gently exploring emotional and body sensations.

• Reconnecting with pleasure, motivation, and joy.

• Building emotional tolerance without overwhelming the nervous system.

• Processing difficult emotions through art, play, or storytelling.

• Identifying what lights them up—interests, confidence boosters, and moments of strength.

Caregiver sessions include:

• Nervous system education.

• Personalized strategies and visuals to use at home and school.

• Support with co-regulation and daily routines.

Suicidality and Self-Harm

What it might look like:
Hopelessness, thoughts of death or dying, cutting, or other self-harming behaviors.

Therapeutic approach:
This is a deeply sensitive and critical area of work. I integrate Synergetic Play Therapy with the Collaborative Assessment and Management of Suicidality (CAMS) model to:

• Understand the root cause of suicidal thoughts and self-harm

• Develop a collaborative safety plan

• Identify the function or “benefit” of self-harm (e.g., distraction, sensation, emotional release)

• Find non-harmful alternatives that offer similar regulation or relief

• Offer directive tools for emotional tracking and safety check-ins

Caregiver collaboration is essential here to ensure kids are supported across all environments.

Trauma and Major Life Changes

What it might look like:
Increased conflict, emotional withdrawal, somatic complaints (like stomachaches), nightmares, regressions, or changes in behavior after a major event (e.g., divorce, death, or move).

How we work through it in therapy:

• Use non-directive play to allow children to process in a natural, developmentally appropriate way.

• Build relational safety and stability.

• Help children name and manage intense feelings.

• Improve interoception (the ability to feel and interpret internal body cues).

• Support narrative integration of trauma through play, art, or sandtray work.

I also provide:

• Age-appropriate education on trauma and the nervous system.

• Coaching for caregivers on how to talk about hard things.

• Emotional regulation tools for everyday use.

Final Thoughts

There is no one-size-fits-all in therapy. Whether a child is navigating anxiety, depression, trauma, or something else, our work together is about helping them feel safer in their bodies, more confident in who they are, and equipped with tools to manage life’s big feelings.

Want to explore how play therapy might support your child? Click the button below to schedule a free 15-minute intro call.