How Does Play Therapy Reduce Anxiety in Children? by Joseph Sacks, LCS — ChildTherapyToys
How Does Play Therapy Reduce Anxiety in Children? by Joseph Sacks, LCSW

How Does Play Therapy Reduce Anxiety in Children? by Joseph Sacks, LCSW

Is your child struggling with anxiety?

Is he or she visibly tense or nervous at different times during the day?

Does he put pressure on himself to get everything perfect, and is distressed when he makes mistakes or things don’t turn out just right?

Do your efforts to get her to relax only make things worse, making you feel powerless to help her?

Do you wonder about Play Therapy and anxiety regarding your child?


Anxiety is one of the most common disorders in children, affecting over 10 percent of those under 18. Unfortunately, it can rob a child of the happiness that he or she needs so much.

The good news is that Child-Centered Play Therapy, together with Parenting Counseling, can do wonders to reduce and even resolve childhood anxiety!

I have seen it bring improvement with many children!

How does it work?

Often anxiety in children is generated by when a child, because of certain stressors in his or her life, develops feelings of shame and being in a state of low self-esteem. These feelings of low self-worth lead to anxiety in several ways. It may lead some children towards perfectionism, where the child feels badly about himself and tries to redeem himself from those feelings by creating self-imposed pressure to be very good, to have amazing performance or near-perfect output.

The underlying psychological mechanism is that the child reasons,


“Feeling so badly about myself is intolerable and I feel helpless to remedy it. What can I actively do to fix it? I know, I will be such a good boy, I will work very hard to accomplish amazing things, and then I will be so accomplished that I will be so proud that I will automatically and necessarily feel great about myself! For sure I will no longer feel badly or ashamed.” Along these lines we find the genesis of perfectionism. The problem is that such a strategy can never work, because objective external accomplishments, no matter how great, cannot defuse the cause and fuel of his low self-esteem. So often even after accomplishing much, the child still feels badly, and then resolves to strive even further towards perfection. This can create great anxiety because after all, consistent, perfect performance is impossible, and the child will inevitably almost always fall short of his desired goals, creating great fear of failure.

To learn more about treating perfectionism in teens or older children, click here.

In addition his idealizing of perfect performance leads him to judge himself very harshly when he is imperfect,

generating much shame and anxiety over being stranded in a state of low self-esteem.


Furthermore, such children may have unfortunately been criticized by people in their life, and they feel they must get everything perfect and achieve amazing things to get themselves beyond the reach of any potential criticism. This pressure generates anxiety.

To learn more about the pitfalls of criticizing children, click here.

Another common cause of anxiety is fear of reprimands and disapproval of the adults in a child’s life.

Children feel very small and powerless compared to adults and they cringe and wither under fear of reprimands, scolding, disapproval and criticism. Some children are constantly worried about not meriting enough approval and avoiding rebuke, and this generates significant anxiety. They feel pressure that they are not Ok they way they presently are, and they constantly have to measure up.

To learn more about the pitfalls of scolding and reprimands, click here.

Sometimes children learn to be anxious by example,


important people in their lives display anxiety under stress and they learn to do the same, thinking, “They get anxious when such things happen, I guess I should be anxious too!”

Anxious children often engage in something called catastrophizing, where their fears spiral out of control, “Oh no, this is going to happen and then it is going to lead to that, and then that and everything is going to fall apart and be terrible!”

However in the Playroom all of this including perfectionism, low self-esteem, shame, fear of reprimands and disapproval, an anxious example and catastrophizing all get turned around!

How does Play Therapy for anxiety work?

In the Playroom, I don’t tell the child what to do, he or she completely makes all of his own decisions and I follow him, showing great respect and validation for all of his expressed feelings, desires, decisions and needs. This gives the child an exhilarating sense of control over his own life and destiny, leading him to think, “I don’t have to be anxious that things are not going to turn out well. I have the power to make things go the way I want and need, to make things go right!” In this way, his or her anxiety gets reduced right off the bat.

Furthermore, I demonstrate for the child in the Playroom and attitude of complete acceptance, validation and non-evaluation.

In other words, no matter what the child does, I don’t judge or evaluate him, I simply reflect back a pure acceptance of how he chooses to create his own experience. This leads the child to think, “The things I do are Ok, I’m fine just the way I am.”

This all is accomplished through the curious Play Therapy for anxiety technique called tracking,


where, similar to a sportscaster describing a game, I reflect back to the child verbally every feeling or desire expressed, decision taken or accomplishment earned. For example, when a child picks up a toy to examine it, establish temporary ownership over it, and considers how he is going to play with it, this is important business for him in his world! Therefore I reflect back and enthusiastic , “Oh, now you’ve got that!” This direct, emotionally charged statement shows the child I am celebrating with him his great accomplishment of realizing and honoring his own desire, of controlling his own destiny, of putting into action his own plan to empower himself! This tracking is done constantly for every action, and the character of the verbal expression I make is personally tailored to suit perfectly each move and decision he makes. Over time it does wonders for building self-esteem, because the tracking gives him a criticism and evaluation-free opportunity to view himself in a positive light. By gaining a simple awareness of the uniqueness and special value of each individual aspect of his self as it develops in the playroom, the natural result is the conclusion that “I am doing just great the way I am. I do good things, I don’t need to worry, everything is going to be fine!”

To find out more about how Play Therapy works in general, click here.

Once a 7-year old girl was in the Playroom and a toy broke.

I didn’t try and help or control her, I let her decide what she wanted to do which was to try and fix it. I then reflected back to her a description of each step in her efforts to fix it without judging or evaluation. She eventually was successful in fixing it and exclaimed herself proudly, “I know how to fix things!” That was the creation of true self-esteem right there! Real self-esteem is esteem that needs to come from the self, not the other. If I praise and evaluate a child, she will gain unhealthy other-esteem. The goal of tracking is to get the child to evaluate him or herself, that creates true self-esteem.

For a fascinating discussion of how celebration is better than praise, click here.


Tracking reduces perfectionism,

as my constant reflection and acceptance shows the child that mediocre, less than perfect performance is just as good as better performance. He learns the beauty of the mundane, the liberation and joy of being just average. He learns that it is not objective, measurable achievement that has real value, but rather it is the honoring of his own desires, his appreciating the uniqueness of his own experience, including his moment to moment feelings and the simple everyday activities of the self, that has true value. Together with my interpersonal celebration of each decision, feeling and simple accomplishment, this greatly relieves any shame he may have been feeling, and drives up his self-confidence and self-esteem, leading him to no longer feel the pressure to achieve perfection and amazing accomplishments.

For a discussion of the benefits of Play Therapy for a child’s emotional health, click here.

Reprimands, criticism, scolding and disapproval, except in case of danger, are practically non-existent in the Playroom.

This gets the child into the habit of being so completely respected, honored, accepted and approved of, that it goes a long way to counterbalance the ill effects of any reprimands he may have received in the past. This greatly reduces his fear and anxiety regarding reprimands. In addition amazingly, it gets the child so used to being treated well that he begins to demand others also treat him likewise outside the session. Once I had an 8-year old who told his father, “Don’t talk to me that way, you need to play with me like Joseph!” The father to his credit took the hint and made changes to his son’s benefit.

99 percent of the time, no matter what the child does in the Playroom, whether he’s unsuccessful at something, accidentally breaks a toy, throws something or spills paint on the wall, my reaction is very relaxed and anxiety-free. Therefore he or she learns the great example, that many different things may happen in life, but there’s no need to get anxious, almost everything is really Ok! One time a 4-year old girl was in the car on the way to our session, and she misbehaved a bit, and her mother said, “Hey you better behave or I’m going to tell Joseph!” She responded, “Oh, Joseph, don’t worry about him, he won’t get angry, he likes me!” She had truly developed the confidence that from me she would get no problems, only good things.

This also reduces catastrophizing, as the child learns from the playroom that things generally have a positive end.

There are so many fantastic benefits of Child-Centered Play Therapy!


Not only does Play Therapy reduce anxiety, but is totally resolves behavior problems such as tantrums, anger and defiance, reduces symptoms of ADHD and even depression, and generates a wonderful parent-child relationship! In addition it is also my kind heart and all the boundless acts of kindness I bestow upon a child in the Playroom that promotes healing. It is my greatest joy to help a child!

Furthermore, I work with teachers to help reduce academic pressure coming from homework and school. I used to be a teacher and I know how to talk to them. I have gotten teachers to reduce to workload at times when necessary which reduces pressure and anxiety.

The power of Parenting!

There is much that parents can do at home to reduce anxiety in their child. The most important thing to remember is to try to not be anxious yourself, or more specifically not to express anxiety in front of the child. This prevents the child from learning an anxious reaction by example. You need to cultivate the value that “Everything is Ok just the way it is. We have no problems! Everything about you, my child, and almost everything you do is just fine!” Problems may arise, but we take them in stride! We react to them with cool, calm acceptance.

In addition, it pays to avoid criticism, reprimands, scolding and disapproval like the plague! Usually whatever benefit you hope to gain through these things is outweighed by the damage done to the child’s emotional health. It’s wiser to tolerate mischief and mistakes with a smile!


During Parenting Counseling, I gradually get to know parents and their child, and how the whole family works, and instead of giving so much direct advice, I help parents to develop their own innate wisdom which I am convinced every parent possesses. In this way I help them to develop their own personally tailored plan to resolve their child’s issue. A plan they developed themselves is one they are more likely to cherish and implement.

To find out how Parenting can help reduce ADHD symptoms, click here.

Play Therapy for anxiety, together with Parenting Counseling are the amazing double tools which can resolve almost any child’s anxiety, and most other issues as well!

To find out more about Child-Centered Play Therapy, click here.

Please be advised that the above represents a parenting ideal, and I don’t expect parents to be perfect. So have patience with yourself and try to adopt new ideas gradually.


Joseph Sacks is a child psychotherapist in lower Manhattan. He specializes in using Child-Centered Play Therapy to resolve behavior issues such as tantrums, defiance, anger and ADHD. It is amazing how well Play Therapy works to resolve these issues!

In addition Joseph helps parents to develop their own unique parenting approach to resolve their children’s issues. The parent-child relationship is the most important element in any child’s life, and by simply tuning up that relationship, we can have a tremendously beneficial effect. Joseph has written over 120 fascinating and well-researched articles on parenting and Play Therapy, which can be found at

Previous article Online Teen Safety
Next article Play Therapy Termination Activity: The Chain of Intentions by Jennifer Taylor