CLINICAL EDITOR’S COMMENTS:


Including somatic interventions that promote physical movements and sensory exploration enable play


  and body underscores the necessity for strategies that engage with the body and facilitate sensorimotor processing. Somatic therapies, initially designed to treat trauma effects in adults (Levine, 2010, 2015; van der Kolk, 2014; Ogden et al., 2006) are developing approaches tailored for children and adolescents. The author’s approach incorporates two emerging therapy models designed to work at the sensory and motor levels of the brain: Sensory Motor Arousal Regulation Treatment (SMART; Warner et al., 2014, 2020), and Synergetic Play Therapy (SPT) (Dion, 2018).


Intervention strategies are most effective when they focus on and activate the brain region where the dysregulation is located (Gaskill & Brown, 2022). The symptoms that lead children to play therapy often stem from dysregulation and disorganization in the limbic and brainstem systems, which are the foundation of all higher level brain functions. The lower structures of the brain are more dominant and active in young children (Siegel & Bryson, 2011). Gaskill (2019) explains that “treatment of regulatory functions must precede cognitive functions. The low brain lacks rational, logical thought and does not understand language; therefore, somatosensory and movement  shows that motor function is intertwined with numerous other brain functions (Ratey, 2001). Therefore, somatic distress may be best addressed through body-based interventions. Sensory motor play meets young children where they are developmentally.


The playroom can be adapted to facilitate somatic regulation by including various somatic tools, with the understanding that the tools facilitate the intervention based on the trained somatic play therapist‘s knowledge. Equipment typically found in occupational therapy rooms (weighted blankets, body socks, large physioballs),    a fabric hammock swing can be integrated into somatic informed play therapy. The clinical vignette below describes a play therapy process involving somatic interventions and sensory-motor play to work through shame-based behavioral dysregulation, and illustrates principles and practices for working more directly with “embodied 


Whole Body Play with Tom (pseudonym) Clinical Vignette Tom, age 7.5, came to play therapy due to emotional outbursts         Tom would verbally lash out at his parents and younger sister. His parents worried about his physical safety. Tom had trouble sleeping, was described as having a short fuse, and often verbalized feeling bad, wrong, and not deserving of good things.


therapists to work directly work with the somatic narrative and meet the child in their own developmental space.


First Session:  sits in a chair with his back to the toys and equipment. Tom’s posture is slumped, with a collapsed chest, his chin tucked and eyes peering up over his Covid face mask. Quietly and meekly, he asks, “Do you  shallow breath as my body resonates with Tom’s emotional state. Slowly and without words, I gently roll a large physioball to him, offering a body-based action to help him regulate his shut down, collapsed and hypoaroused nervous system. Tom talks about the stress of the last 18 months due to the Covid-19 pandemic. He tells   challenges he experiences.


Second Session: Tom’s posture remains collapsed and slumped.  strategies? Before I can offer a strategy, he says, “Maybe I can use  is isolated and alone.


Third Session:       drooping in defeat. He plays in the sand with rakes, funnels, and shovels, steadily manipulating the sand and gaining access to soothing actions on a sensory level while expressing his feelings through words and play.


Fourth & Fifth Sessions: Tom’s sadness and discouragement      energy in his voice and actions. Earnestly he asks, “Can you give  moves to the sand tray and says, “I’m going to show you and use    tells me to guess which label goes with which pile. I get it wrong    with moving the sand with the sand tools.


www.a4pt.org | March 2025 | PLAYTHERAPY | 21


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