Theraplay® for selective mutism and other parenting challenges

I’d found out today that my blog was linked to a blog of a parent in Sweden who has a child with selective mutism.  I used Google’s Chrome browser which has a nifty little ‘translate page’ button, otherwise I would not have known what the page was about, and I’m so appreciative that I was linked to that blog and that I was able to find a really interesting resource, which is, incidentally, not terribly far from my home. I find it amusing that I have found a relatively local resource by visiting a Swedish blog.

I clicked on a resource link on a type of therapy called Theraplay®.  When I opened it up, I was intrigued by the concept and the goals:

Theraplay activities aim at creating a feeling of closeness between the child and parent, which is attained through activities in which the child experiences the adult as creating the structure (the rules, etc.) and also nurturing the child. The goal of therapy is that the child be more at ease with adults and other children, have less of a need to stay in charge, and be more spontaneously able to experience and express her feelings.

Sometimes I feel helpless to deal with my children’s challenges.  There seems to have been always something going on:  high sensitivity, anxiety, clinging behaviors, selective mutism, meltdowns/tantrums, bossing/controlling type behaviors.

I’ve been very depleted from their emotional meltdowns/outbursts.   My 7.5 year old middle child is the one who had selective mutism, and still can be the most demanding, disruptive and controlling, though my 6 year old youngest daughter is reacting to frustrations in some of similar ways.   I have to say, I have felt like a failure many days.  I have felt really depressed sometimes too.

I took one of my fellow bloggers advice and started taking seriously the idea of adrenal fatigue.  I am taking vitamin and herbal supplements to help with elevating my mood and energy levels, and I’ve been feeling a lot better lately, more resilient overall, which is a definite plus.

But, I’m still considering child/family therapy because I feel that my children need some help managing their emotional landscape.  I’ve not done a very good job of helping them for many reasons: because they have always had unusually high needs (cranky, demanding, prone to melt down/explode when frustrated), from infancy onward; because I lacked a safe, nurturing relationship to a parent in my own childhood (I lacked a good working model of how to nurture and how much); because I was very overwhelmed with mothering three closely spaced ‘high needs’ girls; and because it was hard to maintain a continuous fountain of nurturing interactions when I was exhausted and dancing on the border of depression all the time (which really wasn’t true depression, but I’m pretty sure my hashimoto’s thyroiditis was wreaking more havoc than I cared to admit).

At any rate, I was intrigued about this program and wanted to find out more.

From their Theraplay Treatment Protocol page, I got a little bit of information regarding how it works:

Theraplay® is a structured play therapy for children and their parents. Its goal is to enhance attachment, self-esteem, trust in others and joyful engagement. The method is fun, physical, personal and interactive and replicates the natural, healthy interaction between parents and young children. Children have been referred for a wide variety of problems including withdrawn or depressed behavior, overactive-aggressive behavior, temper tantrums, phobias, and difficulty socializing and making friends. Children also are referred for various behavior and interpersonal problems resulting from learning disabilities, developmental delays, and pervasive developmental disorders. Because of its focus on attachment and relationship development, Theraplay has been used successfully for many years with foster and adoptive families…

In planning for treatment, it is useful to think of the activities that characterize the healthy relationship as falling into four dimensions:


The therapist selects and leads the activities (but always remains attuned to the child’s reaction). The fact that the adult is in charge is reassuring, helping the child to develop self-control, and assuring the child of order if the environment is unruly or chaotic. Thus structure addresses both inner and outer disorder. It is especially useful for children who are overactive, undirected, overstimulated, or who want to be in control.


Engaging activities offer pleasant stimulation, variety, and a fresh view of life, allowing a child to understand that surprises can be fun and new experiences enjoyable. The child is focused on in an intensive, personal way in order to make a connection with the child. Engagement is necessary for all children, but is especially appropriate for children who are withdrawn, avoidant of contact, or too rigidly structured. Very withdrawn or autistic children may experience engagement as uncomfortable. In response, the therapist slows the pace and monitors stimulation, but still attempts to entice the child into a relationship.


Soothing, calming, quieting, caretaking activities make the world feel safe, predictable, warm and secure. They also reassure the child that the adult can provide comfort and stability. Nurturing meets the child’s unfulfilled younger needs; helps the child to be able to relax and allow herself to be taken care of; builds the inner representation that the child is lovable and valued. It is especially useful for children who are overactive, aggressive, or pseudo-mature.


Challenging activities help the child take a mild, age-appropriate risk, and promote feelings of competence and confidence. They are fun, are not done alone, and are cooperative rather than competitive. Challenging activities are especially useful for withdrawn, timid, or rigid children.

There is an article in their newsletter article page called Theraplay® with Children with Selective Mutism by Amy Farmer, LCPC, RPT who wrote about treating 5 year old twins with selective mutism using Theraplay®:

In summary, the eleven sessions of Theraplay served as an effective intervention for the treatment of Selective Mutism. The treatment focused on relationship development through experiencing reciprocity, positive attention, joy, and surprise non-verbally. The activities also offered emotional catharsis through laughter and physical activity, success through completion and winning, relaxation, and opportunity for self regulation. By refraining from requirements to relinquish silence in order to engage in relationship and fun, the treatment did not
reinforce the anxiety and oppositional components of Selective Mutism. Once the children experienced confidence and joy in relating, verbal communication emerged as one of many ways of relating to others.

I really like this program’s focus. I really like that it’s based in Attachment Theory, on subject that’s been on my mind since my girls infancy, as I struggled with my own attachment issues stemming from my childhood. I really like their STATEMENT ABOUT THE USE OF TOUCH IN THERAPLAY TREATMENT which contains four different elements of touch: structuring, engaging, nurturing, and calming/containing (which is NOT a “holding therapy”, but a way to respond to a highly dysregulated child).

I really am thinking that this program is highly useful for teaching parents how to solve many childhood behavioral challenges in a very positive, gentle, adult-directed manner that will not just solve individual problems but create a whole new, positive parent-child relationship and instill a sense of safety and confidence that children can build upon their entire lives.  I see how that might be good not just for the child with emotional self-regulation issues, but a way to teach the under-nurtured parent how to be a nurturer for their own children.

I wanted to share this resource with other parents who are looking for hands-on, nurturing approaches to helping their children develop healthy responses to everyday challenges.

This entry was posted in anxiety, Attachment Parenting, creating harmony, emotion coaching, explosive child, highly sensitive child, highly sensitive mom, Intensity, meltdowns, selective mutism, social anxiety, spd, trauma. Bookmark the permalink.

6 Responses to Theraplay® for selective mutism and other parenting challenges

  1. Linda says:

    I am so glad my blog could give some inspiration! I have visited your blog every now and then and will keep on doing so. Unfortunately there is very little info on selective mutism in Scandinavia, so I gather most of my info from resources in English. Theraplay was however introduced to us by our therapist and we have been going for about a year now. It hasn’t effected the selective mutism much, but it has probably has other positive effects on our son (and our family). And our son has loved the sessions! Good luck with your work!

  2. raisingsmartgirls says:

    Thank you, Linda.

    I wish that it was more helpful for your son’s selective mutism. It sounds like such a wonderful program. I think as every child is unique, not every SM child will respond in the same manner to a therapeutic approach. This therapy sounded so promising to me.

    I know that, for my daughter’s case, things that we did outside the classroom weren’t enough to help her inside the classroom, that there had to be direct intervention inside the classroom. And even though she was speaking in one of her classrooms (the early intervention classroom where the intervention was taking place), the progress she made there didn’t transfer over to her community preschool, not until she had her early intervention teacher classroom pay a visit to the community preschool and spend some time there. Once that happened, it caused a ‘breakthrough’. It was like a small miracle. That happened about 18 months after diagnosis.

    I can send you a copy of a selective mutism intervention presentation that my daughters early intervention team attended. Perhaps there are some ideas in there that might help your son.

    Best wishes to you and your son.

  3. Linda says:

    I’d love to receive a copy of the intevention presentation for your daughter’s intervention! My son is starting school in August and we are right now planning for what measures to take to maximize the chances of him feeling secure enough to start communication with his teachers (he has not said a word to the staff at his kindergarten for four years, we are however we are extremely happy about the fact that he speaks with his friends). We have not been able to find anyone (with experience from SM) who has been able to help us with pratical programs for kindergarten and school, so I am of course searching the net and reading everything I can find myself. Your info would be much appreciated!
    You are so right about all children with SM are different and will react differently. We have really enjoyed theraplay so I hope it will work for you and your girls!

  4. raisingsmartgirls says:


    I sent you an email with the presentation. Best of luck to you and your son!

    I’ll be back….I’m off to get some lunch.


  5. gabriella says:

    I’m working with a boy with selective mutism and search all possible information – could you think of sending the presentation also to me? Would be really grateful! Best wishes!

  6. Belinda says:

    Hi, I have a granddaughter (6,5) who is also diagnosed with SM. I would like to have a copy of the presentation as well, so I can show it to my son and his wife. Thanks so much.

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