Sandplay therapy for people coping with negative symptoms of psychosis: a theoretically promising option

Abstract

ABSTRACT Sandplay therapy (SPT) is a promising approach to the treatment of negative psychosis symptoms, due to the psychodynamic lens it brings to both the underlying trauma and the attachment insecurity commonly associated with psychotic episodes. Additionally, SPT and other psychodynamic interventions offer a strengths-based alternative to a cognitive approach to the treatment of psychosis symptoms. Given the evidence that increasing social cognition, attachment security, and engagement with the imagination may all be associated with decreasing negative symptoms of psychosis, it is surprising that SPT, an expressive play therapy with Jungian origins, has not been tested for treatment of psychosis, even for negative symptoms, in any randomised clinical trials. Psychodynamic and cognitive perspectives on psychosis treatment are reviewed, exploring their different assumptions, and implications for direct social work practice as illustrated by a case example, are discussed.