Sandtray Therapy Research Articles

The Emergence of Acceptance and Commitment Sandtray Therapy: A Novel Framework

This paper introduces Acceptance and Commitment Sandtray Therapy (ACST) as a new branch of sand therapy theory. As a novel framework, it offers a fresh approach to conducting sandtray therapy and provides additional avenues for pursuing research. The creation and articulation of ACST is an evolution of my unique experience as an enthusiastic and dedicated student of both Acceptance and Commitment Therapy (ACT) and Sandtray Therapy (STT). Part of this article’s purpose is to introduce ACT’s foundational philosophy and theory. I achieve this by briefly describing radical behaviorism, functional contextualism, and relational frame theory. However, the primary focus of this paper is to highlight the six core psychological processes used in ACST and provide an example using a fictitious client’s tray with those processes in mind. Suggested protocols for implementing this framework, along with therapeutic interventional prompts appropriate for its application, are also offered. This work is significant in that it bridges two worlds: the contextual behavioral science realm of ACT and the interpersonal neurobiology domain of STT. With the emergence of this new model, new possibilities are on the horizon for both professional communities.

A Comparison of Traditional Talk Therapy and Experiential Sandtray Approaches in Counselors in Training

This study explored the comparative effects of traditional talk therapy (control group) and sandtray therapy (experiential group) on group dynamics within a true experimental design. Utilizing the Group Climate Questionnaire-Short Form (GCQ-S), we measured engagement, conflict, and avoidance among master’s level counseling students. Findings revealed a significant interaction between therapy type and time on the engagement subscale, with participants in the experiential group experiencing greater increases in engagement over time. These results underscore the potential of expressive modalities in altering group dynamics and enhancing the effectiveness of group therapy in counselor education.

Sandtray Therapy’s Impact on Trauma Symptoms in Adults

ABSTRACT Adults exposed to trauma report symptoms that harm their emotional and behavioral health affecting their functioning for a prolonged period. Creative interventions have been suggested as a unique expressive approach to assist adults with trauma symptoms. Sandtray therapy is one such technique; however, there is limited literature showcasing the effectiveness of the technique when working with adults with trauma symptoms. In this article, we assess the effectiveness of sandtray therapy on trauma symptoms for five adults with trauma exposures, using an A-B-A single-case research design. Participants completed seven to nine, 50-minute sandtray therapy sessions throughout the study. Results showed a decrease in trauma symptoms for four of the five participants. Thus, sandtray therapy could be an effective intervention for counselors to use with adults with trauma symptoms.

The Embodied Process in Gestalt Sandtray

Gestalt therapy is a dynamic, relational therapy emphasizing embodiment, curiosity, and awareness. This article explores the application of sandtray therapy through a Gestalt therapy framework. Centered around the theoretical principles of embodiment, curiosity, and awareness, this article highlights the importance of the therapeutic use of self and the person-of-the-sandtray-therapist (POST). Special consideration is given to the embodied process as a foundational element for facilitating the Gestalt therapy and Gestalt sandtray process. Gestalt sandtray principles are applied through a case study to illustrate the process, the experience of the therapist (POST), and the builder's reaction.

Using Sand Tray Therapy with Individuals Diagnosed with Alzheimer's Disease

It has been reported that the mental health needs of the aging U.S. population are historically underserved by the counseling profession. In response, this qualitative research investigated the impact of sandtray therapy on individuals diagnosed with Alzheimer's disease. Participants successfully completed the creation of sandtrays while the researcher observed, interviewed, and documented the individual sandtray creations. The researcher, also the sandtray therapist providing the intervention, had nearly seven years of experience working in a private practice setting using sandtray therapy. The sand tray therapist has completed multiple trainings in the modality, including multiple week-long experiences in Adlerian sandtray therapy with Dr. Terry Kottman. Dr. Kottman also consulted on this research and assisted in evaluating the clients' sandtrays. The intervention established that using the sand tray allows the dementia patient to kinesthetically connect to their inner cognitions through the intentional symbolic expression offered by this unique therapeutic medium. Using a series of eight sand trays of varying thematic concepts, the participants were offered a modality to facilitate a synthesization of their continued individuation, presenting a possible neural pathway to connect and express thoughts, feelings, emotions, concerns, challenges, and fears. The findings of this study include the fact that all trays were classified as "empty" and that the majority of the participants placed objects almost exclusively on the right side of the tray, which is commonly associated with the concrete or conscious side. The use of sandtray allowed each individual the opportunity to create autobiographies in the sand and literally navigate through time – past, present, and future, confronting fears, expressing hope and possibilities. The research study results offer insight into the psychotherapeutic effects of using sandtray therapy with dementia patients, as well as a better understanding of the cognitive and expressive abilities and limitations of an individual with impaired memory. The results also offer insight into this population's difficulties with short-term memory and possibly indicate a potential means for monitoring cognitive decline.

SPECIAL ISSUE

Steve Armstrong (1952 – 2022) was a counselor, professor, author, colleague, and friend to many around the world. He died a year ago, July 8, 2022. His groundbreaking work, Humanistic Sandtray Therapy (HST), further established by his book Sandtray Therapy, A Humanistic Approach (2008), made him a key figure and leader in the sand therapy world.
 This issue is dedicated to the memory of his work and that man who created it.

Humanistic Sandtray Therapy: Theoretical Underpinnings and Practical Applications

Multiple models of sand therapies have emerged since Margaret Lowenfeld (2007) first described her world technique. Although sandplay has an identifiable theoretical rationale and system for its application based on Dora Kalff’s (1980) original description, the same cannot be said for sandtray therapy approaches. In this article, I review humanistic sandtray therapy, a model grounded in person-centered and Gestalt theories and unique in its purposeful implementation of attitudes, skills, and techniques associated with humanistic approaches.

Coping with Pregnancy Loss through Sandtray Therapy

This case study explores the use of sandtray therapy interventions with an adult that experienced pregnancy loss. A description of the case will discuss how the use of the sand tray facilitated a client's processing of trauma and grief in the aftermath of an early pregnancy loss, becoming pregnant again, and coping with a new pregnancy after loss. Illustrations of the sand tray setup, prompts, themes, and processing questions will be provided.

Effect of non-pharmacological treatment on the full recovery of social functioning in patients with attention deficit hyperactivity disorder

Long-term treatment of attention deficit/hyperactivity disorder (ADHD) is associated with adverse events, such as nausea and vomiting, dizziness, and sleep disturbances, and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients' social functioning. To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD. A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group (methylphenidate hydrochloride and tomoxetine hydrochloride) or the non-pharmacological group (parental training, behavior modification, sensory integration therapy, and sand tray therapy), with 45 cases in each group. Outcome measures included treatment compliance, Swanson, Nolan, and Pelham, Version IV (SNAP-IV) scores, Conners Parent Symptom Questionnaire (PSQ) scores, and Weiss Functional Impairment Rating Scale (WFIRS) scores. The non-pharmacological interventions resulted in significantly higher compliance in patients (95.56%) compared with medication (71.11%) (P < 0.05). However, no significant differences in SNAP-IV and PSQ scores, in addition to the learning/school, social activities, and adventure activities of the WFIRS scores were observed between the two groups (P > 0.05). Patients with non-pharmacological interventions showed higher WFIRS scores for family, daily life skills, and self-concept than those in the pharmacological group (P < 0.05). Non-pharmacological interventions, in contrast to the potential risks of adverse events after long-term medication, improve patient treatment compliance, alleviate patients' behavioral symptoms of attention, impulsivity, and hyperactivity, and improve their cognitive ability, thereby improving family relationships and patient self-evaluation.

Editor's Commentary

The month's issue shares information about the ACA Research Award for Ching-Yi Kao's sandtray therapy research with older Asian participants. Also, a discussion of Gisela De Domenico's Sandtray-WorldplayTM.

Adlerian Applications of Sandtray Play Therapy

Abstract Adlerian applications of sandtray play therapy is one strategy used by play therapists who practice Adlerian play therapy. Adlerians use a plethora of different kinds of sand trays: spontaneous, non-directed, semi-directed, directed, quasi-directed, therapist-created, and co-created trays with child, adolescents, and adult clients, as well as with families and in parent and teacher consultation. While there is a general guideline of 7 steps in Adlerian sand tray play therapy sessions, therapists can use their own creativity and flexibility to adjust this process based on the needs of individual clients and their treatment plan for working with them. Adlerian play therapists use sandtray therapy in all four phases of therapy: building the relationship, exploring clients' lifestyles, helping clients gain insight into their lifestyles, and reorienting/re-educating clients by facilitating changes in behavior, emotions, and cognitions.

Editor's Commentary

This is the Editor's Commentary on Adlerian Sandtray Therapy as linked to the featured article by Terry Kottman.

VISIÓN BIBLIOGRÁFICA: Terapia Avanzada de la Caja de Arena

This is a review of the Spanish translation of a book first published in English: Advanced Sandtray Therapy: Digging Deeper into Clinical Practice. The review is written by the translator, José Luis Gonzalo Marrodán. The review appears first in Spanish, then in English.

The Embodied Brain and Sandtray Therapy: Stories of Healing and Transformation

This is a book review.

Counseling Mexican American Men Struggling with Paternal Postpartum Depression

Postpartum depression is generally attributed to women after bearing children. However, several studies have indicated that men face a similar condition after the birth of a child. About 10% of men experience paternal postpartum depression. Although this percentage reflects Caucasian men’s experience, studies have found Mexican American men experiencing paternal postpartum depression (PPD), too. This conceptual article addresses critical cultural aspects to consider when counseling Mexican American men struggling with PPD by providing a case study with implications for a counselor to consider when counseling Mexican American men struggling with PPD. In this manuscript, Sandtray therapy was used as an intervention to facilitate the client’s understanding of self, the surroundings, and certain parts of reality.

가정폭력 경험 청소년의 정서안정을 위한 모래상자치료 사례연구

This is a case study of sandtray therapy on an adolescent domestic violence. The subject of this study is a single case of using sandbox therapy for middle school girl. The cases of this study consisted of 30 sessions, and a total of 30 sessions were conducted once a week for 50 minutes from August 13, 2020 to May 10, 2021. At first, the study participant showed acute depression and emotional instability, and substantial anger and distrust made her want to repudiate her father. At school, she had heavy conflict with her teacher and was unfulfilling in her academic achievement. As she got the constant sandtray therapy, however, she broken out of her closure in the dark, getting brighter and more cheerful personality, as well as more active and positive thoughts rather than the negative ones from distorted cognition. Later on, she could decide what career to take and became highly passionate in her studies, to acquiring various certifications about computer. In conclusion, the depression and anxiety that I had in the past decreased, and emotional stability improved, and interpersonal relationships were smooth.

Transformation Hidden in the Sand; a Pluralistic Theoretical Framework Using Sand-Tray with Adult Clients

ABSTRACT Jungian sandplay predominates the existing literature on sand-tray therapy. Although there is a small volume of literature on alternative approaches of using sand-tray with adults, most primarily focuses on children and adolescents. The study aimed to establish a sand-tray therapy framework to be utilized by practitioners who are not Jungian trained and intend to use this intervention with adult clients. The grounded theory multiple case study involved six client-participants receiving six sand-tray therapy sessions. The pluralistic model established incorporates inter-relational and intra-psychic dimensions. Concepts include phenomenological shift and two sand-tray specific mechanisms of phenomenological anchor and phenomenological hook, aiding ‘edge of awareness’ and unconscious processing. In this study, pluralistic sand-tray therapy was deemed successful based on improved CORE-10 clinical scores and the various participant feedback collected.

Sandtray Therapy for Cancer Patients, Survivors, and Family Members

Over one million survivors have lived more than 25 years after receiving a cancer diagnosis. Researchers proposed employing sandtray therapy as an effective means of exploring the lived experience of cancer patients, survivors, and family members. Three of five support group members participated in the research study. Sandtray therapy provided the participants with the power to increase their understanding about themselves, in addition to experiencing the resilience of achieving wellness. Participants used sandtrays to depict their lived experience, discover essential phenomena, and explore resilience.

How Sand Tray Therapy Help in Overcoming Various Mental Disorders

How Sand Tray Therapy Help in Overcoming Various Mental Disorders

“Your Exile is Showing”: Integrating Sandtray with Internal Family Systems Therapy

Internal family systems (IFS) therapy is an experiential model of therapy and views individuals as having numerous “parts” inside of them. These parts maintain a specific role in a client’s life and fall under one of the three categories – managers, exiles, and firefighters. Due to the experiential aspect of IFS and the concept of blending, visualizing the parts inside of a client can become challenging at best and impossible, at worst. This article provides a framework for integrating sandtray therapy with IFS to help clients name, visualize, and see the progress of their parts.