Sandplay

sandplay therapy

Sandplay therapy occupies a distinctive and contested position within the depth-psychology corpus. Founded by Dora Kalff on Jungian and psychodynamic foundations, and tracing its lineage through Margaret Lowenfeld’s World Technique, sandplay invites clients to construct three-dimensional scenes in a sand-filled tray using miniature figures — a process understood to access unconscious material through nonverbal, symbolic, and multisensory means. The corpus reveals a field negotiating several productive tensions. The first concerns theoretical heritage: the Kalffian insistence on a nondirective, noninterpretive stance — preserving what Kalff termed the ‘free and protected space’ — stands in productive friction with Kleinian interpretive traditions and more directive sandtray variants. The second tension is empirical: Roesler (2019) and Wiersma et al. (2022) together represent a sustained drive to establish sandplay’s evidence base across international populations, with meta-analytic effect sizes comparable to established psychodynamic therapies, while simultaneously acknowledging that symptom-focused outcome measures cannot fully capture the individuation-oriented depth work the method claims to perform. A third tension is cross-cultural: the remarkable growth of sandplay in East Asia, particularly China, South Korea, and Japan, raises questions about theoretical translation and methodological consistency. Running through all these debates is the conviction — shared across the corpus — that sandplay’s power resides precisely in its nonverbal, embodied engagement with the unconscious.

In the library 18 passages

Sandplay therapy is a cross-cultural, psychodynamic, nondirective, multisensory psychotherapy method founded by Dora Kalff. Sandplay is used with children and adults with a range of mental health problems.

This passage establishes sandplay’s foundational identity as a Kalff-founded, cross-cultural psychodynamic method and frames the meta-analytic project as a necessary intervention into its underdeveloped empirical evidence base.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022thesis

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Sandplay Therapy (SPT) is a psychotherapy method utilized worldwide, not only in Western countries, but also in Asia and Latin America with an extensive increase in growth over the past 15 years. The nonverbal approach of SPT is especially applicable in working with children, and with adults with trauma, distress, disabilities, and migration issues.

Roesler’s overview positions sandplay as a globally expanding nonverbal modality with specific clinical applicability, grounding the subsequent synthesis of theory, practice, and empirical evidence.

Roesler, Christian, Sandplay therapy: An overview of theory, applications and evidence base, 2019thesis

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With a foundation in Jungian and psychodynamic theories, sandplay has emerged with a specific treatment protocol that emphasizes a nondirective, noninterpretive approach that can tap into unconscious processes.

This passage defines the essential clinical and theoretical distinction between sandplay and related methods, locating sandplay’s specificity in its Jungian-grounded nondirective protocol.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022thesis

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The overall results of this study show a large composite effect size of g = 1.10, favoring sandplay therapy treatment over controls. These results are consistent with the meta-analysis of South Korean sandplay therapy studies.

The meta-analysis establishes sandplay’s large composite effect size across international studies, positioning it empirically alongside established psychodynamic therapies.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022thesis

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This meta-analysis included 40 studies from eight countries representing 1,284 participants, demonstrating uniformly positive findings for sandplay treatment with many different populations and across diverse practice settings.

The conclusion of Wiersma et al. formally establishes sandplay as an evidence-based treatment, grounding this claim in the breadth and consistency of an international quantitative literature.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022thesis

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The sandplay process thus provides the conscious personality with means to address conflicts, traumas, losses, etc., as well as the psychic content necessary to further personality development.

Roesler articulates sandplay’s dual therapeutic function: the amelioration of presenting symptoms and the facilitation of deeper personality development through access to psychic content.

Roesler, Christian, Sandplay therapy: An overview of theory, applications and evidence base, 2019thesis

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Two opposing viewpoints became visible, one emphasizing the importance of frequent interpretation, the other emphasizing the therapeutic power of play in itself without the necessity of interpretation.

Roesler historicizes the foundational theoretical tension within play-based therapies — between Kleinian interpretation and Winnicottian play-as-treatment — that sandplay inherited and resolved through its noninterpretive protocol.

Roesler, Christian, Sandplay therapy: An overview of theory, applications and evidence base, 2019supporting

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It is a key assumption of sandplay therapy that further sessions invite increased access to the unconscious, thereby stimulating the individuation process.

Wiersma et al. identify individuation as sandplay’s deeper teleological aim, noting the inadequacy of symptom-based outcome measures to capture the full depth of the method.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022supporting

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Whether in the practice of Active Imagination or in sandplay, this phase consists of a retrospective conscious reflection on the experience.

Pattis Zoja, in Tozzi’s volume, explicitly aligns sandplay with Active Imagination by locating both within the same four-phase Jungian schema, particularly the final phase of ethical-conscious reflection.

Tozzi, Chiara, Active Imagination in Theory, Practice and Training, 2017supporting

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Recent developments combine the classical approach of SPT with narrative techniques or other art therapy methods and extend the use of SPT, e.g. to the work with couples and families.

Roesler maps the current diversification of sandplay practice, including integration with neuroscience models, narrative therapy, and community trauma work, signaling the field’s theoretical expansion beyond its Kalffian origins.

Roesler, Christian, Sandplay therapy: An overview of theory, applications and evidence base, 2019supporting

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The SCC covers three essential aspects of sandplay: (a) the thematic content of the scene and the process involved in creating it, (b) the creator’s personal story and descriptive words, and (c) the progressive or regressive changes that occur from one scene to the next.

Roesler details the Sandplay Content and Communication instrument, illustrating how systematic coding tools have been developed to render sandplay’s symbolic and processual dimensions amenable to empirical study.

Roesler, Christian, Sandplay therapy: An overview of theory, applications and evidence base, 2019supporting

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A large effect size (g = 1.089) was found with the most improvement noted when sandplay was conducted in an individual format, twice per week, and with sessions lasting 50–60 min.

The South Korean meta-analysis data, cited here, introduces moderator variables — session frequency, format, and duration — as key determinants of sandplay outcome, shaping the methodology of the international study.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022supporting

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A wide range of child and adolescent mental health problems were treated, including behavioral problems, low self-esteem, trauma, substance abuse and anxiety. All of the studies found significant improvements.

Roesler’s effectiveness review demonstrates sandplay’s broad applicability across child and adolescent psychopathology, with uniform significant improvements across studies irrespective of diagnostic category.

Roesler, Christian, Sandplay therapy: An overview of theory, applications and evidence base, 2019supporting

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Therapy sessions were conducted using primarily a nondirective and noninterpretive stance by the therapist. Each participant made their own picture in their own sand tray regardless of whether the therapy took place in an individual or group format.

Wiersma et al. operationalize the nondirective, noninterpretive stance as a methodological inclusion criterion, ensuring fidelity to the Kalffian protocol across the studies admitted to the meta-analysis.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022supporting

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In order to capture the depth of the sandplay method, to expand its theoretical base, and to inform future research, we recommend continued qualitative inquiry, including exploration of the lived experiences of clients who engage in sandplay therapy.

Wiersma et al. conclude by explicitly acknowledging that quantitative outcome measures cannot exhaust sandplay’s depth, calling for qualitative and theoretical inquiry to complement the empirical evidence base.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022supporting

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Wang and Zhang (2015) China Int PSQ-anx; SAS; SDS 1.94 150 Cerebral palsy RCT TAU Child Ind 36 Clinic Other

This data table documents notably large effect sizes for sandplay with cerebral palsy and ADHD populations in China, illustrating both the method’s expansion into neurological conditions and the dominance of Asian RCT research in the evidence base.

Wiersma, Jacquelyn K., A Meta-Analysis of Sandplay Therapy Treatment Outcomes, 2022aside

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