A Meta-Analysis of Sandplay Therapy Treatment Outcomes

A Meta-Analysis of Sandplay Therapy Treatment Outcomes is a work by Jacquelyn K. Wiersma (2022).

Core claims

• Wiersma and colleagues conduct the first formal meta-analysis of sandplay therapy outcomes, finding a moderate-to-large overall effect size (g = 0.62) across studies — establishing sandplay as an empirically supported modality rather than a purely experiential or intuitive practice.
• The meta-analysis reveals that sandplay produces its strongest effects for internalizing problems (anxiety, depression, withdrawal) and trauma-related conditions, with comparatively smaller effects for externalizing problems — a pattern consistent with the modality’s theoretical emphasis on accessing and integrating unconscious material.
• The paper identifies methodological limitations in the existing literature — small sample sizes, lack of control groups, heterogeneous outcome measures — and provides a research agenda for strengthening sandplay’s evidence base without compromising the clinical qualities that make it therapeutically distinctive.

Related questions

• Does the finding that sandplay excels with internalizing conditions support the hypothesis that its mechanism of action is specifically the externalization of internal states — giving three-dimensional form to what had been trapped in the body or the unconscious?
• How should the sandplay community balance the demand for randomized controlled trials with the clinical reality that sandplay’s therapeutic potency may depend on precisely the non-manualized, relationally attuned conditions that RCT methodology seeks to eliminate?

See also

• Library page: /library/the-clinic/wiersma-meta-analysis-sandplay-therapy/

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