Sandplay Therapy Study: A Prospective Outcome Study of Sandplay Therapy with Children and Adolescents

Alexander von Gontard

Abstract

Sandplay therapy is a versatile Jungian psychotherapy suitable for all ages. As the effectiveness has not been analyzed systematically so far, a prospective, open, manualized study over one year with three assessment points (0, 6, and 12 months) was conducted. The instruments included ICD-10 diagnoses, the CBCL (Child Behavior Checklist), and standardized sandtray assessment forms. It was hypothesized that internalizing symptoms would show the greatest reduction. Exploratory and descriptive analyses were also conducted. Fifty-six predominantly middle-class children and adolescents aged 5 to 18 years (median age 10 years) were enrolled. Internalizing ICD-10 disorders predominated, with a high comorbidity rate of multiple disorders. Over the year of therapy, the sandtrays became more centered; the atmosphere was more balanced and less threatening. There was less talking and more silence during the sessions. In the CBCL, a highly significant reduction of total and internalizing behavior occurred, with a significant decrease also of the externalizing symptom scores. Exploratory analyses showed that major changes took place in the first half of the year. In conclusion, sandplay therapy proved to be a highly effective Jungian approach for children and adolescents with internalizing disorders. A randomized-controlled study is planned.

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