What a Child Client Taught Me About Play Therapy, Patience and Advocacy

Over the years, I have had the privilege of working alongside many children and families through play therapy.

Some children have entered my therapy room for only a brief period. Other children have stayed for much longer.

I have worked with some children across many months and through significant periods of change. I have witnessed their joy, uncertainty, frustration, courage and growth. I have sat alongside them as they navigated changes in their families, disruptions to their sense of safety, developmental transitions and experiences that were much bigger than the words they had available to describe them.

No two therapeutic relationships have been the same.

Each child arrives with their own way of understanding the world. They bring their own temperament, developmental needs, culture, family relationships, strengths, fears and ways of communicating. Some children enter the playroom with curiosity and begin exploring immediately. Others move slowly, watching carefully before deciding whether the space, and the person within it, feels safe enough.

As therapists, we often enter this work with considerable knowledge.

We bring our training, theoretical frameworks, ethical responsibilities, clinical skills and growing understanding of child development, trauma, attachment and family systems. We may have spent years learning how to structure a therapeutic space, respond empathically, set limits, support caregivers and recognise themes within children’s play.

Yet children continue to remind us that professional knowledge is only one part of the therapeutic relationship.

The child in front of us also holds knowledge.

They know what the therapy room feels like from their side of the relationship or when an explanation has made sense and when it has not. They know when they feel included in decisions and when adults appear to be making decisions around them. They know when they need more time, more predictability, more honesty or more space.

When we are willing to remain curious, children can become some of our most important teachers.

They can show us where our processes are not as child-friendly as we believed. They can reveal the difference between offering a service to a child and truly including that child in the therapeutic process. They can challenge our assumptions about progress, readiness and what meaningful change should look like. They can also teach us about ourselves.

Every child I have worked with has taught me something.

Some have deepened my understanding of play and symbolic communication. Others have taught me about resilience, grief, trust or the complexity of living within systems that do not always respond in child-centred ways. Others have helped me recognise areas of my own practice that needed to change.

The child I am dedicating this blog post to, did all of these things.

For privacy, I will call them *River.

Meeting River

I worked with River for approximately 18 months. Their parents initially sought support because they wanted River to have a safe space to express their feelings and strengthen their capacity to navigate anxiety.

Across those 18 months, we experienced many highs and lows together. River moved through natural life transitions, changes within their family and the emotional impacts of crime and other difficult experiences.

Using Child-Centred Play Therapy, I watched River explore these experiences in ways that made sense to them.

Rather than relying only on words, River used play, creativity, metaphor, movement and relationship to communicate and make meaning of what was happening in their world. Their play was not always easy to understand. Progress was not always linear or immediately visible.

There were times when I felt confident in the therapeutic process and times when I questioned myself deeply.

River showed me that some of the practices I believed were child-friendly were not yet child-friendly enough. They reminded me that a child can participate in therapy without necessarily understanding why they are there. They taught me that patience requires more than simply waiting and that advocating for a child can mean holding steady when adults and systems are seeking faster answers.

Most importantly, River reminded me that children do not simply receive therapy from us.

They shape the work. They influence the therapists we become.

The lessons River taught me have continued to shape how I explain play therapy to children, approach informed consent, collaborate with parents and advocate for a child’s pace within the therapeutic process. I share more about these lessons below.

Lesson One: Children Need Child-Friendly Explanations of Play Therapy

River was one of the first children I worked with who, with the support of their parent, offered me clear and constructive feedback about the therapy process.

They needed to better understand what play therapy was and why they were coming to see me.

River was a concrete thinker. My usual response, ‘that can be whatever you want it to be,’ didn’t fly. They were a child who needed to know exactly what something was before they could access their imagination and creativity. Through their feedback, they helped me recognise that play therapy can be an abstract and confusing concept for children.

Adults may understand that play is a child’s natural language and that toys can become their words. A child, however, may simply know that they have been brought into an unfamiliar room with an unfamiliar adult and told that they can play.

Without a clear explanation, a child may wonder:

Why am I here?

Am I in trouble?

Is there something wrong with me?

Am I supposed to play in a particular way?

What does the therapist want me to do?

River needed us to dedicate time to answering these questions.

They needed a whole session to understand what play therapy involved, what the therapy room was for and what my role would be. Importantly, they needed reassurance that coming to therapy did not mean they were at fault, broken or in need of being fixed.

This experience encouraged me to reflect more deeply on informed consent in child therapy.

Children may not hold the legal responsibility for consenting to therapy, but they still have a right to be included in conversations about what is happening to them. They deserve information that is developmentally appropriate, transparent and accessible.

Child-friendly therapeutic practice means doing more than explaining the process once during the first session. It means continuing to check a child’s understanding, inviting questions and making space for uncertainty, hesitation or disagreement.

Based on River’s feedback, I developed child-friendly handouts explaining:

• what play therapy is

• what happens in a play therapy session

• why children may come to therapy

• what the therapist’s role is

• what choices the child has within the therapy space

• the limits of confidentiality and what may need to be shared with adults

I also created resources to help parents and caregivers explain play therapy to their children before the first appointment.

River taught me that informed consent is not simply a form completed by an adult. It is a relational and ongoing process.

It is one of the ways we communicate to children:

You matter here.

You deserve to understand what is happening.

Your questions are welcome.

You have a voice in this process.

Lesson Two: Patience and Trusting the Child-Centred Play Therapy Process

River also taught me a great deal about patience.

This became especially important during the moments when I experienced self-doubt and began questioning my skills, the therapeutic process and whether enough progress was being made.

Child-Centred Play Therapy asks therapists to trust deeply in the child’s capacity for growth.

It asks us to provide a consistent, accepting and emotionally safe relationship while allowing the child to lead the content, direction and pace of the sessions.

This can be difficult when the child’s play is repetitive, when themes are unclear or when the changes adults are hoping to see have not yet become obvious outside the therapy room.

There were times when the structure and consistency of therapy were challenged. Appointments were disrupted. The family was navigating competing demands. Questions arose about whether another approach might produce faster results.

Yet River taught me that consistency, patience and relationship were not passive parts of the work. They were the work.

Through the predictability of the play therapy space, River was gradually able to express and make meaning of their experiences.

They did not need me to hurry them towards an outcome.

They did not need me to interpret every piece of play or direct them towards the topic that adults believed was most important.

They needed time.

They needed space.

They needed a regulated, present and accepting witness.

They needed the freedom to return to experiences repeatedly until they were ready to understand or organise them differently.

This does not mean that child therapists should continue indefinitely without reflection, review or clinical accountability. Trusting the process is not the same as avoiding evaluation.

It means remaining curious about the child’s communication, reflecting on the therapeutic relationship, monitoring safety and functioning, consulting with caregivers and supervisors, and considering whether the current approach continues to meet the child’s needs.

It also means recognising that meaningful change does not always happen according to an adult timetable.

River reminded me that growth in child therapy can be quiet.

Sometimes it appears first through a shift in the child’s play.

Sometimes it is visible in their willingness to take a new risk, tolerate a limit, express anger, seek connection or allow another person to witness their vulnerability.

Sometimes the significance of the change only becomes clear much later.

Lesson Three: The Child Therapist as Advocate

The final lesson I want to share is about advocacy.

There were several moments during my work with River when I questioned whether I had the level of parental confidence and buy-in that I had initially believed was there.

At different times, the play therapy process was questioned, challenged or tested. Alternative approaches were suggested, particularly when the meaning of River’s play was not immediately clear or when changes outside the therapy room were slower than the family had hoped.

These conversations sometimes left me questioning myself.

Was I doing enough?

Was I missing something important?

Was Child-Centred Play Therapy still the right approach?

Was I repeating the same explanation without helping the family feel more reassured?

I was also aware that there could be a cost to River if the adults around them lost confidence in the therapy process.

Parent and caregiver involvement is an important part of child therapy. Children do not exist in isolation. Their wellbeing is influenced by their relationships, family circumstances, school environments and broader systems.

When caregivers are under stress, patience can be difficult.

Families may be managing disrupted sleep, school refusal, anxiety, conflict, financial pressure, safety concerns or repeated calls from professionals. They may not have the emotional or practical capacity to wait months for subtle changes.

In many service systems, there is also a strong preference for measurable, rapid and easily observable outcomes.

This can place pressure on therapists to change direction quickly, demonstrate progress or move towards more directive intervention, even when a slower relational process appears to be meeting an important need for the child.

River taught me that advocacy in play therapy sometimes means holding steady.

It may mean respectfully explaining the therapeutic rationale again.

It may mean helping caregivers recognise smaller indicators of change.

It may mean acknowledging the family’s frustration without immediately abandoning a process that the child is using meaningfully.

It may also mean being willing to review the approach honestly, seek supervision, invite feedback and make changes when the child’s needs are no longer being met.

Advocacy is not about defending a therapy model at all costs.

It is about keeping the child’s experience, voice, developmental needs and emotional safety visible within conversations that are often led by adults.

It is about asking:

What might this child be communicating?

What pace does this child need?

What is the potential impact of changing the therapeutic approach or ending therapy now?

Whose need for progress are we responding to?

How can we support the caregivers while continuing to honour the child’s process?

Through River, I came to understand that patience does not always translate easily when families are struggling.

Telling a distressed caregiver to “trust the process” is rarely enough.

Families need transparency, collaboration and meaningful opportunities to understand what the therapist is observing. They need space to express doubt and ask questions without feeling criticised. They may also need practical support to notice and respond to the changes occurring in their child.

The therapist’s role is therefore not only to hold the child in the playroom. It is also to build a bridge between the child’s therapeutic process and the adults caring for them.

Children Are Active Participants in Our Professional Growth

There were many other lessons River taught me during our time together.

One of those lessons, about navigating therapeutic endings with children, became the focus this blog post Navigating Endings in Child Therapy.

Others may become stories for another day.

What remains with me most strongly is that children are not passive recipients of therapy.

They are active participants in the therapeutic relationship.

They notice when a process does not make sense to them. They communicate when they need more information, more time, greater predictability or a different kind of support. Sometimes they tell us directly. At other times, they communicate through behaviour, resistance, silence, play or their relationship with us.

As child and play therapists, our commitment to professional development is not only about completing further training or learning new interventions.

It is also about remaining open to what children themselves can teach us.

River’s feedback changed my intake processes.

Their need for clarity strengthened my commitment to child-friendly informed consent.

Their pace reminded me to trust the depth and wisdom of children’s play.

Their journey challenged me to become a more confident and thoughtful advocate.

Most importantly, River reminded me that growth happens on both sides of the therapeutic relationship.

We may bring our knowledge, training and experience into the playroom, but children bring knowledge too.

When we remain authentic, curious and willing to learn, children can help us become more reflective, relational and responsive practitioners.

That is one of the great privileges of this work.

River is a pseudonym, and identifying information has been changed to protect the child and family’s privacy.