Telling Stories Through Symbols in Family Therapy
In the Marriage and Family Therapy Lab at UH Mānoa, sandplay therapy offers families a creative, hands-on way to explore their relationships, struggles, and hopes. By using miniature figurines and symbols to build scenes in a tray of sand, individuals, couples, or families are able to tell their stories in a nonverbal, symbolic language.
What is Sandplay Therapy?
Sandplay therapy is a form of expressive therapy that utilizes sand, water, and various miniatures to help individuals express their emotions in a creative and nonverbal manner. Developed by Swiss psychotherapist Dora Kalff in the 1950s, sandplay therapy is rooted in the principles of Jungian psychology, emphasizing symbolic and archetypal imagery (Kalff, 2003).
Clients select objects that “speak” to them, such as animals, structures, mythical creatures, spiritual symbols, and everyday items, and place them in the sand to create scenes. These scenes can represent the client’s inner world, relational dynamics, or moments from their family history. This process allows deep emotions and experiences to surface, often bypassing thelimits of words (Homeyer & Sweeney, 2017).
A Global Collection for a Global Community
The MFT Lab’s sandplay collection features symbols and figurines representing cultures and traditions from around the world. This diverse collection reflects Hawaiʻi’s unique position as a cultural crossroads in the Pacific. Clients from all backgrounds can find pieces that resonate with their personal, cultural, or spiritual identity — whether that’s a Buddhist statue, a Hawaiian honu (sea turtle), a Native American animal guide, or a figure from European folklore. Suchdiversity allows clients to connect with their heritage while also exploring new cultural perspectives (Mitchell & Friedman, 1994).
Why Sandplay Matters in Family Therapy
Families in Hawaiʻi are richly diverse, often blending multiple cultural backgrounds, languages, and belief systems. Sandplay allows each family member to contribute their own symbols to a shared scene, creating a visual conversation about who they are, where they come from, and how they relate to one another. This makes sandplay a powerful tool for exploring intergenerational patterns, cultural identity, and the evolving stories that shape family life.
Research shows that group sandplay therapy is effective in improving communication among family members and enhancing interpersonal relationships. For example, studies have shown that sandplay can reduce parent-child tensions while fostering mutual understanding (Zhu et al., 2015). The therapeutic process typically involves four stages: self-concentration; paying attention to one another; communication and mutual understanding; and adjustment and integration.
Evidence-Based Effectiveness
Recent research has demonstrated the efficacy of sandplay therapy across various populations and mental health concerns. A meta-analysis conducted by Freedle et al. (2015) examined 40 studies from eight countries involving 1,284 participants. The results showed a large overall effect size (Hedges’ g = 1.10), indicating that sandplay therapy is an effective treatment method for children and adults with mental health concerns such as anxiety, depression, trauma-related symptoms, ADHD, and behavioral issues.
Reducing Anxiety and Trauma in Children
A recent study by Freedle et al. (2021) demonstrated the efficacy of group sandplay therapy in addressing anxiety and post-traumatic stress symptoms in children affected by natural disasters. The study involved 12 first-grade students whose school was destroyed by a volcanic eruption. Using a mixed-method, pre-post design, the researchers found significant reductions in anxiety and post-traumatic symptoms following a series of five group sandplay sessions. The effect sizes were large for both anxiety (d = 1.25) and post-traumatic symptoms (d = 1.40). Qualitative themes indicated movement toward integration, balance, and access to internal resources, despite ongoing environmental threats (Freedle et al., 2021).
This study highlights the potential of sandplay therapy as a tool for mitigating the psychological impact of traumatic events on children, promoting resilience and facilitating emotional expression in a nonverbal manner.
The Added Value of Sandplay Therapy
A study by Freedle et al. (2020, which included The MFT Lab director Dr. Souza), explored the use of sandplay therapy with emerging adults aged 18–24 years in an outdoor behavioral healthcare program. Using a mixed-method quasi-experimental design with two groups: one receiving traditional treatment and another incorporating sandplay therapy. The researchers found that adding sandplay resulted in greater reductions in psychological distress compared to treatment as usual. Participants reported that sandplay enabled access to deep emotions and memories while fostering creativity and self-expression. Themes such as safety, relaxation, somatic awareness, and new perspectives emerged from qualitative analysis.
This study underscores how integrating sandplay into existing therapeutic frameworks can enhance outcomes for individuals with higher levels of distress or trauma histories.
Honoring Cultural Diversity in Therapy
By offering a broad, multicultural collection of symbols, the MFT Lab ensures that families can engage in therapy in a way that honors their heritage while also inviting curiosity about others. This symbolic dialogue fosters both cultural pride and cross-cultural understanding; essential qualities in Hawaiʻi’s tightly-woven and diverse communities.
The use of symbols in sandplay can reveal underlying feelings and experiences that clients may not yet have the words to articulate. Common symbols encountered in sandplay and their associated meanings include:
- Animals: Represents feelings or instincts
- Figures: Can signify family or social relationships
- Structures: Often reflects stability or insecurity
- Natural Elements: Represents emotions or processes (water for fluidity, fire for anger)
By incorporating elements of sandplay into daily life, families can continue to benefit from this therapeutic approach outside of formal sessions. This may include providing a sand tray at home, using miniatures and symbols, engaging in observation, and encouraging dialogue about the created scenes.
References
Freedle, L., Goodwin-Downs, D., Souza Jr., J., & Cipponeri A. (2020). The added value of sandplay therapy with emerging adults in an outdoor behavioral healthcare program. Journal of Sandplay Therapy. Retrieved from https://www.sandplay.org/journal/research-articles-journal-of-sandplay-therapy-jst/
Freedle, L. R., McGee, M., Blechman, S., Souza, J., & Zandbergen, D. L. (2021). The lava ate my school: The use of group sandplay to reduce anxiety and post-traumatic stress in displaced elementary school students. Journal of Sandplay Therapy, 30(2), 129-147. https://doi.org/10.61711/jst.2021.30.2.323
Freedle L., Wiersma J., McRoberts R., & Solberg K. B. (2015). A meta-analysis of Sandplay Therapy treatment outcomes. Journal of Sandplay Therapy. Retrieved from https://castlemaineplaytherapy.com.au/wp-content/uploads/2024/03/A-meta-analysis-of-Sandplay-Therapy-Treatment-Outcomes-Freedle-et-al.pdf
Homeyer L., & Sweeney D. S. (2017). Sandtray therapy: A practical manual (3rd ed.). Routledge.
Kalff D. M. (2003). Sandplay: A psychotherapeutic approach to the psyche. Temenos Press.
Mitchell R., & Friedman H. S. (1994). Sandplay: Past, present and future. Routledge.
Zhu J., Zhang X., Jiang F., & Hu Y. (2015). Group sandplay therapy improves parent-child relationships for Chinese children with oppositional defiant disorder. The Arts in Psychotherapy, 44(1), 1–8. https://doi.org/10.1016/j.aip.2015.02.001