How Play Therapy Supports Children: A Bottom-Up Approach

By Laura Rosenberg

Parents often wonder how play therapy can benefit their child. The answer lies in its ability to address the root of the issue. Play therapy follows a bottom-up and inside-out approach to psychotherapy.

Bottom-Up vs. Top-Down Therapy

When discussing play therapy, we often refer to two approaches: bottom-up and top-down. These terms relate to which parts of the brain the therapy focuses on.

Top-down therapy works with the higher brain functions, which are responsible for logic, reasoning and thought processes. In contrast, bottom-up therapy engages the lower parts of the brain, which control reflexes, memory and the body's internal alarm system. This area of the brain is also where challenging or traumatic experiences are stored.

The Top-Down Approach

Top-down approaches focus on identifying problematic thought patterns. The process often involves asking, “What is wrong with your thinking, and how can we change it?” While this method helps individuals recognise how they interpret information, it may not always address the underlying emotional or physiological response. As a result, top-down therapy can sometimes overlook the depth of an individual’s experience, expecting them to simply ‘think their way out of it.’ This approach is generally in opposition to the way Play Therapists work.

The Bottom-Up Approach in Play Therapy

In contrast, Play Therapy is a bottom-up therapy that prioritises emotions and bodily sensations. Play Therapists recognise that dysregulated states, such as uncontrollable thoughts and behaviours, often arise when a child feels unsafe. This is especially true for children who have experienced trauma or significant challenges. Such feelings of distress are deeply stored within the lower brain and the body.

Rather than instructing a child to suppress fear by focusing on logic, Play Therapy addresses these feelings through sensory and emotional awareness. The goal is to reassure the brain’s internal alarm system that the danger has passed.

Creating Safety in Play Therapy

A key aspect of bottom-up play therapy is establishing a strong sense of safety for the child. This is achieved by creating a therapeutic environment that is predictable, responsive, nurturing and respectful. Within this space, children can begin to develop an awareness of their body’s signals, such as tense muscles, a racing heartbeat or shallow breathing.

Supporting Regulation Through Modelling

Play Therapists model how to recognise, name and regulate bodily sensations, allowing children to learn by observation. By understanding their own body’s signals, children can make sense of their internal world. This self-awareness helps them process both emotions and thoughts, leading to a sense of integration and safety within themselves. It is within this state of regulation that healing begins.

Why Bottom-Up Approaches Work for Children

Bottom-up Play Therapy is highly effective for children because they naturally express themselves through play rather than verbal discussion. This approach provides opportunities for dual awareness of both thoughts and emotions, shifting the focus from a mind-over-matter perspective to a holistic mind and body connection.

By asking, “What happened to you?” rather than “What’s wrong with you?” Play Therapy embraces a whole-brain, whole-body and whole-child approach to healing. It helps children reach the root of their challenges, creating meaningful opportunities for regulation and growth.

Play Therapy and Counselling Services at Playroom Therapy

Playroom Therapy offers a range of services, including Child Play Therapy, Family Therapy, Parent Support, and Consultancy. With our compassionate and experienced team, children are supported to grow, heal, and develop through the transformative power of play. At Playroom Therapy, we’re here to help children thrive every step of the way.

Let’s Connect!

Ready to learn more? Get in touch with our friendly team at Playroom Therapy today to see how we can support your child’s journey to growth and wellbeing.