The Research Behind the Tray

A curated library of peer-reviewed work on sandtray therapy — across early childhood, school-age clients, adolescents, adults, and the end of life; across schools, telehealth, hospice, refugee settings, and private practice.

Why it matters

What the evidence means for you

The library below is the proof. Here's the short version — what nearly a century of sandtray and play-therapy research actually says for your practice.

It works — and the numbers are real

This isn't a hopeful trend. Meta-analyses of play and sandtray therapy report moderate-to-large effects across trauma, anxiety, grief, and behavior — the kind of evidence you can stand behind.

Bratton et al., 2005 (d ≈ 0.80) · Lin & Bratton, 2015 · Wiersma et al., 2022

It's not just for kids

The tray slips past the verbal defenses adults lean on. The literature follows clients across the whole lifespan — from preschool classrooms to hospice rooms.

Mitchell & Friedman, 1994 · Sourkes, 1995 · Magniant, 2004

It's defensible to your administration

When you have to justify your program, bring data. School-based play therapy is tied to academic gains and lower anxiety — the citations are right here, ready for your next program review or board conversation.

Blanco & Ray, 2011 · Ray et al., 2015 · Drewes, 2009

Digital delivery is on solid ethical ground

Remote and screen-based expressive work isn't a workaround — it's a researched, ethically grounded way to practice. Sandstories' PHI-free design was built around exactly these standards.

Stoll et al., 2020 · Stone, 2019 · Lin et al., 2021
Browse the literature

The full citation library

Filter by topic to find the published work that supports your particular setting, population, or theoretical frame. All entries are drawn from peer-reviewed journals and established clinical texts.

Foundations
Kalff, D. M. (2003). Sandplay: A psychotherapeutic approach to the psyche.
Temenos Press.
The foundational text on Kalffian sandplay — the "free and protected space," the symbolic process, and the non-directive stance.
FoundationsSchools
Lowenfeld, M. (1979). The world technique.
London: Allen & Unwin.
The original 1929 frame: the child as world-builder, the adult as silent witness. The lineage that gave us every sandtray modality.
FoundationsManual
Homeyer, L. E., & Sweeney, D. S. (2022). Sandtray therapy: A practical manual (4th ed.).
Routledge.
The definitive clinical manual for contemporary sandtray practice. Step-by-step protocols across populations and presenting concerns.
Foundations
Boik, B. L., & Goodwin, E. A. (2000). Sandplay therapy: A step-by-step manual for psychotherapists of diverse orientations.
W. W. Norton.
A cross-modality clinical guide — useful for practitioners who don't identify as Jungian but want a structured introduction.
Meta-analysisOutcomes
Wiersma, J. K., Freedle, L. R., McRoberts, R., & Solberg, K. B. (2022). A meta-analysis of sandplay therapy treatment outcomes.
International Journal of Play Therapy.
Pools effect sizes across sandplay outcome studies — the strongest current quantitative summary of the modality's clinical benefit.
Review
Roesler, C. (2019). Sandplay therapy: An overview of theory, applications and evidence base.
The Arts in Psychotherapy, 64, 84–94.
A comprehensive review of the empirical literature, organized by population and presenting concern. The single best place to start.
Meta-analysisChildren
Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes.
Professional Psychology: Research and Practice, 36(4), 376–390.
The most-cited meta-analysis of play therapy outcomes (d = 0.80). Sandtray is included in the modalities reviewed.
Meta-analysisOutcomes
Lin, Y. W., & Bratton, S. C. (2015). A meta-analytic review of child-centered play therapy approaches.
Journal of Counseling & Development, 93(1), 45–58.
Updates the 2005 Bratton meta-analysis for child-centered approaches specifically — sustained moderate-to-large effects.
TraumaChildren
Tornero, M. D. L. A., & Capella, C. (2017). Change during psychotherapy through sand play tray in children that have been sexually abused.
Frontiers in Psychology, 8, 617.
A process-research study tracking how the tray itself functions as a vessel for sexual-abuse survivors to externalize and re-sequence narrative.
TraumaBody
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma.
Viking.
The reference text on trauma physiology and the limits of verbal therapy. The case for non-verbal modalities — including sandtray — sits in here.
TraumaChildren
Perry, B. D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical applications of the neurosequential model of therapeutics.
Journal of Loss and Trauma, 14(4), 240–255.
Foundational NMT framing. Sandtray sits in the right developmental sequence — bottom-up before top-down, regulation before insight.
Trauma-informed
Steele, W., & Malchiodi, C. A. (2012). Trauma-informed practices with children and adolescents.
Routledge.
Practical trauma-informed adaptations for expressive modalities, with explicit sandtray applications.
AnxietyChildren
Ray, D. C., Armstrong, S. A., Balkin, R. S., & Jayne, K. M. (2015). Child-centered play therapy in the schools: Review and meta-analysis.
Psychology in the Schools, 52(2), 107–123.
School-based play therapy reduces anxiety, externalizing behavior, and academic stress. Sandtray modalities included in the synthesized literature.
AnxietyPolyvagal
Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are (2nd ed.).
Guilford Press.
Foundational text on the "window of tolerance." Sandtray work is one of the most reliable ways to widen it for an anxious or hyper-aroused client.
Grief
Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner (5th ed.).
Springer Publishing.
The canonical four-task model of grief work — sandtray fits cleanly into Task II (processing pain) and Task III (adjusting to a world without the deceased).
GriefChildren
Webb, N. B. (2010). Helping bereaved children: A handbook for practitioners (3rd ed.).
Guilford Press.
Developmental framework for children's grief, with extensive case material on play and sandtray work for ambiguous and disenfranchised loss.
GriefTechniques
Neimeyer, R. A. (2012). Techniques of grief therapy: Creative practices for counseling the bereaved.
Routledge.
A creative-practice handbook including specific sandtray protocols for meaning reconstruction and continuing bonds.
PolyvagalTheory
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation.
W. W. Norton.
The theoretical foundation. Ventral, sympathetic, and dorsal states track visibly in the tray — figure proximity, height, and pace.
PolyvagalClinical
Dana, D. (2018). The polyvagal theory in therapy: Engaging the rhythm of regulation.
W. W. Norton.
The clinician-facing companion to Porges. How to read autonomic shifts in session and shape the tray work to widen the window.
SchoolsAchievement
Blanco, P. J., & Ray, D. C. (2011). Play therapy in elementary schools: A best practice for improving academic achievement.
Journal of Counseling & Development, 89(2), 235–243.
Empirical evidence linking school-based play therapy to academic gains. Useful for school-counselor program-defense conversations.
SchoolsManual
Ray, D. C. (2011). Advanced play therapy: Essential conditions, knowledge, and skills for child practitioners.
Routledge.
Skill-building manual for school-based and elementary clinicians. Sandtray contextualized inside a broader play therapy frame.
Tier 2Multi-tiered
Drewes, A. A. (Ed.). (2009). Blending play therapy with cognitive behavioral therapy: Evidence-based and other effective treatments and techniques.
Wiley.
Integration of structured CBT techniques into expressive play work — the empirical basis for hybrid Tier 2 protocols in MTSS frameworks.
AutismChildren
Lu, L., Petersen, F., Lacroix, L., & Rousseau, C. (2010). Stimulating creative play in children with autism through sandplay.
The Arts in Psychotherapy, 37(1), 56–64.
One of the earliest published applications of sandplay specifically with autistic children — clinical observations on engagement and symbolic play.
NeurodivergenceSensory
Malchiodi, C. A. (Ed.). (2014). Creative interventions with traumatized children (2nd ed.).
Guilford Press.
Addresses sensory-processing variability and modality choice. Useful for clinicians whose neurodivergent clients can't tolerate physical sand.
Older adultsExpressive
Magniant, R. C. P. (Ed.). (2004). Art therapy with older adults: A sourcebook.
Charles C Thomas.
A foundational sourcebook for adapting expressive modalities — including sandtray — to geriatric care, dementia, and end-of-life work.
AdultsLifespan
Mitchell, R. R., & Friedman, H. S. (1994). Sandplay: Past, present and future.
Routledge.
Adult sandplay outcomes and case material — counters the misconception that sandtray work is "just for kids."
HospiceEnd-of-life
Sourkes, B. M. (1995). Armfuls of time: The psychological experience of the child with a life-threatening illness.
University of Pittsburgh Press.
Seminal text on pediatric palliative work. The use of expressive material — including sandtray figures — for legacy and meaning-making in dying children.
Cross-culturalAdolescents
Hong, S. M., & Mason, E. C. M. (2016). Counseling Korean Americans in groups: A culturally responsive intervention with adolescents using sandtray.
Journal of Multicultural Counseling and Development.
Specific protocol for culturally responsive group sandtray work with Korean-American adolescents — applicable framework for other bicultural identity work.
RefugeeTrauma
Rousseau, C., Lacroix, L., Singh, A., Gauthier, M.-F., & Benoît, M. (2005). Creative expression workshops in school: Prevention programs for immigrant and refugee children.
The Canadian Child and Adolescent Psychiatry Review, 14(3), 77–80.
Evidence base for expressive-arts interventions with refugee children in schools — sandtray modalities specifically appear in subsequent extensions of this work.
TelehealthAlliance
Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review.
Frontiers in Psychiatry, 10, 993.
Foundational ethical scaffolding for any digital expressive work — privacy, alliance, jurisdiction, and competency boundaries.
Digital play
Stone, J. (Ed.). (2019). Integrating technology into modern therapies: A clinician's guide to developments and interventions.
Routledge.
Practitioner-facing guidance on integrating digital tools into expressive and play therapy — including frameworks applicable to digital sandtray.
TelehealthPlay
Lin, Y.-W., Bratton, S. C., Sweeney, D. S., & Brumfield, K. (2021). Telehealth-based play and expressive therapy approaches.
International Journal of Play Therapy (special section).
Emerging evidence base for remote delivery of play and expressive modalities — relevant for any clinician evaluating digital sandtray work.
About this bibliography. Citations are drawn from peer-reviewed journals and established clinical texts. This page is actively maintained as our literature review continues — if you spot a missing study, an outdated edition, or an error, please write to Hello@sandstories.app. We welcome submissions of newly published work, especially RCTs, dissertation outcomes, and applications in underrepresented populations and settings.