Using Play to Heal Attachment Wounds in Children: An Attachment-Focused Play Therapy Approach
Attachment wounds don't always look like sadness—they often look like behavior. Play therapy is one of the most powerful ways to rebuild relational safety with children because play is literally how attachment gets built in the first place. If you’ve ever found yourself understanding attachment theory but wondering, Okay, but what do I actually do with this in session—keep reading.
How to Use Attachment Theory in Play Therapy Practice
Attachment. Relational healing. What's your attachment style? You've heard all the buzz—but what does it actually mean, and how do you use it in the therapy room?
I'll be honest, attachment is my jam! But there was a time when I wasn't totally sure what it looked like to move from theory into treatment. Attachment kept coming up in my caseload—children in kinship care, foster care, adoptees, kids going through divorce. It was clear relational harm had happened. I understood that much. But, I wanted to go deeper and actually understand how to treat it, how to plan for it, and how to really support these families.
So if you've ever wondered the same thing, I've got you, here in this blog, and in my upcoming APT-approved play therapy trainings right here in St. Louis.
What does attachment actually mean in practice?
Attachment isn’t just a theory you learned in college or graduate school. It’s built over hundreds and hundreds of micro moments between a caregiver and a child. Attachment is built through both positive micro moments of being cared for, calmed, soothed, nurtured and delighted in, and in more difficult moments of being met with anger, dismissal, or intimidation by a caregiver. These early experiences stack up over time and start to form a child's “internal working model”—their core beliefs about whether the world is safe, whether they are worthy of love, and whether other people can be trusted.
That internal working model doesn't stay in childhood either. It carries over into friendships, romantic relationships, school performance, and can follow us into adulthood. It’s the blueprint a child's nervous system builds for every relationship they will ever have. The good news is we know attachment systems are not fixed; they can change! That is where the beautiful work can happen!
What does disrupted attachment actually look like?
Here’s the thing: attachment trauma in children isn’t always obvious.
Attachment wounds don’t always look like sadness. They often look like behavior.
Some examples of how attachment shows up in behavior include:
Difficulty tolerating transitions, like going to school, or getting into the car
Pushing caregivers away during emotional moments
Seeming totally fine until they’re suddenly really not fine and having big tantrums
When we understand that attachment is communicated through behavior, it completely changes how we see the kids on our caseload.
Why is play such a powerful tool for attachment work?
Okay, nothing is perfect. But play is pretty darn close for this work, and here’s why.
Attachment is built and rebuilt through present-moment relational experiences. And, play is how attachment gets built in the first place.
Think about early infancy: being rocked, sung to, fed, held, smiled at. That back and forth of attunement and delight and co-regulation through silliness. That is play. That is also attachment. Those two things go hand-in-hand.
And here’s what makes this so exciting for us as clinicians. Play is a full-body, sensory experience. Just like those early childhood moments of being held, rocked, soothed and delighted in, play engages the whole nervous system. When we bring play into the therapy room intentionally, we’re not just being creative. We’re recreating the sensory and relational conditions where connection was supposed to happen in the first place.
And because it’s play, because it feels fun and light and a little silly, it’s so much less threatening than sitting across from someone and talking about hard things. The child's nervous system gets to experience connection, co-regulation, and safety without having to talk directly about the thing that hurts. That’s the power of play!
What does attachment-focused play therapy actually look like in a session?
Attachment-based play therapy is usually going to be dyadic, meaning you are working with the caregiver and child together. The goal is not task completion or doing it "right." The goal is presence, attunement, and creating moments of joint attention and joy that recreate what the child may have missed in earlier years.
Attachment-focused play therapy models like Theraplay and Filial Therapy are built around exactly this—using structured play experiences to strengthen attachment, increase relational safety, and deepen caregiver-child connection.
The goal is not just to be a better-behaved child. The goal is for a child to believe the world is a little safer and that they are worthy of connection. That shift starts in those small moments in the playroom.
How do you support caregivers as part of the attachment work?
This piece matters so much and it doesn’t get talked about enough.
Attachment is not built in 45-minute sessions. It’s built in the many many micro moments that happen at home, in the car, on the way to school, before bed. The caregiver is doing attachment work every single day, whether they know it or not.
That is why caregiver work is so important! Not just to help caregivers carry over tools and strategies to home, but to help them really understand their child. To help them see past the behavior to the hurting heart underneath. When a caregiver can start to see their child's big behavior as a child who is scared and struggling rather than a child who is difficult or defiant, it gives them a completely new lens to view their child through. And that new lens changes everything about how they respond.
A caregiver who feels supported and who understands what their child is carrying is much more able to show up in those hundreds of daily micro moments with warmth, patience, and connection. That is where the real healing happens.
And just like we hold space for the child, we have to hold space for the caregiver, too. Parenting a child with attachment wounds is genuinely exhausting, and caregivers need to feel seen and understood just as much as the kids do.
Want to go deeper into attachment and play therapy?
If attachment-focused play therapy is lighting something up for you, we’d love to have you join us for Playful Connections: Using Play Therapy to Enhance Relational Safety with Children.
This 3-hour experiential training is designed for clinicians who are ready to move beyond understanding attachment theory and start using attachment-centered play therapy interventions with greater confidence and intention.
Together, we’ll explore how attachment wounds show up in the playroom, how to use play to create relational safety, and how to involve caregivers in meaningful ways that support lasting change beyond the therapy office.
July 31st | 8:30-11:30 AM | In-person in Downtown St. Louis
You’ll leave with practical tools, experiential learning, and a clearer roadmap for supporting children and families on your caseload.
Frequently Asked Questions
What is the difference between attachment theory and attachment trauma?
Attachment theory describes how hundreds of early micro moments between a caregiver and child shape a child's internal working model—their core beliefs about safety, connection, and whether they are worthy of love. Attachment trauma happens when those early experiences involve harm, loss, or chronic inconsistency, and the child's nervous system learns that relationships are not safe.
What does attachment trauma look like in children?
It does not always look like sadness or withdrawal. It often looks like behavior. Difficulty with transitions, pushing caregivers away, big emotional outbursts that seem out of proportion, or a child who seems fine on the surface but struggles to let people in. Understanding this reframes so much of what we see on our caseloads.
Why is play therapy effective for attachment wounds?
Play is a full body sensory experience, just like the early childhood experiences of being held, rocked, soothed and delighted in that attachment is originally built through. When we use play intentionally in the therapy room we are recreating those relational and sensory conditions in a way that feels fun and accessible rather than threatening. That gives a child's nervous system the chance to have a new, corrective relational experience.
How do I involve caregivers in attachment-focused play therapy?
Caregiver sessions are a critical place to help parents understand what they’re seeing in their child’s behavior and to help them see past it to their child's hurting heart. Parent support sessions can help caregivers respond in more connected and therapeutic ways.
How can I learn more about using play therapy for attachment work?
Join us at Playful Connections on July 31st in St. Louis, a 3-hour experiential training on using play therapy to build relational safety and secure attachment with children. Three NASW CEUs included.
About the Author
Jasmine Berger, LCSW, is a registered play therapist supervisor and founder of Bud to Bloom Play Therapy in St. Louis, Missouri. Jasmine specializes in helping children and families heal from trauma, attachment disruptions, anxiety, and behavioral challenges through play-based interventions. She also provides training and consultation for social workers and child and family therapists in Missouri and across the U.S..
