Again this year the growth of sandplay research has been a world-wide phenomenon. When we first fell in love with sand and symbols in the late 1980s, there was a very small evidence base, consisting primarily of enthusiastic case presentations delivered at conferences. In this Newletter we scan some of the research outcomes published so far this year. We found literature from China, Indonesia, USA, Korea, Moldova, Russia, Indonesia, Not surprisingly 8 of the 10 studies shared here were focused on support for young people.
There has been an increase in research (particularly on using sandplay in groups) from Korea, with the establishment of the Korean Society for Sandplay Therapy's Journal of Symbols and Sandplay, founded in 2011. From our understanding, the take-home message seems to be that sandplay is increasingly being trialled with a widening array of symptoms, and continues to show significant positive effects. This year sandplay has been documented as contributing to improvements for children with autism spectrum disorder, and those impacted by cyberbullying, smartphone addiction, suicidal ideation, PTSD and emotional disorders.
A study from China (He, Hu, Song, & Liang, 2025) systematically reviewed the development of SP from 1985 to 2025. The results showed that symbolic and imaginal expression, core mechanisms of SP, are strongly influenced by the cultural context. SP research shows significant positive effects on trauma recovery, emotional regulation, and social adaptation. Artificial intelligence and augmented reality technologies have just begun to be explored (2 out of 71 studies reviewed) in SP assessment and intervention.
A meta-analysis of the South Korean literature by Kim et al. (2025), examined the effectiveness of sandplay therapy through 77 studies, including 35 dissertations and 42 journal articles published in South Korea between 1991 and May 2024. The overall mean effect size was high, confirming sandplay's positive impact on psychological issues. The emotional domain showed the largest effect, particularly in reducing anxiety and depression and enhancing emotional stability. The cognitive domain showed improvements in self-regulation and self-concept, while the behavioral and social domains demonstrated reductions in behavioral problems and better peer relationships. A higher total number of sessions and greater session frequency improved effectiveness. Interestingly, sessions shorter than 60 minutes were found more effective than longer ones. Both structured and unstructured approaches had significant effects. The strongest effects were observed in young children.
A randomised controlled trial from Russia (Kraus, 2025) examined the effectiveness of Sandplay Therapy in reducing self-handicapping behaviours and improving the quality of life in children with autism spectrum disorder (ASD). Participants were 30 children diagnosed with ASD, who were randomly assigned to either the experimental group (n = 15) receiving Sandplay Therapy or the control group (n = 15) receiving no intervention. The intervention consisted of eight 90-minute sessions conducted over eight weeks. Self-handicapping behaviours were measured using the Self-Handicapping Scale, and quality of life was assessed using the Pediatric Quality of Life Inventory. Assessments were conducted at pre-test, post-test, and five-month follow-up. The results indicated a significant reduction in self-handicapping behaviours in the experimental group, while no significant changes were observed in the control group. Similarly, quality of life improved significantly in the experimental group, whereas the control group remained stable. Improvements were sustained at follow-up. Even though the numbers in the research groups were small, the author claims that these findings "highlight the potential of nonverbal, expressive therapies in supporting emotional regulation and adaptive functioning in children with ASD".
A conference paper from Republic of Moldova by Creangă (2025), also advocates for Sandplay as an effective therapeutic intervention method for children with autism. The author notes that sandplay stimulates communication, emotional regulation, and sensory integration, helping to reduce anxiety and improve interactions. The author notes that Sandplay is regarded as an effective therapeutic intervention for fostering language development and social skills in children with autism.
A controlled trial from Korea by Kim et al. (2025) explored group sandplay therapy (GST), with children aged 11 to 12 years old who had experienced cyberbullying. The intervention group participated in 10 GST sessions, each lasting 40 min, held once a week in groups of three or four. The control group received no treatment. The Korean Youth Self Report (K-YSR) was employed to evaluate the effectiveness of the intervention. The results indicated that the GST intervention group experienced significant reductions in anxiety/depression, somatic symptoms, and aggressive behavior compared to the control group.
A study from Korea by Lee et al. (2025) examined the intervention effects of group sandplay therapy (GST) on children at risk of smartphone addiction. The participants consisted of 113 school students aged 11 to 12). The intervention group participated in the GST program once a week for 40 min over 10 weeks, while the control group received no intervention. The Youth Smartphone Addiction Scale (S-scale) and the Korean Youth Self Report (K-YSR) were used to assess the program. Compared to the control group, the intervention group that received GST showed a significant reduction in smartphone addiction, withdrawal/depression, and somatic symptoms, compared to the control group.
A non-randomized, controlled trial from Korea conducted by Shin et al. (2025) explored group sandplay for supporting children experiencing suicidal ideation. The control group did not receive any intervention, and the sandplay group received 10 group sessions of sandplay therapy once a week, 40 min each. The sandplay group significantly reduced depression and anxiety compared to the control group, and also significantly improved self-esteem.
A study from Indonesia by Dharmayanti et al. (2025) evaluated the effectiveness of Sand Tray Therapy in reducing PTSD symptoms and improving well-being in children and adolescents. The study involved five subjects who were selected through a screening process and considered as representative of a population with PTSD and low psychological well-being. The research instruments used are the Posttraumatic Stress Disorder Checklist (PCL-5) and Ryff's Psychological Well-Being Scales (PWB). The results indicate that sand tray therapy has a clinically significant positive effect in reducing PTSD symptoms and improving psychological well-being.
A study from Iran, by Jadidi Mohammadabadi (2025) assessed the effectiveness of sandplay in improving the academic morale of second-grade elementary students in Kerman, Iran. The research used a pre-test-post-test control group design. The population was 50 second-grade female students. The results indicated a significant positive relationship between sand play therapy and students' academic morale. The author suggests that sandplay enhances morale by providing visual and verbal reinforcement, enabling students to form mental representations of concepts, objects, and attitudes. "This process improves communication skills, fosters creativity, and strengthens critical thinking, self-confidence, perseverance, and collaboration".
A conference paper from Indonesia (Ifalahma et al., 2025) reports on a study of sandplay with children with emotional disorders, including anxiety, depression, and behavioral dysregulation. Using a quasi-experimental design, 20 children aged 5–6 years were assigned to either an experimental group receiving Sand Play Therapy or a control group. Emotional symptoms were measured using the Emotional Behavior Problems Questionnaire before and after a four week intervention. Results showed the pre-post test scores between groups were significantly different, confirming the effectiveness of the sandplay intervention.
References available on request.
While there is an unending flow of new research with single modality creative arts, we found seven articles researching multi-modal ET published so far this year. They are from USA, Venezuela, India and Czech Republic (emerging from the university where we first introduced sandplay in 2019). They cover ET with PTSD, ET as a way to increase educational engagement, to support recovery from childhood sexual abuse, combining ET with eco-therapy, as part of inpatient trauma recovery, and healing religious trauma.
A systematic review of the literature from the USA found that ET can be effective with military veterans with PTSD (Poor, et al., 2025). ET is effective in reducing PTSD symptoms for military veterans.
In the proceedings from a conference in the Czech Republic (Polínek & Telekyová, 2025) there is a description of how ET could be integrated into education. The paper argues for the systematic inclusion of expressive therapeutic and psychotherapeutic elements in school education, "not only in the field of cognitive learning development (e.g. mathematics, science), but especially in the field of mental health education, prevention of mental health problems and development of key social competences". The paper presents research demonstrating the positive impact of expressive approaches on the saturation of basic psychological needs, and presents the results of a project that monitored the effectiveness of expressive-therapeutic interventions in the development of social behaviour and soft skills in second grade primary school pupils.
At the World Congress of Psychotherapy 2025, Alvarado-Segovia and Ruiz-Gallegos (from Venezuela) presented on supporting migrants with PTSD through mindfulness-based ET. They developed an integrative psychotherapeutic model based on expression, arts, creativity, and mindfulness. The program was generated from the literature and from groups conducted by the Venezuelan Foundation for Psychology of Art between 2018 and 2024. They found that the program fostered emotional regulation, creative expression, and identity reconstruction in migrants with PTSD.
A literature review from India on ET (blending dance and movement, art therapy, and music therapy) for survivors of child sexual abuse was conducted by Lavania and Ballal (2025). The literature indicated that ET offers a safe space for recovery that encourages hope, self-determination, and healthy relationships. These approaches encourage cognitive processing, emotional expression, and physical connectedness.
From Lesley University in the USA come several dissertations describing various elements of ET and their outcomes. Codding (2025) examined the therapeutic potential of integrating expressive arts therapy and eco-therapy in immersive retreat settings. Drawing on current research and insights from both brief and extended retreats, the study emphasizes the synergistic benefits of practices such as somatic movement, yoga, art-making, journaling, and guided engagement with the natural environment. Qualitative research and observations indicate that participants experience enhanced creativity, emotional release, a deeper connection to nature, and increased mindfulness.
Also from Lesley University, Ruggeroli (2025) explored body-oriented expressive arts for inpatient trauma recovery. She explored concerns that excessive restriction on patient expression (due to hospital expectations on behaviour) inhibits possible aspects of recovery beyond stabilization. Her findings suggest that symptom and setting-appropriate adaptation and application of body-oriented expressive arts therapies may increase space for motivation to tolerate somatic symptoms that were initially uncomfortable, and for ongoing engagement in a program.
A third Lesley University dissertation (Whitman, 2025) reviewed literature on expressive arts in the healing of religious trauma. Whitman found that expressive arts, as a somatic and well-rounded approach to processing religious trauma, promoted self-regulation, built confidence, and supported clients to find an affirming community.
References available on request.