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Ethical Issues Confidentiality

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Ethical Issues


• The American Art Therapy Association explains Art Therapists “shall respect and protect confidential information obtained from patients in conversation and/or through artistic expression". Sand therapy is a form of Play therapy and both have overlapping ethical dilemmas.

• According to the American Art Therapy Association when the client is a minor all disclosure and consent is handled by the parent or legal guardian. Counselor’s must obtain confidentiality with the client and provide care and refrain from disclosure of information to the parent or guardian that might adversely affect the treatment of the client.

What is Sandplay Therapy?

In sandplay therapy, the counselor provides a sand tray, water, and a multitude of objects and materials with which to imaginatively create scenes. This technique can be used effectively with children, adolescents, adults, couples, groups, and families (Labovitz-Boik & Goodwin, 2000). By means of figures and the arrangement of the sand in the area of the sand tray clients set up a world corresponding to his or her inner and outer life (Kallf, 1991; Labovitz-Boik & Goodwin, 2000).

• Based on Jungian theory

• Developed as a productive means to aid individuals in bringing to consciousness what is not seen in reality (Labovitz-Boik & Goodwin, 2000).

• Understanding the non-verbal communication of children is challenging and therefore many helping professionals have implemented Sandplay Therapy as an adjunct to their current practice (Labovitz-Boik & Goodwin, 2000; McNally, 2001).

• Think of Sandplay as the “bridge” between the conscious and unconscious (Kallf, Turner, & Kallf, 2003).

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• Therapists are ethically obligated to practice within the boundaries of their competencies.

• It is important to have adequate training when working with such a special population. The International Association for Play Therapy established the process in order to be considered a play therapist.

Sandplay Therapy Training

Helping professionals who hold a masters in medicine, psychology, certified social work, pastoral counseling, school counseling, or marriage and family counseling from regionally accredited university and are licensed or credentialed to practice within their professional are able to enroll in Sandplay training programs. Training programs are offered through The Sandplay Therapists of America (STA) organization (Sandplay Therapists of America, 2010).


•Landeth (2001) explains that play therapists are ethically responsible to refer a child whom they believe needs further evaluation. If the play therapist fails to refer a child he or she could be held liable for neglecting the special needs of the child

Positives of Sandplay Therapy
    • Because most children play in sand or dirt, Sandplay is a medium which is attractive to children and provides a means through which the counselor and child can communicate (Labovitz-Boik & Goodwin, 2000).
    • Emotionally disturbed, traumatized, or abused children have great difficulty verbalizing their conflicts. The counselor provides a safe and accepting environment in which the child can allow his/her inner voice to speak. The concrete and observable manifestation of material created by the child brings to focus that which has been repressed (Labovitz-Boik & Goodwin, 2000; McNally, 2001).
    • Sandplay is inherently unintentional: Fears, tensions, and fixed ideas fall away once a child is engaged in the sandplay. During the process of sandplay the child’s conscious mind relaxes allowing insight to the unconscious material lying below the surface. Unconscious ideas and feelings are seen through the selection of figures and shaping of the sand, while at the same time the ambitions of the conscious mind are silenced. This process brings clarity fosters the possibility of a new outlook on life for the child (Kallf, Turner, & Kallf, 2003) .

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  • Limitations of Sandplay Therapy
  • • Cost of Materials
  • Materials needed for sandplay therapy can be considered to be expensive.
  • Sand, sand trays, and a large selection of realistic and mythological miniature objects are needed for this type of therapy. With a large selection of play materials, children are able to “create their own sand world” (Chesley, Dodie & Wagner, 2008, p.408).
  • - Expensive play materials are also a challenge in the school setting. Due to money concerns within the school environment, an appropriate large selection of materials may not be available, hindering the effectiveness of the therapy session.
  • • Sandplay Therapy Training
  • -There are not a lot of training opportunities in the field of sandplay therapy.
  • -According to Campbell (2004) even though sandplay therapy is offered in certain school districts, there are few training opportunities for school counselors in play-based techniques. Only 39 universities in the United States offer training in play-based techniques in counselor education programs (Campbell, 2004, p.7).
  • • Research
  • -There is a lack of scientific research to support the effectiveness of sandplay therapy. More evidence-based research is needed in this field. An expansion of qualitative and quantitative research is necessary for the study of children’s narratives. The “development of psychometrically sound methods for studying the content of children’s stories” is a way researchers can help expand quantitative research. (Chesley, Gillet, & Wagner, 2008, p.409).
  • -Methods of research only include narrative case studies and process and outcome research, and lack empirical research. According to Campbell (2004), “there is a clear and continuing need for rigorous empirical research into the efficacy of play-based therapeutic work with children” (p.8).
  • • Time Consuming for the School Setting
  • -Sandplay therapy sessions tend to be longterm. Typically, there needsto be at least 8-10 sessions in order for the child to “reach the resolution stage of the sandplay process” (Campbell, 2004, p.6).
  • -Time can be an issue for both the school counselor and the student.