The effectiveness of Theraplay for children under 12 – a systematic literature review

Background Theraplay is a relationship‐focused model of treatment based on attachment theory involving both adult and child. The study aims to review the quality of Theraplay research and Theraplay’s effectiveness for children aged 12 years and under with a range of presenting difficulties, to inform future practice and identify areas for further research. Methods A systematic literature search was conducted using PsycINFO, CINAHL, MEDLINE and Web of Science. Quantitative studies using Theraplay only as a treatment for children aged 12 years and under with any presenting difficulty were identified. Additional manual searching was conducted, including eligible studies’ reference lists. Critical appraisal tools were used to provide a narrative synthesis of Theraplay’s effectiveness and research quality. Results Only six eligible articles were identified, meaning there was a lack of rigorous evidence eligible to offer conclusions into Theraplay’s effectiveness. The review highlighted the small evidence base, mixed quality research methodology and high levels of heterogeneity in how Theraplay is practiced and evaluated. Of the eligible studies, Theraplay was found promising in its effectiveness when used with internalising and externalising difficulties, dual diagnoses and developmental disabilities. Conclusions Theraplay is regularly practiced across the world; however, the evidence base of rigorous research to inform Theraplay’s effectiveness and mechanisms of change is lacking. Firm conclusions could not be offered, although Theraplay was shown to be promising intervention for some presentations. Further research into Theraplay’s effectiveness and key mechanisms of change are recommended to enhance the quality and depth of Theraplay literature