EMDR Therapy, Play Therapy, and Polyvagal Theory for Children

The first week of February is International Play Therapy Week, a time to celebrate and raise awareness around the power of play and play therapy. We turned to EMDRIA member Dora Henderson who integrates EMDR therapy and play therapy to share more about this powerful combination.

The Power of Integrating EMDR Therapy, Play Therapy, Somatics, and Polyvagal Theory for Effective Trauma Healing in Children

Guest Blog Post by Dora Henderson, LMHC, RPT-S

Understanding play therapy in EMDR contexts

Play therapy allows children to communicate and process emotions non-verbally, offering an essential bridge for younger clients who may find traditional talk therapy challenging. Integrating play-based interventions within EMDR’s phases enhances a child’s engagement and ability to process traumatic material. Research underscores that play helps children feel safe and grounded, providing a structure that aligns well with EMDR’s phases (Green, 2020).

In the first phase of EMDR, history and treatment planning, observing children’s play patterns offers insights into attachment styles, emotional regulation abilities, and signs of resilience. These observations guide treatment planning and allow therapists to tailor interventions that fit the child’s developmental stage. A trauma-informed assessment through play establishes rapport, helping children feel understood and accepted within the therapeutic alliance.

Somatic awareness in EMDR therapy

Somatic practices are essential in EMDR with children, helping them connect with their bodily sensations, which is often an area where young clients struggle. Somatic awareness techniques—such as gentle movements, grounding, and deep breathing exercises—help children stay connected to the present moment. During the preparation phase (Phase 2 of EMDR), these practices align with Polyvagal Theory, which emphasizes the importance of the autonomic nervous system’s role in trauma responses (Porges, 2011). Using these techniques, therapists support children’s ability to modulate arousal states, fostering resilience for later EMDR phases.

Applying Polyvagal theory in preparation and desensitization

The preparation phase is enhanced by integrating polyvagal-informed practices, especially through introducing the concept of “Neuroception,” where the brain unconsciously scans for cues of safety or danger. Making this concept accessible to children can be as simple as using playful elements—like envisioning a safe place as a “superhero headquarters.” This approach helps children understand their nervous system responses, empowering them to access their “ventral vagal state,” the state of calm and connection essential for emotional regulation. Puppets representing each state in the Polyvagal Theory offer a powerful, tangible way to build awareness. Characters like “Sympathetic Sam,” “Vee the Ventral Vagal Pal,” and “Droopy Dorsal” for the dorsal state give children engaging tools to recognize and label their physiological states, enhancing both their understanding and self-regulation skills.

During the assessment and desensitization phases of EMDR (Phases 3 and 4), children may need additional support to manage distressing memories. Tools like sand trays, puppets, or expressive arts allow children to externalize trauma, maintaining dual attention, a core component of EMDR therapy. One effective example is the Intero-Ception™ puppet, where children can “place” their concerns, allowing them to process memories without feeling overwhelmed. According to Shapiro (2001), dual attention is essential for maintaining a connection to the present while processing traumatic memories safely.

Strengthening the positive installation and body scan phases

In the installation and body scan phases of EMDR (Phases 5 and 6), somatic practices deepen children’s integration of positive beliefs associated with targeted memories. Techniques such as “wiggle your toes” or “stand strong like a tree” help children focus on sensations of calmness and grounding. Polyvagal-informed body scans and learning about the vagus nerve also make body scan work engaging for children, allowing them to connect with their physical experiences in a fun way. Additionally, introducing Intero-ception™ puppets that represent their “inside selves” supports children in building interoceptive awareness. Research supports that grounding exercises facilitate body awareness, making it easier for children to internalize new, adaptive beliefs (Siegel, 2012). These techniques encourage children to recognize and build on positive sensations, reinforcing their connection to safety.

Re-evaluation and long-term benefits

In the re-evaluation phase of EMDR (Phase 8), play therapy and storytelling can help children narrate their progress, reinforcing the adaptive changes they have made. Storytelling not only reinforces resilience but also strengthens children’s self-concept as they see themselves as active agents in their healing journey. By incorporating elements from play therapy, somatic awareness, and Polyvagal Theory, therapists enable children to integrate their experiences in a way that builds lasting emotional and physiological regulation skills.

Practical challenges and solutions in integrative EMDR therapy

Practitioners may encounter challenges in integrating these approaches, particularly when navigating children’s shifting emotional states. It can be helpful to have a toolkit of grounding and play-based strategies readily available, allowing the therapist to adjust the session based on the child’s immediate needs. Research highlights that adaptive, flexible approaches yield the best outcomes in trauma-informed care for children (Green, 2020).

Exploring Integration

Combining play therapy, somatic practices, and Polyvagal Theory within EMDR therapy sessions enhances the therapeutic experience, especially for young clients. This approach addresses children’s unique needs and builds essential self-regulation skills they can carry into adulthood. EMDR therapists are encouraged to continue exploring these integrative methods, drawing on the robust research supporting the intersection of neuroscience, play, and trauma treatment for children.

Dora Henderson is a playful and passionate Licensed Mental Health Counselor, Registered Play Therapist Supervisor, Trauma Play Therapist Supervisor, and EMDR Certified Therapist and Consultant. As a Certified SSP (Safe & Sound Protocol) Therapist, she’s all about using the magic of sound, music, and Polyvagal Theory to bring calm to kids and adults alike. Henderson has a history working in classroom settings, co-founded the Neuroscience of Play Therapy Summit, and leads A Safe Space Counseling. She is a children’s author (Percy the Perspecto-Pus) and speaker with a passion for storytelling and playful Polyvagal practices to bring calm to classrooms and beyond.

References

Green, E. J. (2020). Play Therapy with Traumatized Children: A Prescriptive Approach. Guilford Press.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W.W. Norton.

Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures. Guilford Press.

Siegel, D. J. (2012). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Press.

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Additional Resources

If you are a therapist interested in the EMDR training:

If you are EMDR trained:

If you are an EMDRIA™ Member:

EMDR Therapy, Play Therapy, and Polyvagal Theory for Children