In the evolving landscape of mental health interventions, especially for vulnerable populations such as children exhibiting suicidal tendencies, recent research published in BMC Psychology is gaining considerable attention. The study, conducted by Shin, Kim, Kim, and colleagues, delves deeply into the therapeutic potential of sandplay group therapy for children identified as being at risk of suicidal ideation. This investigation not only presents compelling evidence supporting the efficacy of a creative, non-verbal therapeutic modality but also challenges traditional approaches reliant predominantly on verbal psychotherapy. As the global mental health crisis continues to intensify, especially under the shadows of post-pandemic stressors, embracing innovative, child-centric methodologies like sandplay therapy could mark a paradigm shift in early intervention strategies.
Sandplay therapy, rooted in Jungian analytical psychology, involves clients creating scenes in a sandbox using miniature figures and objects, allowing for symbolic expression of unconscious processes and emotions. It serves as a non-intrusive medium whereby children can externalize and process complex feelings without the constraints of language. Given that children at risk of suicidal ideation often struggle to articulate their emotions and thoughts verbally, this method holds unique therapeutic promise. Significantly, the researchers’ decision to evaluate the effects of sandplay in a group setting rather than individual therapy broadens the applicability and potential social benefits of the intervention, addressing isolation—a known exacerbator of suicidal ideation.
The study’s methodology warrants particular attention for its rigor and innovation. Participants were carefully screened to identify children displaying early signs of suicidal thoughts, which inherently represents a sensitive and challenging research cohort. The group interventions were structured over an extended period, allowing both the therapeutic processes and outcomes to be meticulously observed and analyzed. Data collection combined quantitative measures—such as standardized suicidal ideation scales—with qualitative assessments from clinicians and observer reports, ensuring a multifaceted understanding of therapeutic impacts. Such a rich data set enabled the team to discern not only symptomatic changes in suicidal thoughts but also improvements in emotional regulation, peer interaction, and self-concept.
Remarkably, the findings revealed substantial reductions in suicidal ideation among participants post-intervention. This effect was sustained during follow-up assessments, indicating that sandplay group therapy could invoke meaningful, lasting mental health benefits. The participants also demonstrated enhanced social cohesion within the group, fostering a sense of connectedness and mutual support. This social bonding is critical to ameliorating feelings of alienation and hopelessness which are often precursors to suicidal behavior in children. The group dynamic added a layer of peer validation and support, reinforcing the therapeutic process and deepening the emotional safety net for participants.
Crucially, the study underscores the importance of symbolic play as a therapeutic mechanism. Sandplay allows children to communicate indirectly through metaphors and imagery, circumventing the cognitive and developmental barriers that can complicate traditional verbal approaches. This symbolic communication taps into the child’s inner world, often revealing nuanced emotional pain and conflict that might otherwise remain inaccessible. The researchers suggest that this form of expression facilitates emotional catharsis and cognitive reprocessing essential to healing. Therapists act as sensitive witnesses and facilitators, helping children to reflect upon and integrate the symbolic narratives emerging through play.
Furthermore, the non-judgmental, creative environment established within the sandplay groups appears to nurture a therapeutic alliance built on trust and safety. Given that children at risk of suicide frequently experience mistrust toward adults and authority figures, creating a space where they can express vulnerability without fear of judgment represents a vital component of effective intervention. The group setting additionally provides opportunities for modeling and practicing social skills, empathy, and conflict resolution, all of which contribute to improved psychosocial functioning beyond symptom reduction.
The implications of these findings extend far beyond the confines of clinical settings. Educational institutions, community organizations, and child welfare systems stand to benefit from incorporating sandplay group therapy into their mental health programming. By providing accessible, non-stigmatizing, and culturally adaptable interventions, sandplay therapy aligns well with preventative strategies aimed at reducing the incidence and severity of suicidal ideation among children. The adaptability of the method also suggests potential for early intervention with diverse populations facing varying psychosocial stressors, including trauma, family disruption, and bullying.
Technologically, the study leveraged innovative observational tools and coding schemes to analyze sandplay sessions comprehensively. Video recordings of group interactions were subjected to both behavioral coding and symbolic content analysis, enabling researchers to quantify engagement levels, thematic content, and interaction patterns. This rigorous approach allowed for precise identification of therapeutic mechanisms at play during session dynamics and offered insights into how specific symbolic expressions correlated with clinical improvements. Such methodological advancements pave the way for future research to refine and optimize sandplay therapy protocols.
While promising, the authors also emphasize the need for cautious interpretation due to certain limitations. The study’s sample size, though sufficient to detect significant effects, calls for replication with larger and more diverse populations to enhance generalizability. Additionally, differentiating the specific therapeutic contributions of sandplay itself versus general group support remains an area for further exploration. Nevertheless, the convergence of quantitative and qualitative data provides robust preliminary validation of sandplay group therapy as an effective modality for supporting children vulnerable to suicidal ideation.
Intriguingly, the study aligns with emerging neuroscientific perspectives on non-verbal therapies. Neuroimaging research has begun to highlight how creative, play-based interventions activate brain regions implicated in emotion regulation, reward processing, and social cognition. Sandplay, by engaging these neural substrates through multisensory symbolic enactment, may facilitate neuroplastic changes that underpin recovery and resilience in at-risk children. Integration of psychodynamic theories with neuroscientific models represents a fertile ground for advancing understanding of therapeutic processes in child mental health.
The public health significance of reducing childhood suicidal ideation cannot be overstated. Suicide is a leading cause of death among children and adolescents worldwide, with complex etiologies that demand multifaceted preventive approaches. The present study’s demonstration of an effective, psychologically rich therapy tailored to children’s developmental needs offers hope for mitigating this crisis. By incorporating sandplay group therapy into broader mental health frameworks, practitioners can address the emotional underpinnings of suicide risk in a manner that honors children’s innate capacities for creativity and meaning-making.
Moreover, the creative and visually engaging nature of sandplay therapy holds potential for amplification through digital and hybrid delivery models. Virtual sandboxes and augmented reality platforms might extend therapeutic outreach to remote or underserved populations, enhancing accessibility and adherence. As mental health services grapple with increasing demand and resource constraints, digital augmentation of evidence-based therapies like sandplay could transform service delivery and democratize healing opportunities for at-risk youth.
The study’s findings further challenge mental health professionals to reconsider prevailing assumptions regarding the communication limitations of suicidal children. Rather than focusing on deficits in verbal expression or willful silence, recognizing the power of alternative expressive modalities can enrich therapeutic repertoires. Embedding sandplay group therapy alongside cognitive-behavioral and pharmacological treatments may yield synergistic benefits, addressing both the experiential and neurochemical dimensions of suicidal ideation.
In summary, the research conducted by Shin, Kim, Kim, and colleagues represents a landmark contribution to child mental health interventions. It evidences that sandplay group therapy is not merely an artistic or recreational activity but a sophisticated psychotherapeutic tool capable of transforming the trajectories of children at risk of suicide. As the field advances toward integrative, developmentally sensitive approaches, such innovative methodologies will be essential in crafting compassionate, effective responses to one of the most pressing challenges in pediatric psychology.
Continued investment in rigorous research, practitioner training, and implementation infrastructure will be critical to translating these findings into widespread clinical practice. Ultimately, the hope is that early, imaginative, and relational therapies like sandplay will reduce tragic losses, foster resilience, and help children reclaim agency over their mental and emotional well-being. In the battle against childhood suicidal ideation, such breakthroughs offer a beacon of light—and a call to action for clinicians, policymakers, and researchers alike.
Subject of Research: The effects of sandplay group therapy on children at risk of suicidal ideation
Article Title: Effects of sandplay group therapy on children at risk of suicidal ideation
Article References:
Shin, H., Kim, O., Kim, M.S. et al. Effects of sandplay group therapy on children at risk of suicidal ideation.
BMC Psychol 13, 800 (2025). https://doi.org/10.1186/s40359-025-03150-9
Image Credits: AI Generated
