Hidden Hurt
Recognizing the Signs of Trauma in Children and Supporting Recovery Through Play Therapy
When parents reach out for child therapy, they are often concerned about behaviors they can see. Maybe their child is having frequent meltdowns, becoming aggressive with siblings, struggling at school, withdrawing from friends, or having difficulty sleeping.
While these behaviors can certainly be concerning, they are often symptoms of something deeper. For some children, these changes may be connected to experiences that have left them feeling overwhelmed, unsafe, powerless, or emotionally flooded.
Trauma can affect how children view themselves, their relationships, and the world around them. Understanding the impact of trauma can help parents respond with greater compassion and seek support when needed.
What Is Childhood Trauma?
Trauma occurs when a child experiences an event, series of events, or circumstances that overwhelm their ability to cope. While many people think of trauma as a single catastrophic event, children can experience trauma in a variety of ways.
Examples may include:
Abuse or neglect
Exposure to domestic violence
The loss of a significant caregiver
Serious accidents or medical events
Natural disasters
Community violence
Separation from caregivers
Chronic instability or unpredictable caregiving environments
Importantly, trauma is not defined solely by what happened. Two children can experience the same event and respond very differently. A child's developmental stage, temperament, support system, and relationships all influence how they process difficult experiences.
How Trauma Can Affect Children
Trauma affects more than emotions. It can influence a child's nervous system, relationships, sense of safety, ability to regulate emotions, and beliefs about themselves.
Some common signs of trauma in children include:
Emotional Signs
Increased anxiety or worry
Excessive fears
Irritability or anger
Sadness or depression
Emotional numbness
Frequent mood swings
Feeling easily overwhelmed
Behavioral Signs
Aggression or defiance
Increased tantrums
Withdrawal from activities or relationships
Difficulty concentrating
Hypervigilance or being constantly "on guard"
Regressive behaviors such as bedwetting or increased clinginess
Difficulty with transitions
Physical Signs
Sleep disturbances
Nightmares
Frequent headaches or stomachaches
Changes in appetite
Increased fatigue
Toileting accidents/bedwetting
Relationship Difficulties
Trouble trusting adults
Difficulty making or maintaining friendships
Separation anxiety
Challenges interpreting social situations
Difficulty seeking comfort when distressed
For many children, these reactions are not signs of misbehavior. They are attempts by a developing nervous system to adapt to experiences that felt overwhelming or unsafe.
Why Children Often Don't Talk About Trauma
Adults often process experiences through conversation. Children process experiences differently.
Young children frequently lack the language, emotional awareness, or cognitive development needed to fully explain what they have experienced. Instead, they communicate through behavior, relationships, and play.
This is one reason why trauma can be difficult to recognize. Children may not tell adults directly that they are struggling. Instead, they show us through their actions.
As child development experts often note, play is the natural language of children. Through play, children can express feelings, explore experiences, solve problems, and communicate ideas that may be difficult to put into words.
How Play Therapy Supports Healing
Because play is children's natural form of communication, play therapy offers a developmentally appropriate way for children to process difficult experiences.
In Child-Centered Play Therapy, children are provided with a carefully designed playroom and a therapeutic relationship characterized by acceptance, empathy, and emotional safety. Rather than directing the child's play, the play therapist follows the child's lead and trusts the child's natural capacity for growth and healing.
Research examining Child-Centered Play Therapy with children who have experienced traumatic events has found improvements in areas such as self-concept, self-competence, social functioning, emotional adjustment, and behavioral concerns. Studies have included children who experienced domestic violence, sexual abuse, natural disasters, war-related trauma, and other adverse experiences. While additional research is still needed, the existing findings suggest that Child-Centered Play Therapy can be a helpful intervention for children who have experienced trauma.
Researchers have proposed that the play process allows children to safely express emotions, explore experiences, and work through difficult feelings in ways that match their developmental level. Rather than requiring children to verbally describe traumatic experiences before they are ready, play creates opportunities for expression through action, symbolism, creativity, and relationship.
What Happens in Child-Centered Play Therapy?
Many parents are surprised to learn that a play therapist does not spend sessions teaching lessons, asking a long list of questions, or directing every activity.
Instead, my role is to create the conditions that allow healing and growth to emerge naturally.
Within the playroom, children are encouraged to make choices, solve problems, and direct their own play. This process helps children develop a greater sense of competence and personal agency, qualities that are often disrupted by traumatic experiences.
As a child therapist, I carefully track the child's experience, reflect feelings, communicate understanding, and provide therapeutic limit setting when necessary. I also offer encouragement that supports the child's growing sense of capability without evaluating or judging their performance.
Over time, children often encounter moments of frustration, uncertainty, excitement, sadness, anger, or fear within the safety of the playroom. Rather than immediately solving these experiences for them, I support children in moving through them. Through repeated opportunities to experience challenges and regain equilibrium, children develop increased frustration tolerance, emotional regulation, confidence, and resilience.
One of the most powerful aspects of Child-Centered Play Therapy is that children discover they are capable. They learn that they can make decisions, solve problems, express feelings, recover from setbacks, and navigate difficult emotions. These experiences help build self-worth from the inside out.
When Should Parents Seek Support?
Every child experiences stress and difficult emotions. However, it may be helpful to consult a child therapist if your child is experiencing persistent changes in behavior, mood, sleep, relationships, or daily functioning.
Seeking support early can help children process difficult experiences before patterns become more deeply ingrained. Children are remarkably resilient, especially when they have safe relationships and opportunities to express themselves in ways that match their developmental needs.
If you are looking for a play therapist in San Luis Obispo or the Central Coast, Child-Centered Play Therapy can provide a safe and supportive space where children can communicate, process experiences, and strengthen their capacity for healing and growth.
References
Humble, J. J., Summers, N. L., Villarreal, V., Styck, K. M., Sullivan, J. R., Hechler, J. M., & Warren, B. S. (2020). Child-centered play therapy for youths who have experienced trauma: A systematic literature review. International Journal of Play Therapy, 29(1), 56-68. https://doi.org/10.1007/s40653-018-0235-7
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach. U.S. Department of Health and Human Services.
Landreth, G. L. (2012). Play therapy: The art of the relationship (3rd ed.). Routledge.
Ray, D. C., Bratton, S. C., Rhine, T., & Jones, L. (2001). The effectiveness of play therapy: Responding to the critics. International Journal of Play Therapy, 10(1), 85-108.
