Introduction
It is a common misconception that play therapy and occupational therapy are the same because they both involve play. In reality, while both approaches use play, they do so in different ways and for different purposes. Understanding these differences can help caregivers choose the type of support that best suits their child’s needs.
What is Play Therapy?
Play therapy is a form of psychotherapy that uses play as the primary way children express themselves, process experiences, and make sense of their inner world. Because children often lack the language to explain complex or overwhelming feelings, play becomes their most natural way of communicating thoughts, emotions, and relationships.
Through play, children explore fears, build self-understanding, practise new ways of coping, and gradually develop emotional and behavioural resilience.
Play Therapy’s Focus
Play therapy focuses on a child’s psychological and emotional development, such as:
- Emotional regulation and expression
- Behaviour patterns and underlying needs
- Self-esteem and identity
- Relationships and attachment
- Coping with stress, change, or difficult experiences, including building emotional resilience and flexibility
Play therapy can be non-directive, where the child leads and the therapist follows, or more directive and structured, depending on the child’s needs and the therapeutic approach. In both cases, play is not simply an activity — it is central to the therapeutic process through which change occurs.
In simple terms, play therapy works from the inside out. Children’s behaviours are often outward expressions of their internal emotional world. When feelings such as fear, stress, frustration, or shame are overwhelming or difficult to understand, they may show up as meltdowns, withdrawal, defiance, or aggression.
Rather than targeting behaviour alone, play therapy focuses on helping children understand and work through these underlying emotional experiences. As children develop greater emotional awareness, regulation, and a stronger sense of self, behaviour often shifts naturally as a result.
What is Occupational Therapy?
Occupational Therapy supports children to develop the skills they need to participate in everyday life. It looks at how a child engages in daily activities across different environments, including at home, at school, and in the community.
In this context, the term ‘occupation’ refers to the activities that fill a child’s day. These include self-care, learning, social participation, and play. When these activities feel challenging or overwhelming, occupational therapists work to understand which skills are still developing and how to best support the child’s independence and participation.
Occupational Therapy’s Focus
Occupational Therapy supports a child’s functional development, including:
- Fine and gross motor skills
- Sensory processing and regulation
- Attention and participation
- Self-care skills such as dressing, feeding, and toileting
- Transitions, routines, and school readiness
In occupational therapy, play is used in different ways. Therapists balance child-led play with more guided, goal-focused activities to support each child’s development. Play may be used as a therapeutic tool to build skills such as strength, coordination, regulation, and problem-solving.
Play can also be a goal of therapy when a child is still developing the ability to explore, imagine, take turns, or play alongside others. In these cases, therapy focuses on building the foundations needed for meaningful play.
Occupational therapy works from the outside in, starting with the everyday activities a child needs to take part in and building the motor, sensory, and/or regulatory skills that support participation. When these skills are still emerging, daily tasks can feel hard and may show up as frustration, avoidance, difficulty with routines, or reduced engagement. Rather than a lack of effort, these challenges often reflect the skills that need support. As these skills develop, daily activities, including play, become easier and participation feels more comfortable over time.
Key Differences at a Glance
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Play Therapy
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Occupational Therapy
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Focus
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Emotional, psychological, and relational processes
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Functional skills for daily living
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Main driver of change
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Meaning-making, emotional integration, relationships
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Skill development, practice, adaptation
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Use of play
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Play is central to the therapeutic process
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Play is a tool to build skills and can also be a goal of therapy
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Targets
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Emotions, behavioural patterns, self-concept
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Sensory, motor, regulation, routines
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Scope
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Inner world that affects outward behaviours
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Daily actions and skills
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Which one is right for my child?
The most helpful starting point is to look at where your child is experiencing the greatest difficulty.
- If challenges are primarily related to emotions or behaviour, such as intense emotional reactions, anxiety, low confidence, grief, difficulty with changes, reduced flexibility, or relationship struggles, play therapy may be helpful. Play therapy focuses on understanding the emotional processes and experiences that sit beneath these behaviours.
- If challenges are mainly related to daily functioning, such as sensory sensitivities, coordination difficulties, attention, or managing everyday tasks, occupational therapy may be more appropriate. Occupational therapy supports the development of the skills needed for participation in daily life.
- Some children benefit from both therapies, either at different stages or at the same time, as they address different layers of development and often complement each other.
If you’re unsure, that uncertainty is completely normal. Gaining a clearer understanding of your child’s needs is often the first step, and a conversation with a trained therapist can help guide the decision.
Conclusion
Ultimately, the goal of therapy is to support children to feel capable, confident, and engaged in their everyday lives. Choosing the right approach is not about finding a “perfect” therapy, but about identifying what best meets your child’s needs at this point in time.
At Ohana Therapy, our therapists work collaboratively with families to understand each child’s unique profile and needs. If you have concerns or questions, we are here to support you in exploring the most appropriate next steps for your child.
References
- Beisbier, S. & Cahill, S. (2021). Occupational Therapy Interventions for Children and Youths Ages 5 to 21 Years. The American Journal of Occupational Therapy, 75(4), 7504390010.
- Brown, T. & Lynch, H. (2022). Children’s Play-Work Occupation Continuum: Play-Based Occupational Therapy, Play Therapy and Playwork. Canadian Journal of Occupational Therapy, 90(3).
- Landreth, G. L. (2012). Play Therapy: The Art of Relationships. Routledge.
- Lynch, H. & Moore, A. (2016). Play as an occupation in occupational therapy. British Journal of Occupational Therapy, 79(9), 519-520.
- Schaefer, C. E., & Drewes, A. A. (2014). The therapeutic powers of play: 20 core agents of change (2nd ed.). John Wiley & Sons.
- VanFleet, R, Sywulak, A. E., and Sniscak, C. C. (2010) History, Theory, Principles, and variations of child-centered Play Therapy. Child-Centered Play Therapy. New York: The Guildford Press.
