PLAY THERAPIST Compares Theraplay vs PCAP – ATTACHMENT-Based Interventions | #TRIBE Talk - Ep. 30

In this episode of TRIBE Talk, play therapist Aleisha walks us through two well-known attachment-based interventions: Theraplay and PCAP (Parent Child Attachment Play). Both approaches focus on strengthening the relationship between the child and their caregiver, using structured, playful interactions to build connection, safety, and emotional regulation.

We explore how each approach works in practice, where they overlap, and how they differ in structure, delivery, and focus. Through a trauma-informed lens, this episode helps parents, carers, and professionals understand how attachment-based therapies can support children’s emotional development—particularly for those with trauma histories—by working directly with both the child and the parent to create meaningful, relational change.

Episode Highlights:

• What Theraplay and PCAP (Parent Child Attachment Play) are
• How both approaches use play to strengthen attachment and connection
• Key similarities between Theraplay and PCAP
• Important differences in structure, delivery, and focus
• The role of the parent within each intervention
• How attachment-based therapies support children with trauma histories
• Choosing the right approach for a child and family
• What outcomes and progress can look like over time

Check Out Aleisha's Podcast on Integrative play Therapy Here: https://youtu.be/NadoiJ_q1DA

Transcript

SPEAKER_01 0:00

Welcome to Tribe Talk everyone. I'm Laura Neal and today I'm joined by our play therapist Alicia Thomas and we're going to be talking about two therapies, PCAP and Theraplay. Today we're going to be talking about two attachment-based therapies, one called PCAP, Parent-Child Attachment Play, and Theraplay. So both of these therapies are used for childhood attachment needs, but big questions: what do they do and who can they help? So Alicia's here joining me and she's going to walk us through them, aren't you? Yeah. Alicia's been on the podcast before. She is our play therapist here at the clinic. Alicia, do you want to say a little bit about yourself?

SPEAKER_00 0:45

Yeah, my name is Alicia Thomas. I am a play therapist, one of the play therapists that we have here. And I'm trading in lots of different therapies.

SPEAKER_01 0:54

Yeah, I use a very integrative model of play therapy demo, which is actually what you talked about briefly the last time that we met. I did. So today we're going to talk about Theraplay and PCAP. Starting off with what they are. So let's start off with PCAP, parent-child attachment play. What is it?

SPEAKER_00 1:15

So you said it at the beginning that it's an attachment-based therapy. It works on that relationship between the parent and the child. It's a 10-step model, so it's not a 10-week model, 10-steps, and it can be quite flexible in the way that it's approached, but it's used to strengthen the relationship. It focuses really on attunement between the parent and the child. But it's it's it's similar but different to therapy.

SPEAKER_01 1:44

Okay. So let's move on to what is therapy, and then we can look at why they're different.

SPEAKER_00 1:51

Yes, again, uh an attachment-based therapy works on that relationship and that bond between the parent and the child, um, and it uses a lot of playful and interactive activities to help that happen. It's very experiential. What does that mean, very experiential? So you're you're doing it in the moment. So the therapist is heavily involved in therapy, but you're practicing those activities together and you're really feeling the bond strength and you're working through it together.

SPEAKER_01 2:20

Okay, so both of these therapies they happen with the child and the parent, they're not a therapy that is solely undertaken with the child on their own.

SPEAKER_00 2:29

No, parent is involved. Um, I guess that leads us to how they're a little bit different as well. So parent is involved from the start with therapy. In PCAP, um, sorry, parent and the child at the start of therapy, but in PCAP it's just the parent at the start with the therapist, and then we introduce the child a little later on.

SPEAKER_01 2:50

Yeah, so um PCAP, which is actually something I'm trained in as well, which is unusual for a play-based therapy. Um, but with PCAP, you actually start at the beginning um uh teaching the parent about attachment, isn't it? So you're going through what is attachment, what might this look like at your in your home, what might you be seeing, um, where therapy is quite different, where you start off with um looking at the interactions between the parent and the child.

SPEAKER_00 3:16

So with therapy, you start off with an observation, we call that the mim, um, and the therapist will will video that interaction and then observe and pick up on on all the different dimensions they're called in therapy. Yeah, so we're looking at nurture, structure, challenge, and engagement, um, and the therapist is looking out for what's going well, what could be improved upon to plan the rest of the therapy. Whereas in PCAP, um at the beginning you're teaching the parent, you're you're with them teaching them about attachment, and also some skills. So we've got the play skill, how do they relax into play? How do they get more playful? Do they play at all right now? Then you've got containment, and then you've got reflective functioning.

SPEAKER_01 3:58

Right, yeah. So two very different therapies. They are, but both attachment-based therapies, which can be confusing, I think, at times.

SPEAKER_00 4:06

Both focusing on strengthening the same thing but in different ways.

SPEAKER_01 4:10

Yeah.

SPEAKER_00 4:10

And for different reasons. Um, but yeah, both attachment-based, both focusing on that relationship and the attunement between the parent and the child.

SPEAKER_01 4:21

Um, so to give everybody an idea of what they look like, could you walk us through what a typical PCAP program might look like?

SPEAKER_00 4:28

So the therapist will meet the parent or parents, um, and we're we're looking at how what is their experience right now with that child. Are they playing um often? What is that relationship looking like? What struggles are they coming up against? We provide a pre-measure called autopsy, which is is all about the the parents' confidence in how they're able to manage any challenges or how they are within that relationship with the child. So we we do that, then we begin those teaching sessions, I guess, of attachment um play, containment, and then reflective functioning. And like I said, we're we're looking for how how relaxed are you within play and kind of teaching that skill with containment, we're getting them to recognise how, even though we're working on this attachment, boundaries and um containment of the space can still be present, and that that's not going to impact negatively on the relationship, it's only going to improve it. So, how do we do that in a manageable and gentle way for the child? Then we've got reflective functioning, which is the the head, heart, hands model, um, and it's all about that parent attuning to the child and really putting themselves in the child's shoes and thinking how would they think, how would they feel, how would they react to this. Um, so really sitting alongside that child. Then comes there is some homework with PCAP, so there's create your own boundaries, there's create a toy box for the child, and when they've done that, then they're really thinking about what that child likes. When they've completed that, the sessions begin. And what that looks like is a structured session once a week, which is your your special time or your playtime or your PCAP time, it's your time together with that child with that specific box that you've created. That box will then go away for the rest of the week. It is purely for that session because it's a very special time together.

SPEAKER_01 6:32

And the items in that box are different from other items that they can access day to day?

SPEAKER_00 6:37

Yes, it's it's specific to that box. Um, maybe there are some things that they have around the house that they have access to on other days, but that item in there remains in that box. So that box is created, bespoke to the child. So each box I have I've created with the parent is very different because each child's interests are different.

SPEAKER_01 7:00

So, from a behavioural perspective, this is looking at what does the child find reinforcing? So, what will they actually want to engage in, and then that's why that goes away, so that they're invested in that one-to-one time with a parent. If they look at the time because they actually want to engage with the parent in that activity that they don't get to um on a day-to-day basis.

SPEAKER_00 7:19

So maybe it's something even a little more special, like slime that they don't have free access to. Yeah, so yeah, it is very reinforcing.

SPEAKER_01 7:25

Yeah. Okay, so that's PCAP. Can you walk us through a therapy programme?

SPEAKER_00 7:32

Yes, so we meet the parent, we do um kind of a an intake interview because it's important with therapy to understand the the parents' backgrounds or the carers' backgrounds because it's quite an intimate therapy. There's a lot of tactile um within within the sessions. So we we have that interview, then we do the mim, like I mentioned, the observation where the therapist will film those interactions and look through those four um dimensions. The therapist then goes away, observes, um, creates a plan and some goals, takes it back to the parent and says, This is what I've seen, this is what I'm thinking, and so the plan of therapy is created based off those dimensions. Where do they feel that that improvement needs to happen? Where where is there a little less skill that we need to build upon?

SPEAKER_01 8:26

So, within that, could you have um a young person who is really skilled in one area and not in another?

SPEAKER_00 8:33

100%. So you may not be targeting one dimension at all. So if if we've got a child who um is really great with structure, completely accepts it and is absolutely fine, but really struggles with nature, we're really going to hone in on that nurture.

SPEAKER_01 8:49

Okay, so both looking at attachment in different ways, really. Yeah. Yeah. Absolutely. Okay, great, thank you. So starting off with PCAP again, um, how do they support parents and children? Or how does that support parents and children, or how do they? How does PCAP support parents and children?

SPEAKER_00 9:08

It strengthens that relationship, like I've said lots, um, but it really improves that attunement. That parent is really noticing what that child may be thinking, feeling, anticipating what they may do next. They're really alongside in that child's issues. Um and it it also builds their confidence because that topsy measure that I mentioned, it's it's all about their confidence, how they're feeling in that relationship, and to consider those questions throughout, then noticing their their confidence build.

SPEAKER_01 9:37

For some parents, I can imagine that um having that one-to-one time will be a new experience for them as well. Yeah. Um, it doesn't come naturally within their day-to-day life. Yeah, it's it's making that time essentially to build in that one-to-one time.

SPEAKER_00 9:53

And recognising the importance of that time. Yeah. It it can feel maybe like a chore or a challenge to it's it's another thing that we have to do, but it is so beneficial to have that time. So with with PCAB in particular, it's it's 20 minutes. It's that's the containment part. It is this amount of time that we have together, but that is such important time. And yeah, kind of including that in your your timetable of your day, I guess, and recognising it is important, even though it can feel like another thing to do.

SPEAKER_01 10:27

A question around that. So I think you know, as a parent, I would be saying, Well, I do have one-to-one time with my child. Um but PCAP is slightly different because it's not just about the one-to-one time, it's about that engaging in an attachment-focused way over that one activity. So it's not one-to-one time where you're maybe watching television together or you're going out shopping together, or you're having um a c just a conversation. So walk us through the importance of that, what that looks like around that activity, and why is that different from one-to-one time.

SPEAKER_00 11:04

So I guess when we um just naturally have one-to-one time or what we think is one-to-one time with others, there are so many distractions around that are just present within our days. We have our phones, we have the TV, we have somebody knocking the door, but there's lots of things that can be going on, and we may just nip and and do this and then come back, but then that moment is broken. Um, but with PCAF, but there's a real emphasis on we want no phones, that there's no distractions, you are fully, fully there with that child alongside them, the eye contact between you. You are so invested in them in that moment that you're giving yourself to them, which is very different from just natural interactions, I guess.

SPEAKER_01 11:52

I think it is, because if I think of one-to-one time with my children, for example, they are older, but you can actually use uh PCAP with teenagers as well. Okay. Um but it might be that we're going shopping or we're going for a coffee, um, it might be that we're watching a program on TV together, sometimes we're having conversations, but actually that um one-to-one interaction over a specific activity we probably do very rarely within our week. Um, and that's the importance of it in terms of building that attachment and that opportunity for eye contact, for um just that that joint back and forth.

SPEAKER_00 12:29

Absolutely, and I would say that's the the fundamental of PCAP. I've spoken about um kind of the typical PCAP process of having this toy box, but some teenagers won't like that, they're not interested in that, which that's not reinforcing, that's just another thing to do. So, what could that look like for a teenager? That may be sitting side by side in a car, going on a drive together, and but really tuning in, going from the walk to the park or around the lake or whatever it may be, whatever interests them, you're you're devoting yourself to them in those 20 minutes.

SPEAKER_01 13:01

Yeah, and it's that devotion and that I am here just for you and child led as well. Yes, yeah.

SPEAKER_00 13:09

With teens especially, um, you know, they may be more inclined to talk, and in that moment, lots of things may may come up for them. Let them lead, let them, let them have their time and and tap into that reflective functioning thing, you know, the skill that we've learnt. How can we listen to them? How can we really sit alongside them and and feel how they may feel?

SPEAKER_01 13:32

I need to do some PCAP, I'm gonna have to go home and think about when I can build that into my day.

SPEAKER_00 13:37

Yeah.

SPEAKER_01 13:38

Okay, so that's PCAP. So what about therapy? How does therapy support?

SPEAKER_00 13:44

Again, works on the attachment and the relationship and the the bond between the parent and the child. Um again, it's about co-regulation as well. So the children might find um one of the dimensions quite difficult and they may begin to dysregulate or withdraw, um, avoid even, and how does the parent manage that in the moment? How do they kind of tweak that activity to to continue that that relationship and continue that engagement that they're having with each other, that moment that they're having with each other? Um it increases the confidence because the parent is learning how to engage with their child in a different way. Therapy, I would say, takes a little bit more thought and creativity in how you're going to include nurture into your day, how you're going to include structure into your day, and your challenge and your engagement. They're very playful, fun activities, but they can easily translate into just normal life. Yeah.

SPEAKER_01 14:47

And I I would guess as well, um, therapy is not a therapy that I um I provide, um, but it helps parents to recognise the areas that maybe their children are not so good at and they're compensating for, possibly. So one that comes up, um just thinking of a couple of little boys that I've worked with previously, is they're very good at challenge, but they're not very good at accepting nurture, um, or it can be completely the other way around. But um parents have almost compensated for that, but therapy gives the opportunity to slowly start integrating those things so you're not compensating as much in terms of doing it for them.

SPEAKER_00 15:24

Yeah, definitely, and look at them as individual dimensions, yeah. Because I think maybe if we have a child who really struggles with challenge and dysregulates with that, we may forget to give that nurture because we're we're so focused over here where the dysregulation is that this is this part gets missed. So it's it's nice to look at them in their four separate quadrants to to realise where we need to spend that time. Yeah, so useful.

SPEAKER_01 15:50

Both are building um attachment relationships, and they're very much about that um one-to-one interaction, that attunement, that eye contact, um, that being there just for the child, and they're there for you. Um, so you've got that back and forth that we know is so important within attachment. Um, but a question we've got, which is a really, really important question, is when would you use each one? Why would you pick therapy or why would you pick PCAP?

SPEAKER_00 16:18

Because they're both attachment based, and I suppose yeah, it is quite difficult to think about which one would support best, and to that I'd say you need to think about what what is the issue. Is it that um the relationship is strained and the quality of the relationship needs to improve, that would look more like PCAP. If it's that the the child is resistant to the relationship and there's a block um between that parent and child, um that would be more therapy. But it is quite tricky to think about which one and when.

SPEAKER_01 16:58

Yeah. Um so something that always comes up as well is um does the parents attachment style or attachment interactions do that does that have an impact?

SPEAKER_00 17:07

100%. Because like I said, with therapy, but with PCAP as well, it's important to know what is their history, how how are they within relationships, because it may we may see the child with a challenge, but the parent is a part of that dyad as well. And that's gonna that's gonna matter, it's gonna it's gonna seep in. We try to not let it, but it does.

SPEAKER_01 17:29

Yeah. And I think particularly with something like theroplay, um, because you've got those four different dimensions that you're working on, if a parent um finds one of those dimensions quite difficult, it's very likely the child is gonna find that dimension difficult. Um but it might be that you need to do some work with a parent first, because otherwise you're gonna put them in a difficult situation.

SPEAKER_00 17:52

Which you absolutely don't want that child viewing that, and you know it's gonna push them even further away from that dimension. But everyone has their own experiences and they matter, um, especially within therapy. It is quite an intimate therapy, I feel. Um, like I said, there's a lot of tactile, but you're very close to each other, um, therapist and parent, because the therapist is included in therapy, but parent and child, and whether they mean to or not, maybe that's their chance to recognise some of my own stuff is present within this room. Yeah. And how do we work through that?

SPEAKER_01 18:27

Yeah. And I think that's important for um practitioners or um individuals assessing. Um therapy is, I would say, the go-to attachment therapy that we see recommended more than any any other therapy, but it's not always the right therapy in terms of there are other attachment therapies, you need to be very mindful of what is it you want this therapy to achieve. Yeah. Um, because they actually do slightly different things.

SPEAKER_00 18:53

They target the same thing, but in different ways and under different umbrellas, if that makes sense. Yeah. But it sometimes therapy isn't right. No. Absolutely. Sometimes PCAP's not right, but yeah, yeah, it it it has to be considered which one because they are different.

SPEAKER_01 19:12

Different, but they can both be incredibly effective when they're used. When used in the right way. Yeah. For the right goal, for the right thing.

SPEAKER_00 19:21

Yeah.

SPEAKER_01 19:21

Brilliant. Well, thank you, Alicia. Hopefully that has been helpful to everybody listening. If you enjoyed today's talk, then please subscribe to Tribe Talk for more trauma informed care in practice.