The Way We Play in the Sand: A Meta-Analytic Investigation of Sand Therapy, Its Formats, and Presenting Problems

Sand therapy is a group of expressive arts interventions that is implemented with a variety of age groups that present to therapy with any number of chief complaints. In this study, we sought to establish an overall effect size for sand therapy, its efficacy with a variety of presenting problems, and the impact moderator variables may have had on effect size. For this meta-analysis, 36 studies were included, which yielded a Hedges’ g of 1.165. Additionally, meta-analyses were conducted on several different presenting problems including anxiety (k = 7, g = 1.425), anger (k = 5, g = .760), depression (k = 7, g = 1.071), parent–child relationship issues (k = 5, g = 3.932), and self-esteem (k = 6, g = 1.588). The impact of moderator analyses was conducted which indicated that sand therapy was as effective in group formats (k = 11, g = 1.073) as it was in individual settings (k = 7, g = 1.285). Additionally, age groups were analyzed, which indicated that sand therapy had high effect sizes that were roughly the same for adults (k = 14, g = 1.414), adolescents (k = 8, g = 1.035), and children (k = 14, g = 1.112). We discuss clinical implications for the use of sand therapy and further research suggestions.