The benefits of sharing house-tree-fire-water-person drawings with parents when their anxious child is in sandplay therapy.

Introduction: The purpose of this study is to critically reflect on the value of the House-Tree-Fire-Water-Person (HTFWP) drawing as a tool to engage the parents of children aged 10-12 in sandplay therapy for Generalized Anxiety Disorder (GAD). To do so, we draw on empirical work that addressed gaps in the existing parent-psychologist alliance literature by exploring the usefulness of sharing the HTFWP drawing series with parents at feedback sessions.

Methods: We employed an instrumental, multiple case study design. The sample consisted of 7 cases, involving parents (n = 9) and child-clients referred for GAD (n = 7). Parent-generated data included the verbatim transcripts of initial semi-structured interviews, three HTFWP drawing elicitation conversations (i.e. HTFWP-facilitated feedback sessions) and a post-intervention semi-structured interview. Child-generated data included three HTFWP drawings and child-driven explanations of these drawings. Psychologist-generated data included journal-recorded reflections and process notes. Using reflexive thematic analysis, we identified patterns in these data.

Results: Findings suggest that an alliance created between parent and psychologist through sharing the HTFWP drawing series with parents was a win for everyone (parents, child and psychologist). This 'win-win' situation included enhanced care for the child, bolstered parental support and heightened efficacy for the psychologist.

Conclusion: The HTFWP drawing has high potential to support the therapeutic process, with emphasis on its facilitation of a parent -psychologist alliance and spillover benefits for parents, the treating psychologist and the child-client.