Objectives. This study aimed to explore therapists’ understanding of how people with a wide range of physical problems address the psychological aspects of these problems through sandplay, what happens for them in the process, what changes they experience and what sandplay can contribute to working with such people.
Design. This exploratory qualitative study used grounded theory to systematically analyse the data and construct a substantive theory of therapists’ understanding of the processes and themes involved in sandplay therapy with people with physical problems.
Methods. Semi-structured interviews were carried out with nine sandplay therapists with the participants asked about their experiences of using sandplay to address physical problems.
Results. The participants offered evidence of their clients’ ability to address their physical problems and the corresponding psychological issues through symbolic expression in the sand. The emergent theory suggested that such symbolic expression could facilitate access to feelings and experiences that can be difficult to address through verbal therapy alone, thus facilitating the process of integration and recovery.
Conclusions. The theory suggests how therapists thought that clients may address their physical problems through sandplay and what is important in that process. There was also a suggestion that the focus and themes unfolding in sandplay process may vary depending on whether the clients present with somatisation, chronic illness, or terminal illness.