Implementation and Outcomes of Play-Based Therapies for Emotional Regulation and Social Functioning Among Autistic Students: A Conceptual and Implementation Model within Comprehensive School-Based Mental Health Systems

Abstract

Children and adolescents with autism spectrum disorder (ASD) often experience heightened anxiety, difficulties with emotional regulation, and challenges in social-emotional functioning, highlighting the critical role of school-based mental health interventions. This literature review synthesizes current evidence on the effectiveness of play-based therapies—compared to non-play or no-treatment approaches—in improving emotional and social outcomes for students with ASD. Findings indicate that play-based modalities, such as structured play therapy, drama and art-based interventions, and peer-mediated play programs, can enhance self-regulation, reduce anxiety, and foster social connectedness by leveraging children’s natural modes of expression and engagement. However, implementation in school settings remains inconsistent. Reported barriers include limited clinician training and supervision in play therapy methods, time constraints within school schedules, lack of administrative support, and insufficient resources. These challenges contribute to gaps between evidence and practice. The review underscores the need for systemic support, professional development, and interprofessional collaboration to strengthen the use of play-based approaches within comprehensive school mental health frameworks. Implications for policy, clinician training, and future research directions are discussed. This capstone evaluates the effectiveness and feasibility of play-based therapies for children and adolescents with autism spectrum disorder in school settings. The review integrates empirical findings from 2010 through 2025 and synthesizes outcomes for emotional regulation, anxiety, and social-emotional functioning. It also examines implementation barriers and practical adaptations that affect intervention fidelity and reach in real-world school contexts (Daniel, Berkovits, Eisenhower, & Blacher, 2025)

Keywords: autism spectrum disorder, play-based therapy, school mental health, emotional regulation, implementation barriers