How Play Therapy and Medication Work Together

When symptoms affect your child’s daily life

If your child’s ADHD or anxiety is disrupting school, friendships or family life, you may be wondering whether play therapy or medication is the better next step. The answer is not always one or the other: each approach can address a different part of the difficulty.

This guide explains what each approach does, when coordinated care may help, how treatment can connect with classroom support and what personalized care looks like at Robin Trivette, PMHNP-BC, PLLC.

How play therapy and medication can work together

Medication may reduce symptoms that make everyday tasks feel unmanageable. A child with ADHD may be better able to pause, listen and stay with an activity. A child with anxiety may feel less overwhelmed by physical fear or persistent worry. That steadier baseline can make it easier to take part in therapy.

Therapy serves a different purpose. It helps your child recognize feelings, practice coping skills, work through conflict and learn new responses. Medication does not teach those skills, while a child who is extremely restless, distressed or shut down may struggle to use them until symptoms are more stable.

In a study of 579 children with ADHD, the National Institute of Mental Health found that carefully managed medication combined with behavioral treatment offered advantages in areas including anxiety, social skills and parent-child relationships.

Combined care does not mean every child needs medication. The appropriate plan depends on symptom severity, developmental needs, health history and how your child functions at home, at school and with peers.

How play therapy builds social and emotional skills

Children do not always have the words to explain fear, frustration, shame or racing thoughts. Play gives them a developmentally natural way to communicate. Through stories, art, games, puppets or role-play, a child can express experiences that may be difficult to discuss directly.

A therapist can use what happens in play to help the child identify emotions and try safer responses. A character who loses a game may open a conversation about frustration. A pretend classroom may reveal worries about making mistakes. Role-play gives a child a low-pressure place to practice asking for help or handling disagreement.

Depending on the child and treatment goals, play-based work may support skills such as:

• Pausing before acting and recovering after disappointment
• Noticing body signals connected with worry, anger or overstimulation
• Using breathing, movement or words to manage distress
• Taking turns, reading social cues and resolving peer conflict
• Trying another solution when the first approach does not work

These abilities develop through practice and a trusting therapeutic relationship, not through symptom reduction alone. You can learn more about my approach on the play therapy service page.

The role of thoughtful pediatric medication management

Before medication is considered, a careful psychiatric evaluation should clarify what is happening. ADHD, anxiety, sleep problems, learning differences and trauma can overlap. Information from you, your child and, when appropriate, the school helps show where symptoms occur and how much they interfere with daily life.

For ADHD, medication may improve attention, impulse control or task persistence. For anxiety, it may reduce persistent fear and intense physical arousal. The goal is not to change your child’s personality or remove every uncomfortable emotion. It is to reduce disruptive symptoms enough for your child to participate more fully at home, at school and in therapy.

Medication choice should account for health history, current symptoms, possible side effects and family concerns. A clinical review indexed by PubMed Central cites guidance recommending follow-up within two to four weeks after starting or adjusting certain psychiatric medications.

Follow-up visits provide time to discuss sleep, appetite, mood, school performance and changes noticed by teachers or family members. Treatment can then be adjusted, continued or reconsidered according to benefits and side effects. My medication management and individual therapy page explains psychiatric evaluation and ongoing care in more detail.

Connecting treatment with 504 plans and IEP support

Progress in an office does not automatically remove barriers during the school day. A child may understand a calming strategy but still struggle to use it in a noisy classroom, during a timed test or while moving between activities. School observations can also show whether treatment gains are carrying over into daily life.

At Robin Trivette, PMHNP-BC, PLLC, I have experience completing evaluations for IEPs, Section 504 plans and school accommodations. I also help parents work through the school system and identify resources their children may need. An evaluation can document diagnoses, functional difficulties and relevant recommendations, although the school team makes eligibility and placement decisions.

Depending on the barrier, accommodations might include movement breaks, reduced distractions, a visual schedule, nonverbal transition reminders, access to a quiet space or adjusted testing conditions. The support should address the child’s specific functional needs rather than rely on a generic list.

With appropriate permission, focused communication among clinicians, parents and school staff can help everyone use consistent coping language and track practical outcomes. Parents can also read my guide to ADHD school accommodations, 504 plans and IEP next steps in North Carolina.

Personalized, collaborative care with Robin Trivette

At Robin Trivette, PMHNP-BC, PLLC, I provide psychiatric evaluations, medication management, supportive therapy and play therapy for children and adolescents. I bring more than 20 years of behavioral health nursing experience to an individualised treatment plan built around your child’s symptoms, history and goals.

Care can be coordinated in different ways. I can provide medication management alongside therapy, or collaborate with your child’s established therapist when the referral is specifically for medication management. Your child can keep a trusted therapeutic relationship while adding psychiatric support.

The process begins with an online request. Brittany will contact you within 24 to 48 hours to arrange a free 15-minute phone screening and discuss whether the practice is a suitable fit. If you decide to proceed, a 90-minute intake appointment comes next, followed by a personalized treatment plan.

In-person care is available in Cary. Medication management and supportive therapy are also available by telehealth for clients across North Carolina.

Request a phone screening

To discuss your child’s needs, complete the online request form for a free 15-minute phone screening. You can also call Robin Trivette, PMHNP-BC, PLLC at (919) 297-8438 or email brittanytrivette@durhampsychiatricservices.com. In-person care is at 515 Keisler Dr Suite 104, Cary, NC 27518, USA.