Therapy takes place in the transitional space between client and therapist or, more specifically, between the reality of the conversation and expression in the room and the meaning that the client projects onto the therapist and the interaction. Therapy involves exploration and identification of this creation. For adults, this can often occur verbally.

For young children and even teens, bringing their inner process into verbal awareness is often difficult. Young children have not developed the needed verbal or cognitive skills for talk therapy; for them, action bridges the "reality" of bodily states and the "symbolic" interpretation of the effects of their movement. Action, curiosity, reflection, imagination constitute the realm of play.

Play is the natural language of children and the primary way they learn about their world and themselves. Through play, children express themselves and their current concerns. In play therapy, the therapist helps put words and ideas to some of their actions and motifs. Teens enter the realm of symbols, myth, irony and satire. With teens, Susan uses collage, drawing, journaling, and chess and logic games to draw out their ways of knowing and to help them recognize what they know and feel. Child and teen therapy, like adult therapy, utilizes the relationship between the client and therapist to provide a sense of being understood and accepted.