Using the symbolic expression of sand tray to kinesthetically connect to the inner cognitions of individuals diagnosed with a neurocognitive disorder

This qualitative case study investigated the impact of sand tray on individuals
diagnosed with Alzheimer’s and other forms of dementia. Four participants successfully
completed the creation of sand trays while the researcher observed, interviewed, and
documented the individual sand trays. The intervention established that sand tray allows
the dementia patient to kinesthetically connect to their inner cognitions through the
intentional symbolic expression offered by this unique therapeutic medium. Using a
series of eight sand trays of varying thematic concepts, the participants were offered a
modality to facilitate a synthesization of their continued individuation, presenting a
possible neural pathway to connect and express thoughts, feelings, emotions, concerns,
challenges, and fears. The findings of this study include the fact that all trays were
classified as “empty” and that the majority of the participants placed objects almost
exclusively on the right side of the tray, which is commonly associated with the concreteor conscious side. The use of sand tray allowed each individual the opportunity to create autobiographies in the sand and literally navigate through time – past, present, and future, confronting fears, expressing hope and possibilities. The results of the research study offer insight into the psychotherapeutic effects of using sand tray with dementia patients, as well as a better understanding of the cognitive and expressive abilities and limitations of an individual with impaired memory. The results also offer insight into the difficulties with short-term memory in this population and possibly indicate a potential means for monitoring cognitive decline. Keywords: Neurocognitive disorder, Alzheimer’s, dementia, sand tray, play therapy