Puppetry and mask work

1. Introduction

Version followed: no single manual exists. This guide puts together (a) the brief psychodramatic mask series of Rojas-Bermúdez and Moyano as adapted for adolescents by Pires, Rojas, Sales and Vieira (2021); (b) the published puppet assessment and therapy techniques reviewed by Viklund (2025): Woltmann and Bender, Irwin, Irwin and Malloy, Ross, Portner, Wüthrich, Knell, Ablow and Measelle, Russ; (c) Landy's four proposed uses of masks (1985) as summarised by Pires et al.; (d) de-roling practice as described by Sally Bailey; and (e) UK art-education safety guidance on plaster for anything cast on the body.

Puppetry and mask work is a family of projective techniques, not a single therapy. Drama therapists, psychodramatists, play therapists and art therapists all use it inside their own frameworks. In each case the client puts feelings, roles and conflicts into an object they make or choose: a puppet held at arm's length, or a mask worn over the face. They then speak and act through that object. The core idea of change is distance. The fiction, or the object, "filters" difficult feeling, so the client can feel it without being engulfed by it [source: BADth FAQs, on aesthetic distance]. Masks can also ease access to inner content and reduce the pressure of face-to-face contact [source: Pires et al. 2021]. In psychodrama the mask is treated as an intermediary object (Rojas-Bermúdez), something that carries communication between people who find direct contact too hard [source: Pires et al. 2021, citing Rojas-Bermúdez 2017]. Change comes from embodying and dialoguing with the projected roles, then de-roling and reflecting on how they connect to real life [synthesis, consistent with the sources above].

Professional frame. In the UK, "dramatherapist" is a protected title, and it is unlawful to use it without registration with the Health and Care Professions Council (HCPC) [source: BADth FAQs]. Art therapists are HCPC-registered in the same way [uncertain]. In the USA, drama therapists hold the RDT credential from NADTA, and psychodramatists are certified by ABE (linked to ASGPP) [uncertain]. Play therapy in the UK is not a statutorily regulated profession; BAPT and PTUK run voluntary registers [uncertain]. Using a puppet or a simple mask as a warm-up needs no special credential. Using them for enactment of trauma material, structured puppet assessment, or full-face masks in groups should only be done by a clinician trained in drama therapy, psychodrama or play therapy, or under that clinician's supervision. The Berkeley Puppet Interview and the Affect in Play Scale also need their own training and scoring manuals [synthesis].

2. Framework

There is no fixed phase model across the family. Two published structures can be followed directly.

A. Brief psychodramatic mask group (Pires et al. 2021, adapting Rojas-Bermúdez and Moyano)

Format: 8 weekly sessions of 90 minutes. A director leads, with an auxiliary ego (a psychodrama trainee) present throughout. Each session runs warm-up, then enactment, then sharing [source: Pires et al. 2021].
Phase 1 (sessions 1–2), body and safety: diaphragmatic breathing and body and sensory exploration. Goal: group cohesion and body awareness before any projection.
Phase 2 (sessions 3–5), making: preparing materials and painting a series of four masks on cardboard. Each mask is written up on a characterisation sheet.
Phase 3 (sessions 6–8), playing: using the masks in a psychodramatic self-presentation, embodying each mask as a character, role-playing life situations in mask, and group discussion of each mask [source: Pires et al. 2021].
Criteria for moving on are not stated in the source. Suggested criteria: move to making only when members can stay present in body exercises without dissociating or leaving; move to masked enactment only when each member has a finished mask they are willing to wear and has practised taking it off on cue [synthesis].

B. Puppet work with children and families (as reviewed by Viklund 2025)

Assessment phase (1–3 sessions). Use a semi-structured technique such as the Puppet Therapy Assessment Technique, the Family Puppet Interview or the Ross technique. Diagnostic work tends to be semi-structured; ongoing therapy is usually less structured [source: Viklund 2025].
Rapport phase. Start with psychologically safe, low-demand play, especially where resistance is strong. Families need more structure than individual children, because family dynamics emerge quickly. Telling anxious clients roughly what to expect lowers their anxiety [source: Viklund 2025].
Working phase. Weekly puppet play and story-making, either child-led (as in Dynamics of Three, where the therapist follows) or with the therapist using puppets to model and question. Session counts are not given in the sources [uncertain].
Ending phase. Review the puppet stories made over the course of therapy. Let the child decide whether a self-made puppet goes home, stays, or is ritually put away [synthesis].
Moving on, or referring: if a safe, trusting space cannot be built, consider referral [source: Viklund 2025]. If puppets feel aversive or babyish, switch to other media such as toy vehicles, stuffed animals or blocks [source: Viklund 2025].

Screening before any enactment phase [synthesis]: screen individually before entry. Ask about trauma history involving the face, mouth or breathing (smothering, strangulation, gagging, forced masks or hoods, and medical masks for some clients). Ask about claustrophobia, dissociation, psychosis or poor reality testing, skin conditions and allergies, and current self-harm risk. Very disturbed or psychotic children may lose contact with reality or destroy puppets, and very young children may lack symbolic capacity [source: Viklund 2025]. Masks have also been used with adults who hear voices [source: Cichocki et al. 2016, cited by Pires et al.; uncertain], so psychosis is not an absolute exclusion. It does call for a specialist setting.

3. Guiding principles

Distance is the instrument. The fiction lets feelings be felt without engulfing the client [source: BADth FAQs]. In practice: if the client floods, add distance (move from mask to puppet, from first person to third person, from enacting to drawing). If they are flat and detached, reduce it [synthesis].
The object carries the communication. A mask or puppet works as an intermediary object [source: Pires et al. 2021]. In practice: speak to the puppet or mask character first, and to the person only after de-roling.
Negotiate content and process with the client, at the start and throughout [source: BADth FAQs]. In practice: the client chooses the puppet, the mask design, and whether to wear the mask at all.
Follow the client's lead in play, and add structure when the work drifts. Unstructured play builds rapport but can turn chaotic and pull therapy away from its goals [source: Viklund 2025]. In practice: decide in advance how much you will direct each session.
Notice choice and rejection. Which puppets a child picks up or avoids is itself material [source: Viklund 2025]. In practice: record choices and rejections without interpreting them aloud.
Interpret tentatively. All puppet tools involve interpretation, which can label clients and flatten play if applied rigidly [source: Viklund 2025]. In practice: never treat puppet or mask content as proof of abuse or as a diagnosis. Even the Berkeley Puppet Interview links to DSM categories without yielding a diagnosis [source: Viklund 2025].
Body before projection. Warm-up comes first in every session [source: Pires et al. 2021]. In practice: never begin with masks on.
Always de-role. Step out of the role on purpose before leaving [source: K-State/Bailey]. In practice: every masked or puppet enactment ends with a de-roling act and sharing.
Physical safety is part of the therapy frame. In practice: use no casting on the face unless you can meet the safety conditions in 4.10. Card or ready-made masks are the default [synthesis, based on NSEAD guidance].

4. Intervention inventory

Part A: masks. Part B: puppets. Part C: closure and de-roling for both. Example language is illustrative throughout. Steps marked [synthesis] are suggested ways to carry out a technique whose published description gives only its outline.

4.1 Body and breath warm-up before mask work

Purpose: build group safety and body awareness before projection. Used as the whole of sessions 1–2 in the brief mask group [source: Pires et al. 2021].
Steps: (1) Seat or stand the group in a circle. (2) Teach slow diaphragmatic breathing, hand on belly. (3) Guide sensory exploration: notice feet, hands and face, then move gently in the room. (4) Close each warm-up with a brief check-in [synthesis on the details; the source names only breathing and body/sensory exploration].
Example language (illustrative): "Let the breath drop down to where your hand is. Notice your face from the inside: forehead, jaw, mouth."
Watch for: face-focused attention can itself trigger some clients. Offer eyes-open options and the choice to attend to the hands instead. Before using body exercises, weigh each adolescent's characteristics, and avoid any exercise that could harm them [source: Pires et al. 2021].

4.2 Making a mask series (four card masks)

Purpose: put different aspects of self or different roles into separate external forms [source: Pires et al. 2021, adapting Rojas-Bermúdez and Moyano 2012].
Materials: cardboard, brushes, finger paints, pencils, scissors, and a mirror, plus cloths and chairs for later enactment [source: Pires et al. 2021]. The source does not specify the base form or adhesives [uncertain]. Pre-cut blank card shapes with eye holes, and elastic or a stick handle, are a practical choice [synthesis].
Steps: (1) Give each participant four blanks. (2) Invite them to paint a series of four masks across sessions 3–5 [source: Pires et al. 2021]. (3) Leave the theme open, or offer a frame such as different faces I show, or faces I hide [synthesis]. (4) Participants alternate between making their own masks and looking at others' [source: Pires et al. 2021]. (5) Store the masks safely between sessions. Never let anyone handle another person's mask without permission [synthesis].
Example language (illustrative): "Make four faces. They don't need to be anyone you know, and they don't need to be pretty."
Watch for: perfectionism, or refusing to finish; copying a neighbour's mask; a mask that is blank or deliberately destroyed. Treat these as information, not failure [synthesis]. A sign it is working: the masks differ from one another, and the maker can say something about each.

4.3 Mask characterisation sheet

Purpose: deepen the projection by giving each mask an identity before it is embodied [source: Pires et al. 2021].
Steps: for each mask, the maker writes its name or title, its approximate age, the situation where it might be used, its most and least liked features, and its most and least intimate or superficial features [source: Pires et al. 2021]. Write your own simple form. Do not copy a published sheet [synthesis].
Example language (illustrative): "Where would this face go? Who would see it?"
Watch for: the same answers across all four masks, which may signal low differentiation. Writing that drifts from the character's voice into raw autobiography means it is time to add distance [synthesis].

4.4 Psychodramatic self-presentation through masks

Purpose: let each member introduce themselves to the group by way of their masks [source: Pires et al. 2021].
Steps: (1) The protagonist sets the masks out in the stage space. (2) Holding or wearing each mask in turn, they introduce it in the first person ("I am…"). (3) The director interviews the mask character briefly. (4) The mask is set down, and the person steps out of the stage space before the next one [synthesis on steps 1–4; the source names "psychodramatic self-presentation with the masks"].
Example language (illustrative): "Speak as this mask. What's your name, and what do you do for the person who made you?"
Watch for: speaking about the mask instead of as it, which is fine early on. Rising distress while wearing the mask: remove it, step out, and return to the person's own name.

4.5 Embodying each mask as a character

Purpose: explore the posture, movement and voice of each projected role [source: Pires et al. 2021].
Steps: (1) Look at the mask in the mirror before putting it on [synthesis; a mirror is listed among the room materials]. (2) Put it on and let the body find a way of standing and moving. (3) Walk the room as the character, then add a sound, then a sentence. (4) Meet another masked character for a short non-verbal or verbal encounter. (5) Take the mask off on the director's cue (see 4.11) [synthesis on sequence].
Example language (illustrative): "Let the mask tell your shoulders how to sit. How does this one walk?"
Watch for: disorientation, trance-like states, or reluctance to take the mask off. Full-face masks reduce visual cues and can raise arousal [synthesis]. Keep sessions short, and make sure the space is clear of trip hazards when vision is restricted [synthesis].

4.6 Role-playing life situations in mask

Purpose: bring a mask character into a scene from the participant's real life, to rehearse or explore [source: Pires et al. 2021].
Steps: (1) Protagonist and director choose a real situation, such as school, family, or friends. (2) The protagonist plays it wearing the mask that would "go" to that situation. (3) Other members or the auxiliary ego take the remaining roles. (4) Optionally, replay the scene with a different mask from the series. (5) Sharing follows [synthesis on steps; the source states role-playing life situations in mask].
Example language (illustrative): "Which of your four faces goes to the dinner table? Let's see that scene."
Watch for: scenes that touch abuse or acute trauma. Freeze the scene, reduce it to a tableau or a narrated version, and move to sharing (see Section 5) [synthesis].

4.7 Group discussion of masks

Purpose: build reflection and peer feedback [source: Pires et al. 2021].
Steps: masks are laid out or held up. The maker speaks first. Others share what they see and what the mask stirs in them, framed as their own response and not as interpretation [synthesis on framing].
Example language (illustrative): "Tell us what you notice in yourself, not what you think it means about them."
Watch for: peers "diagnosing" one another; humiliation; laughter at a mask. Step in at once.

4.8 Mask for two sides of a conflict (Landy)

Purpose: externalise an inner conflict as two faces. This is one of Landy's proposed uses of masks [source: Landy 1985, as summarised in Pires et al. 2021; Landy's own procedure, uncertain].
Steps [synthesis]: (1) Name the conflict. (2) Make one mask per side, or one mask with two halves, or an outside and an inside face. (3) Embody each side in turn, then hold a dialogue between them, either switching masks or with an auxiliary holding the second mask. (4) De-role, then reflect on what each side needs.
Example language (illustrative): "Give the part that wants to stay a face, and the part that wants to go another face. Let them talk."
Watch for: one side silenced. Signs it is working: each side gains a voice, and the client names a possible middle position.

4.9 Masks for group identity, dreams and imagery, and social role (Landy)

Purpose: Landy's other three proposed uses are expressing identity in a group, exploring dreams and imagery, and expressing a social role [source: Landy 1985, as summarised in Pires et al. 2021; procedures uncertain].
Steps [synthesis]: identity in a group: each member makes a mask of "how I come into this group" and introduces it, and later a second mask of "how I'd like to be here". Dream: make the mask of a dream figure, embody it, and let it speak to the dreamer. Social role: make the mask of a role the client plays (pupil, carer, "the joker"), then explore what the role shows and what it hides.
Example language (illustrative): "Let the figure from the dream wear this face. What does it want to tell you?"
Watch for: dream figures that are frightening. Keep these as puppets or flat images if arousal climbs.

4.10 Plaster-bandage face casting ("life mask")

Purpose: make a personal mask cast directly from the client's face, used in art and education settings. Clinical use is not described in the sources [uncertain]. Use this only when its specific meaning (literally "my face") is needed, and only after card masks (4.2) have been considered [synthesis].
Contraindications [synthesis]: any history of smothering, strangulation, suffocation, being held down, gagging, or facial assault; claustrophobia; panic disorder; active psychosis or dissociation; facial skin conditions, broken skin or a plaster allergy; beards (use a thick barrier, or do not cast); and anyone who cannot reliably signal or tolerate stillness. Do not cast the face of a child in an individual therapy room. If it is done at all with young people, do it with a second adult present and the carer's informed consent [synthesis].
Physical safety [source: NSEAD]: plaster heats as it sets and can reach about 60°C. Prolonged contact at around 45°C can damage skin. Casting any part of the body is called "potentially very dangerous", especially when thicker than a few millimetres. If a cast is attempted at all, use no more than two layers of plaster-impregnated scrim (e.g. ModRoc). Never immerse any body part in liquid plaster. Use cold water, and add powder to water, never water to powder. Control dust. Rinse plaster out of the eyes for several minutes and seek medical advice. Severe burns from misuse have needed tissue removal or amputation (HSE case study of a 16-year-old art student) [source: NSEAD].
Steps [synthesis drawing on art-rageous and YoungstarsWiki practice, restricted by the NSEAD limits]: (1) Gain explicit consent, and agree a stop signal that works with eyes closed (a raised hand or a squeeze). (2) The client sits reclined or lies comfortably. Hair is covered, and a greasy barrier cream goes on the skin, eyebrows and hairline. Eyes are covered with cling film or left uncast [source: YoungstarsWiki; art-rageous]. (3) Always keep the nostrils uncovered [source: YoungstarsWiki; art-rageous]. Leaving the mouth uncovered too lets the client speak or signal [synthesis]. (4) Apply wet strips in at most two layers, per NSEAD (the craft pages advise 2–4 layers; follow the stricter NSEAD limit). (5) Talk to the client throughout, and check in by asking for a hand signal. (6) Remove the cast as soon as it is firm, which takes about 5–10 minutes [source: art-rageous]. Let the client move their face to loosen it, rather than pulling it off [source: YoungstarsWiki]. (7) Stop at once if the client signals or reports heat or distress. (8) Do not pour plaster water into sinks [source: YoungstarsWiki].
Example language (illustrative): "Your nose stays open the whole time. I'll talk to you all the way through, and if you raise your hand I'll take it off straight away."
Watch for: breathing changes, breath-holding, a stiffening or frozen body, tears, and heat complaints. Being cast while lying still with the face covered can recreate helplessness. Treat any sign of it as a reason to stop, not to push through [synthesis].

4.11 Taking off the mask (mask de-roling)

Purpose: separate the person from the role before they leave the stage [source: K-State/Bailey on de-roling in general; the mask-specific steps are synthesis].
Steps [synthesis]: (1) The director calls the end of the scene. (2) The client removes the mask slowly, with both hands, and holds it out to look at it. (3) They say one thing the character felt, then one way they differ from the character, then their own name. (4) They put the mask down in a set place, or hand it to the director, as a ritual handoff [source: K-State/Bailey, on returning a prop or costume]. (5) They shake out the body [source: K-State/Bailey]. (6) Move to sharing.
Example language (illustrative): "Hand the mask to me. Tell us your own name, and one way you are not that character."
Watch for: a client who keeps talking as the character, or who is reluctant to let go of the mask. Repeat the de-roling steps, then ground with body and room orientation before they leave.

4.12 Assembling and introducing a puppet collection

Purpose: give clients enough projective range [source: Viklund 2025].
Steps: include realistic and royalty figures, wild and domestic animals, fantasy figures (monster, witch, devil) and occupational figures (doctor, nurse, farmer). Choose puppets that look appealing and invite play. Have around 15–20 for individual assessment and 20–30 for family work [source: Viklund 2025]. Display them at the child's eye level so the child can choose [source: Viklund 2025, describing the sentence completion task]. Note what the child chooses and what they reject.
Example language (illustrative): "These are all the puppets. You can pick any of them, or none, and look for as long as you like."
Watch for: a child who thinks puppets are childish, or who is fearful, overcontrolled, or has trauma or attachment problems. These children may avoid puppets, so offer other media [source: Viklund 2025]. Check that puppets are washable, and remove any with small detachable parts for under-3s [synthesis].

4.13 Spontaneous Group Puppetry (Woltmann and Bender)

Purpose: let children respond to conflict themes performed by adults. It was developed in the 1930s on psychoanalytic lines with hospitalised children aged 2–16 [source: Viklund 2025].
Steps: (1) Adult puppeteers perform a show on a theme such as aggression or sibling rivalry. (2) Children react freely and may talk to the puppets. (3) The show can stop at the point of conflict so the children can suggest solutions, then it resumes. (4) A group discussion follows [source: Viklund 2025].
Example language (illustrative, a puppet speaking): "Oh no, my brother took my toy again. What should I do, everybody?"
Watch for: over-arousal in the audience. Choose themes in proportion to the group's stability. A sign it is working: children offer and test solutions [synthesis].

4.14 Puppet Therapy Assessment Technique (Irwin)

Purpose: a semi-structured assessment for children aged about 5–12, adaptable for adolescents. Children under 5 may struggle to make up stories [source: Viklund 2025].
Steps: (1) Warm-up: the child explores and chooses from about 15–20 puppets. (2) The child presents a made-up puppet show to an imagined TV audience. (3) Post-play interview about the story's main idea, the child's preferred character, the moral, and links to the child's real experiences [source: Viklund 2025]. If the child is inhibited, the therapist asks who, what, where and when questions through a puppet [source: Viklund 2025]. Analyse content and form, defences and coping style, preoccupations and conflicts [source: Viklund 2025].
Example language (illustrative): "Our show is on TV now. Who's in it? Show us what happens." Afterwards: "If this story had a lesson, what would it be?"
Watch for: no psychometric data are reported. Use it as clinical observation only, never as evidence of a specific event [source: Viklund 2025; principle 3].

4.15 Family Puppet Interview (Irwin and Malloy 1975)

Purpose: assess family process (engagement, leadership, whose ideas are accepted, emotional climate, coherence, strengths) [source: Viklund 2025].
Steps: (1) Lay out about 20–30 puppets. (2) Each member chooses puppets. (3) The family makes up an original story with a beginning, middle and end, and acts it out through the puppets rather than narrating it, in about 30 minutes. (4) The family gives the story a title or moral. (5) Then interview them [source: Viklund 2025].
Example language (illustrative): "Together, make up a story nobody has heard before, and act it out with the puppets. It needs a beginning, a middle and an end."
Watch for: one member taking over the story, or a child excluded from it. Notice it, and use it in later family work [synthesis].

4.16 Ross Family Puppet Technique (Ross 1977)

Purpose: look at parent–child interaction around a specific difficulty, with families of young school-age children [source: Viklund 2025].
Steps: (1) Put a box of puppets in the child's lap. The child chooses a parent puppet and a child puppet. (2) The family re-enacts a troublesome situation, using the same words and tone as in real life. (3) Roles are reversed. (4) The family plays the situation the way they wish it had gone [source: Viklund 2025].
Example language (illustrative): "Show me last night's bedtime exactly as it happened, same words and same voice. Now swap: you be the mum puppet."
Watch for: shame in the parent during the role reversal. Frame it as curiosity, not as an audit [synthesis].

4.17 Puppets in Psychotherapy Scales (Portner 1981)

Purpose: a structured diagnostic sequence for school-age children [source: Viklund 2025].
Steps: structured story-opening play with toys first, then the child chooses from a set of 28 puppets and plays a spontaneous drama on a small stage, then the story, moral and character preferences are discussed using mutual storytelling [source: Viklund 2025]. It has rating scales, but the review gives no data on them. The scales come from a dissertation and are not widely available [uncertain].
Example language (illustrative): "Here's the start of a story; you finish it."
Watch for: use only with the original scoring materials.

4.18 Dynamics of Three (Wüthrich, Harter and Gauda)

Purpose: a Jungian, client-led puppet play for children and adults [source: Viklund 2025].
Steps: (1) The client chooses three props. (2) The client chooses three puppets (human, animal or mixed). (3) The client decorates the stage; an adjustable ironing board can serve as one. (4) The client decides who plays which puppet and leads the play; the therapist follows and may play one or two puppets [source: Viklund 2025]. Clients often make their own puppets, with polystyrene or papier-mâché heads and fabric bodies [source: Viklund 2025].
Example language (illustrative): "You're the director. Tell me which one I'm playing and what I should do."
Watch for: the therapist taking over the plot. Stay inside the role you have been given, and ask the director for instructions [synthesis].

4.19 Puppet Sentence Completion Task (Knell's puppet version)

Purpose: gather self-report from children aged 3–7 who cannot answer direct questions [source: Viklund 2025].
Steps: (1) Set puppets at eye level, and the child chooses one. (2) The therapist's puppet starts a sentence, and the child's puppet finishes it. (3) Choose stems to fit the child's situation, for example about likes, fears and problems, and do not use them all [source: Viklund 2025].
Example language (illustrative, the therapist's puppet): "When I go to bed, I feel… now you finish it!"
Watch for: a young child who echoes your puppet. Prompt with choices, and repeat the alternatives in the question [source: Viklund 2025].

4.20 Berkeley Puppet Interview (Ablow and Measelle 1998)

Purpose: a structured, validated self-perception and relationship interview for children aged 4–8 [source: Viklund 2025].
Steps: two identical, non-gendered dog puppets each make an opposite statement about themselves, then ask the child about themselves. The child answers in words, or by pointing or touching a puppet. Practice items come first. The full interview has 41 items and takes 10–25 minutes, with open follow-ups [source: Viklund 2025]. The scales link to DSM categories but do not give a diagnosis [source: Viklund 2025]. It is a licensed instrument: train in it, and do not improvise items [synthesis].
Example language: use the manual's administration wording only.
Watch for: with autistic children, introduce each puppet separately at the start [source: Viklund 2025].

4.21 Affect in Play Scale (Russ)

Purpose: rate emotional and cognitive processes in pretend play, for ages about 6–10 [source: Viklund 2025].
Steps: two neutral-faced puppets (a boy and a girl) and three coloured blocks are used. The child has five minutes of free play, which is videotaped. The task stops after two minutes without play. Instructions can be used to elicit an affect. The play is rated on 1–5 scales for emotional content, emotional expression and cognitive qualities such as imagination, which takes about 15–20 minutes [source: Viklund 2025]. Use the published manual [synthesis].
Watch for: get video consent from both the carer and the child, and store recordings according to data-protection rules [synthesis].

4.22 Therapist-voiced puppet (questioning and modelling through a puppet)

Purpose: lower the demand of direct questions for an inhibited child [source: Viklund 2025, on the Puppet Therapy Assessment Technique]. Puppets can also model coping before stressful medical procedures [Shapiro 1995 is listed in the NADTA bibliography; uncertain].
Steps [synthesis]: (1) Choose a gentle, curious puppet. (2) Let it be a bit unsure itself ("I get worried sometimes"). (3) Ask simple who, what and where questions, and accept answers given through the child's puppet. (4) Put the puppet away clearly at the end.
Example language (illustrative): "Hedgehog wants to know: who was at the party in your story?"
Watch for: a child disclosing harm through the puppet. Follow safeguarding procedures (Section 5.8). Do not use the puppet to press for details [synthesis].

4.23 Client-made puppets

Purpose: deepen ownership of the projection and cut costs in groups [source: Viklund 2025]. Finger puppets combined with mask making appear in the play therapy literature (Jenkins 2002) [uncertain].
Steps [synthesis]: (1) Offer simple bases: a sock, a paper bag, a wooden spoon, or a papier-mâché or polystyrene head on a fabric body [source on materials: Viklund 2025]. (2) Make a character, give it a name and a voice. (3) Introduce it to the therapist or the group. (4) Use it in the stories that follow.
Materials safety [synthesis]: use child-safe scissors and water-based, non-toxic paints and glue. Use low-temperature glue guns only with an adult. Avoid small parts with under-3s. Ventilate if you use spray adhesives, or better, do not use them at all. Check for latex and other allergies.
Watch for: a client who destroys their own puppet. Pause, slow the session down, and explore without punishing [synthesis].

4.24 Closure and de-roling of puppets

Purpose: return the projected material to the object, and the client to the here and now [source: K-State/Bailey on de-roling generally; puppet steps are synthesis].
Steps [synthesis]: (1) The puppet says goodbye in its voice. (2) The client takes the puppet off their hand and puts it in a "home", such as a box or shelf, or hands it back to the therapist [ritual handoff: source K-State/Bailey]. (3) The client says their own name and one thing they will do after the session. (4) They shake out their hands and arms [source: K-State/Bailey]. (5) Sharing or a talk about real life follows.
Example language (illustrative): "Let Wolf go back to his box now. Wiggle your hand out. Who's here now? You are."

5. Handling problems

Most of this section is [synthesis]. The sources describe procedures, and give little on managing difficulties beyond the points cited.

5.1 Resistance, or "puppets are babyish"

Respect it. Offer other media, such as toy vehicles, stuffed animals or blocks [source: Viklund 2025]. With adolescents and adults, offer "object" puppets (a glove, a spoon, a scarf) or card masks in place of character puppets [synthesis].
Lower the demand: you play the puppet and the client only advises it. Or the client directs, as in Dynamics of Three, without handling anything [synthesis].
With strong resistance, build safety first with psychologically safe activities [source: Viklund 2025].

5.2 Stuck or repetitive play

If the same story repeats, introduce one change through your own puppet: a new character, an unexpected event, or a question about "what happens next" [synthesis].
If play becomes chaotic, add structure: a beginning, middle and end; a stage boundary; a time limit [source: Viklund 2025, on structure; specific steps are synthesis].
With impulsive children, expect simple or chaotic stories, and use more structured tasks [source: Viklund 2025].

5.3 Overwhelm, flooding and retraumatisation during enactment

Early signs: frozen posture, breath-holding, shaking, staring, a sudden change of voice, a character who will not stop, leaving the room [synthesis].
Response sequence [synthesis]: (1) Stop the scene and freeze. (2) Remove the mask, or take the puppet off the hand. (3) Step out of the stage space. (4) Ground: feet on the floor, name the room, the date and the people present, breathe slowly (back to the 4.1 warm-up). (5) De-role (4.11 or 4.24). (6) Add distance before deciding whether to go on: third person, narrating, a small figure or drawing instead of enactment, or just ending the scene. (7) Debrief and check safety before the client leaves. Agree a check-in contact if needed.
Prevention [synthesis]: screen (Section 2), agree a stop signal for every masked enactment, work with fictional characters before autobiographical scenes, keep trauma scenes at the level of tableau or story until the client can tolerate more, and avoid making the perpetrator mask or puppet, or embodying it, early in therapy.
In groups, make sure one facilitator (for example the auxiliary) can leave with a distressed member while the other holds the group [synthesis; the source model has a director plus an auxiliary, Pires et al. 2021].

5.4 Too much or too little distance

Too close (the client is flooded or merged with the role): add distance. Move from mask to puppet, from wearing the mask to holding it, from first person to third person [synthesis, building on BADth's description of fiction as a filter].
Too far (intellectualised, flat, joking): reduce distance. Give the character a voice, put it into a scene from the client's own life (4.6), or let the client face the mask in the mirror [synthesis].
Landy developed a fuller theory of under- and over-distance; it is not drawn on here [uncertain].

5.5 Refusing to remove the mask, or staying in role

Repeat the de-roling ritual calmly, and give the mask a place to "rest". Remove it together, with permission. Name the person and the room [synthesis].
If the client remains confused or dissociated, treat it as an acute clinical concern. Assess mental state and do not end the session until they are oriented; involve the clinical team if needed [synthesis]. Masks have been linked to trance and possession experiences in ritual and theatre contexts [source: CORE thesis record "Masks and metamorphosis"].

5.6 Destroying puppets or masks

Deeply disturbed or psychotic children may destroy puppets [source: Viklund 2025]. Set a limit (we don't break the puppets), offer a sanctioned outlet (a puppet that can be bashed, or paper to tear), and reflect on the feeling [synthesis].
When a client destroys their own mask, do not rush to repair it. Ask what the destroyed face needed [synthesis].

5.7 Non-adherence, absences, and ruptures in the group

Masks and puppets in progress belong to their makers. Keep them safe while the maker is absent, and never use them in someone else's scene [synthesis].
If a peer mocks a mask or puppet, step in at once. Restate the group agreement and repair the hurt in sharing [synthesis].
If the client feels "seen through" by an interpretation, apologise, return to the client's own meaning, and go back to tentative, curious language [synthesis; see Viklund 2025 on the risk of labelling].

5.8 Children: safeguarding, consent and assent

Disclosure through a puppet or mask: treat a disclosure made through a puppet like any other disclosure. Stay calm and do not ask leading questions or press for details. Record the child's words and the context exactly, including which puppet "said" it. Follow local safeguarding and mandatory-reporting procedures (in the UK, the employer's designated safeguarding lead and the local authority) [synthesis].
Do not use puppet play as evidence. None of the reviewed techniques except the Berkeley Puppet Interview has published psychometric support, and even the BPI does not give a diagnosis [source: Viklund 2025]. Puppet content is not forensic evidence of abuse. Forensic interviewing is a separate, specialist role [synthesis].
Consent and assent: get informed consent from the person with parental responsibility (or the competent young person). Get the child's own assent in age-appropriate words before each new medium (puppets, masks, video, casting). Respect a "no" at any point. Get separate consent for any video recording (for example the Affect in Play Scale) and for keeping or displaying artwork [synthesis].
Parent or carer involvement: in family techniques (4.15, 4.16) the carer takes part. Prepare carers beforehand so that role reversal and wish scenes are not experienced as blame [synthesis].
Age adaptations: preschoolers may lack symbolic capacity or self-control, or may not separate fantasy from reality, and can treat puppets as ordinary toys [source: Viklund 2025]. Use simple, structured tasks (4.19) and short sessions. For autistic children, introduce puppets one at a time, repeat the alternatives in a question, and accept that some find puppets aversive [source: Viklund 2025].
Face casting with children: see 4.10. NSEAD's body-casting limits apply in schools, and they are strict [source: NSEAD]. Prefer card or paper-plate masks [synthesis].

5.9 Materials and physical safety

Plaster: heat, layer limits, no immersion, cold water, dust control and eye first aid, as in 4.10 [source: NSEAD].
Masks restrict vision. Clear the floor, make sure eye holes are large enough, use no masks during fast movement, and keep a spotter for anyone wearing a full-face mask [synthesis].
Hygiene: do not share worn masks or hand puppets between clients without cleaning them. Give each client their own mask [synthesis].
Tools: child-safe scissors; no craft knives with children or high-risk clients; count tools at the end in settings where there is a risk of self-harm [synthesis].

Touch. Fitting, tying, removing and casting masks all involve touching the face and head. Ask first each time and say what you will do; let clients put on and take off their own masks wherever possible; accept a no at once; never touch sexual or genital areas; and stay alert to trauma histories and cultural norms about touching the face and hair. [synthesis]

5.10 Cultural and personal meanings of masks and faces

Masks carry ritual and religious meaning in many cultures [source: CORE thesis record "Masks and metamorphosis"]. Some clients may find mask-wearing or particular puppet figures (devils, witches) unacceptable on religious grounds. Ask before you offer them, and give alternatives [synthesis].
Do not copy sacred masks or ceremonial forms from living traditions. If a client brings their own cultural mask practice, respect it, and seek guidance from people in that community [synthesis].
Face coverings may have charged meanings for some clients, for example detention, medical procedures, or covering imposed by others. Ask about this before suggesting a mask [synthesis].

Sources

Sources:

Further reading (bibliographic details from the pages above; full texts not drawn on):

Landy, R. J. (1985). The image of the mask: Implications for theatre and therapy. Journal of Mental Imagery, 9, 43–56.
Landy, R. J. (1993). Persona and Performance: The Meaning of Role in Drama, Therapy, and Everyday Life. Guilford Press.
Rojas-Bermúdez, J. G., & Moyano, G. (2012). Enmascararse/Desenmascararse. Las máscaras en sicodrama. In Actualizaciones en Sicodrama (pp. 113–136). Edicions Espiral Maior.
Rojas-Bermúdez, J. G. (2017). El objeto intermediario e intraintermediario. In Teoría y técnica sicodramáticas (2nd ed., pp. 184–203). Punto Rojo Libros.
Irwin, E. C., & Malloy, E. P. (1975). Family puppet interview. Family Process, 14(2), 179–191.
Irwin, E. C. (2002). Using puppets for assessment. In C. E. Schaefer & D. Cangelosi (Eds.), Play Therapy Techniques (2nd ed., pp. 101–113). Jason Aronson.
Jenkins, R. L. (2002). Finger puppets and mask making. In C. E. Schaefer & D. Cangelosi (Eds.), Play Therapy Techniques (2nd ed., pp. 115–122). Jason Aronson.
Gerity, L. A. (1999). Creativity and the Dissociative Patient: Puppets, Narrative and Art in the Treatment of Survivors of Childhood Trauma. Jessica Kingsley.
Shapiro, D. E. (1995). Puppet modeling technique for children undergoing stressful medical procedures. International Journal of Play Therapy, 4(2), 31–39.
Jennings, S., & Minde, Å. Art Therapy and Dramatherapy: Masks of the Soul [year and publisher uncertain].
Cichocki, L., Palka, J., Leff, J., & Cechnicki, A. (2016). The use of masks in the treatment of patients with chronic auditory hallucinations. Psychoterapia, 1, 17–28.

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