This systematic literature review was conducted to collect and analyze the most relevant empirical evidence on the impact of using play outside a therapeutic setting to reduce negative emotional symptoms in children aged 3–7 years. The PRISMA method was used for literature search and review to simplify the revision of the roadmap structure for research purposes (Moher et al., 2015). To this end, a literature search was carried out based on articles published in two databases: MEDLINE/PubMed and ScienceDirect. The selection of publications was carried out over a two-month period, up to and including 07/06/2024 and additionally for 3 weeks until 12/11/2024. To focus on the most current and relevant play practices, we analyzed papers published in the last 5 years (2019–2024). For the search strategy, 14 blocks of descriptors, combined using the Boolean operator AND, were utilized: (1) “play & “emotional intelligence”; (2) “play & stress”; (3) “play & anxiety”; (4) “play & depression”; (5) “play & emotional regulation”; (6) “play & fear” (7) “play & “emotional or behavioral problems” (8) “game & “emotional intelligence”; (9) “game & stress”; (10) “game & anxiety”; (11) “game & depression”; (12) “game & “emotional regulation”; (13) “game & fear” (14) “game & “emotional or behavioral problems.” In ScienceDirect, the descriptor “preschooler” was added to each block, as this database does not have the capability to automatically filter articles by a specific age group. In PubMed, the automatic selection option was used to find articles with sample ages of 2–5 and 6–12 years. In both databases the automatic selection option was used to find research articles.

Articles had to meet the following criteria to be included in the study:

The exclusion criteria for articles were as follows:

Despite the fact that these exclusion criteria are common to PRISMA reviews, they impose limitations on the article selection and narrow the scope of the studied works.

First, the articles were screened based on their titles and abstracts. The selection process involved identifying studies related to the subject and eliminating those that did not meet the inclusion criteria or were unrelated. A complete analysis of the chosen studies was performed by critically reading the full texts. Any studies that did not meet the set criteria, as well as duplicate records, were excluded.

A total of 9,625 articles were identified through the initial database keyword searches. An additional 14 records were identified via Scopus, Google Scholar, and references of meta-analyses on similar subjects. Of these 9,639 articles, 132 duplicates were excluded. Screening for inclusion or exclusion criteria resulted in 101 studies being identified after reading their titles and abstracts. After a critical review of the full texts, 33 studies were included in the further qualitative review analysis (see Figure 1).

This review did not include an assessment of the methodological quality of the selected works because the main goal was to identify the potential and features of play outside a therapeutic setting for overcoming negative emotional states and to improve emotional resilience. To eliminate this limitation, a criterion on statistical data processing was included in the selection criteria, and the methodological characteristics of the selected studies were analyzed.

Types of play used in different play interventions were determined based on cultural-historical approach. For some interventions involving non-directive child activity, several categories have been identified. During the review, a new category “outdoor play” was also added, which emphasizes playing on the playgrounds. Outdoor play may include play with rules (for example, catch-up or hide-and-sick) or a pretend play on playground. However, the descriptions of the interventions were not sufficient to accurately attribute them to one of the initial categories. In addition, outdoor play also has its own unique characteristics, such as body movement, interaction with nature, and others.

The categorization was carried out by one expert.

The review included 33 empirical studies aimed at assessing the potential of play to overcome negative emotional symptoms and improve emotional intelligence outside the therapeutic setting. Tables 1, 2 provide detailed information of the included studies in the following areas: methodological characteristics of the included studies (Table 1), play intervention characteristics and features of play providing the effect (Table 2).

The analysis of the selected studies revealed that play has a multifaceted impact on the mental state of preschoolers. Specifically, the review identified 13 psychological parameters in the emotional and social domains of the child that can be developed or corrected through play. Studies have shown the effectiveness of play in addressing all major psychological consequences of stressful events. Play not only helps relieve tension, reduce stress and anxiety but also fosters the development of emotional regulation and comprehension (Meng et al., 2022; Selzing-Musa et al., 2021), which contributes to stress resilience and coping with challenges (Chen, 2012; Gong and Zhang, 2012; Guo et al., 2010). The possibility of receiving support for subjectivity in the play and sufficient autonomy helps not only to overcome negative feelings but also develop self-help skills for other stressful events.

It is important to emphasize that the analysis of the studies demonstrated the accessibility of using play. Unlike therapeutic play and play therapy, organizing non-therapeutic play does not require extensive additional training for specialists. Non-therapeutic types of play and programs based on them can be implemented either without specialized training for educators, nurses, psychologists, and other professionals who work with children or with a brief introduction to instructions, game structure, and preparation, as well as training for parents. But we should note that organizing even non-therapeutic play requires basic psychological or pedagogic education, knowledge about the patterns of child mental development in different ages. Such types of play as pretend play, play with rules and toys, digital play, outdoor play can be organized both at home and in kindergartens.

A special role in using play to overcome negative emotional states and develop emotional intelligence belongs to toys. It is important that toys and play materials (e.g., costumes and props) correspond to the themes of the child’s experiences and are sufficiently varied (Goldstein, 1994). For instance, to address anxiety and fears related to adapting to a new kindergarten, it is necessary to have a sufficient number of toys that can represent children and educators in the play (Gorshkova and Lvova, 2023). At the same time, the main advantage of play is opportunity to use symbolic toys and open play materials (ribbons, fabrics, sticks, etc.), which facilitates the task of selecting toys (Veraksa A. N. et al., 2022).

Finally, the studies reviewed demonstrated effectiveness of play in different timeframes. One-time play sessions are commonly used to reduce situational emotional symptoms (Akhtar et al., 2023; Jones et al., 2021). Systematic play sessions contribute both to the negative symptoms reduction and emotional development (Jaggy et al., 2023; Stavrou, 2019). Prolonged non-therapeutic play exposure leads to an effect after only 6 weekly sessions. This indicates the potential of using non-therapeutic play in educational practice.

Thus, play outside a therapeutic setting can be used for overcoming negative emotional symptoms and develop emotional intelligence. In the reviewed studies, play outside the therapeutic context was used in education, parenting practices, before medical procedures, and to adapt to an orphanage. At the same time, the accessibility of its organization, corrective and developmental potential indicates the possibility of its use for children faced with various stressful situations. However, this assumption needs further research.

Play can have a comprehensive impact on the mental state of children through various pathways affecting motivational, emotional, cognitive, and behavioral levels. Seven blocks of identified pathways can be used separately or simultaneously, increasing the development potential of the play. Different types of play have different characteristics and combine different pathways of influence on the child emotional sphere.

In contemporary preschool education, significant importance is placed on pretend play as a special type of children’s activity, which is reflected in the number of studies where this type of play is used for development or correction. From the perspective of the cultural-historical approach, pretend play has the most essential impact on psychological development during preschool years (Hakkarainen and Bredikyte, 2010). Pretend play is a culturally conditioned type of activity where children, through imaginary situations, reproduce various aspects of adult life, thus learning social roles and relationships by enacting different plots (Elkonin, 2005). The uniqueness of pretend play lies in the emergence of a special relationship between the child and the situation, characterized by the dual nature of children’s experiences and actions (Veraksa, 2011; Vygotsky, 2017). In pretend play, the child operates on two levels—perceptual and symbolic—which together form the dialectical structure of play (Veraksa, 2022). For example, when a child builds a house out of pillows in play, they consider the real properties of the pillows but imagine them as a roof or bricks. While playing “hospital,” the child simultaneously cries like a patient and rejoices as a player. In other words, the child progresses to an activity centered on social relations and guided by an internal plan, leaving behind the play centered on and dominated by objects. Vygotsky conceptualizes this transition as a progressive separation between the visual field and the field of meaning (Hakkarainen and Brėdikytė, 2015; Hakkarainen et al., 2017; Vygotsky, 1978).

Therefore, according to the cultural-historical approach, pretend play serves as zone of proximal development for the child: what is challenging for the child to achieve through direct adult instruction becomes attainable in play, such as controlling aggressive behavior and regulating emotions (Vygotsky, 2017). A similar view on the developmental potential of pretend play can be found in other approaches. For example, Winnicott (1951) considered play as a transitional space because children use both objects and phenomena form the external world (e.g., toys) and aspects derived from their inner world (dreams or fantasies). In the transitional space, the child experiences his “omnipotence,” builds trust to the world, gets a new experience, and takes the next step toward development (Sagan, 2011). Additionally, in pretend play, the child reproduces models of social relationships (Elkonin, 2005). The child takes on various social roles, becoming an obedient student, a teacher, a hero, etc., and gains experience in partnership relationships with playmates. In play children exercises shared regulation, including emotional regulation, toward others because children must regulate their own behavior and, at the same time, control the behavior of playmates (Brėdikytė and Hakkarainen, 2017). These features of pretend play determine the variety of pathways impacting the child’s psyche. It is noteworthy that the review of studies showed that all 7 generalized blocks of mechanisms are characteristic of pretend play, which indicates its potential to address negative emotional symptoms and develop emotional intelligence in young children.

The review also showed that play with rules can contribute to reducing emotional symptoms in children. Play with rules is a type of play that imposes external rules that must be followed throughout the play (Veraksa et al., 2023). The main advantage of this type of play is that it allows to vary the complexity of the tasks for emotional regulation by adding new game components or exercises, for instance relax techniques or aerobic exercises (Azher et al., 2020; Bargale et al., 2021). In play with rules, through the addition of various components, an adult can transmit to a child cultural way of mastering their own internal processes. Following the rules of the game promotes the development of self-regulation, including emotional and social self-regulation (Savina and Wan, 2017). However, research showed that play with rules is effective for the development of older preschool children (6–7 years), while for younger preschoolers, following external rules remains a difficult task (Elkonin, 2005). For children under the age of 5–6 years, it is easier to follow the rules related to their self-chosen role in the pretend play. As well as pretend play, play with rules unfolds in imaginary situation, but commonly there is no plot and role development in play with rules, children do not use symbolic means. When playing with rules, children are more focused on following the rules or achieving a goal than on expressing their own emotions and experiences. To sum up, mentioned features limit the range of pathways through which play with rules can influence the child mental state and development. Main developmental mechanisms of play with rules are active involvement, opportunity to include additional information and/or techniques, imaginary situation.

It was revealed that play with toys can reduce negative emotional symptoms in children. The effect of playing with toys on a child mental state depends on the degree to which the child is immersed in an imaginary situation in play. When a child simply manipulates a toy, the effect either does not reach (Karaca and Guner, 2022) or through distracting the child’s attention helps to reduce anxiety (Arıkan and Esenay, 2020; Islaeli et al., 2020). In studies where a child creates a plot in a game with toys, indeed playing a pretend play, not only negative symptoms are reduced, but emotional regulation also develops (San et al., 2021). Thus, the number of pathways impacting the child’s mental state and development in play with toys depends on the quality and level of the certain game.

Digital play in the reviewed studies is also considered as a beneficial activity. Digital games are programs that organize and direct the play process on various electronic devices. In most studies digital play is used as a distractor or to introduce new information to a child (Dwairej et al., 2020; Matthyssens et al., 2020), which reduces anxiety, stress or fear. In one study digital play based on fairy-tale was proved to develop emotional regulation (Nicolaidou et al., 2022). However, first disadvantage of using digital play is social isolation while playing. Most digital games do not involve interaction with an adult or a peer, while positive social interaction is an important pathway to reduce negative emotional symptoms and develop emotional intelligence (Fonseca et al., 2021; Lozada et al., 2014; Smith and Carlson, 1997). Secondly, research have revealed that positive impact on child development from digital play is unsustainable (Veraksa et al., 2023b). Digital play does not contribute to systematic, qualitative changes in child development. Although some research uses digital play to address emotional symptoms in children, its corrective and developmental potential is limited.

The review of studies showed that outdoor play is another type of play to lessen emotional symptoms and improve emotional resilience. In the reviewed studies outdoor play implies the child’s play on the playground (Bao et al., 2022; Sobko et al., 2020). Thus, it may include elements from pretend play, play with rules or toys. In research it is highlighted that outdoor play commonly include physical activity (running, jumping, physical exercises, etc.), which helps to reduce tension (Wickel and Belton, 2016). Exposure to the natural environment also serves to overcome negative emotions (Sobko et al., 2020). Another, important mechanism in outdoor play is intensive social interaction with peers, which leads to socio-emotional development (Little and Wyver, 2008). Despite the mentioned pathways impacting the child’s mental state and development in outdoor play, its effectiveness depends on the specific child activity in it.

To sum up, the reviewed studies report that different types of play improve the emotional sphere of children. Pretend play involves the greatest number of pathways through which play influence the child psyche. At the same time, it is important to clarify that the corrective and developmental effect in non-therapeutic play is achieved not only through the play itself. Some features of the play providing the impact (e.g., emotional scaffolding, verbalization of emotions, parental presence, positive child–parent interaction, incentives, use of special material and additional information) depend on the involvement of a sensitive adult in the play. As a bearer of cultural experience and knowledge, the adult can enrich the child’s play, influence its depth and development, and provide models of actions, roles, and plots (Fleer, 2022). The participation of an adult in play ensures that the child gains unique experiences, thereby potentially determining the developmental potential of the play (Veresov et al., 2021). Thus, when implementing non-therapeutic play, it is important to consider not only the type of play and its features providing the effect but also the quality of adult involvement.

The main limitation of this review relate to the selection of publications. The selection process from search databases was conducted mainly without the use of automated algorithms. The search based on selected keywords might have excluded relevant studies, which reduced the number of reviewed studies. Additionally, this review did not include an assessment of the methodological quality of the studies using specialized tools (e.g., NHMRC framework, QualSyst, etc.). However, to eliminate this limitation methodological characteristics and statistical tests were analyzed in the review process.

The following summarizes our findings about implementation of non-therapeutic play to reduce emotional symptoms and develop emotional intelligence in young children.

A future study should focus on a narrower topic to undertake a comprehensive analysis, especially the corrective effect of non-therapeutic play in children with high level of emotional or behavioral symptoms. An alternative approach would include evaluating the implementation of non-therapeutic play for children faced with different stressful events other than medical procedures (e.g., relocation, family difficulties). Finally, it is necessary to conduct research to determine whether non-therapeutic play have a long-lasting sustainable effect.