In work with adult trauma survivors the therapeutic relationship can become highly charged with trauma-related transferential dynamics, placing severe strain on the therapist and potentially resulting in vicarious traumatization. This article reports on the findings of a thematic analysis of the literature on the use of sandtray when working with adult trauma survivors. The research confirms the benefits of using sandplay work as it increases safety for client and therapist, fosters communication of the often ‘unspeakable’ experience of trauma and, as a result of the activity involved in sandtray work, provides experiences of empowerment for the client, thus facilitating healing from traumatic experiences.