Unlocking Children’s Internal Worlds: 25 Years of the Story Stem Assessment Profile (SSAP)

For more than 25 years, we have been training professionals in the use of the Story Stem Assessment Profile (SSAP), a powerful and nuanced tool designed to help us understand the internal worlds of children aged 4 to 10 years old.

At its heart, it’s a play-based, narrative assessment where children are invited to respond to a series of story beginnings or conflicts using small figures, animals and props. Through their storytelling, we can gain rich insights into their attachment representations and relational expectations.

An example of a story stem is one where a child accidentally knocks over a saucepan while their mum is making dinner and ends up burning their hand. We observe what happens shows and says next—does the parent tend to the child’s injury? Are they comforted or dismissed? Is there an escalation in the situation, or does the parent avoid addressing it?

What makes SSAP so distinctive, and enduring is that through play, it is able to combine clinical depth and theoretical rigour. It’s one of the only tools available for this age group children often find enjoyable, whilst for the clinician, it offers a multidimensional view of a child’s strengths, challenges, defences, and underlying needs.

“Through their storytelling, we can gain rich insights into their attachment representations and relational expectations.”

The SSAP was originally developed at Great Ormond Street Hospital in the context of working with maltreated children involved in court proceedings. The idea emerged organically from giving children the beginnings of stories which they were then invited to complete. This formed the foundation of what would later become a 13-story battery. Initially, the SSAP was used primarily as a psychotherapeutic tool. As a young academic, I chose to focus my PhD on the SSAP and helped refine the coding system, demonstrate its psychometric properties, and, above all, show its value in capturing a child’s internal world. We began using the tool in research with adopted children and quickly recognised its potential, which led to us starting to deliver training in its use in the early 2000s.

We have published many papers on the SSAP, particularly in looked-after (fostered) and adopted children. Our findings suggest it is particularly sensitive to the effects of early adversity, illuminating both overt and defensive patterns, helping to identify internal working models that may not be immediately observable either in a child’s behaviour or in observations from adults.

Over the years, we’ve trained hundreds of people: clinical psychologists, child psychotherapists, educational psychologists, play therapists, social workers and academics. It’s being used in countless settings including adoption and fostering services, looked-after children’s teams, CAMHS, clinical and legal settings, as well as academic and service evaluation contexts.

We use the SSAP as part of a broader assessment framework within an independent fostering agency. Each child completes the SSAP with a clinical psychologist, which are looked at across a battery of other measures. The SSAP is then transcribed, coded, and incorporated into a written report, which is then shared with social workers and families in both foster and residential care settings. The findings contribute to tailored recommendations that support the child’s relational and emotional needs.

The SSAP is recognised in the NICE guidelines and underpinned by a robust and growing body of research, which has shown its reliability and clinical utility across varied contexts. Whether in therapeutic work or court reports, it offers something unique, a window into a child’s internal world that might otherwise remain unspoken.

“The SSAP is recognised in the NICE guidelines and underpinned by a robust and growing body of research, which has shown its reliability and clinical utility across varied contexts.”

Our training programme runs over four days and examines the theory and practice of the tool, including its roots in attachment theory. We teach people how to deliver the story stems, code children’s responses, and then focusing on clinical interpretation, analysis, and reporting. It’s not just a technical process, but a deeply reflective one, which leads people to become accredited.

I work with a Social Worker who was trained on the SSAP over a decade ago and recently told me “This training has changed the way I understand the children I work with. I feel like I’ve been given a key to make sense of their inner world, whilst also using my own clinical intuition.” I often hear versions of this from people we’ve trained. People leave feeling better equipped and more confident in their assessments and recommendations.

What strikes me most, after all these years, is how the SSAP continues to evolve as professionals who use it keep finding new ways to apply it. I’ve seen it used in service reviews, complex court assessments, therapeutic planning, and reflective supervision. Today, the SSAP is not only widely used across the UK but also internationally, with versions translated into multiple languages. What I continue to love about the SSAP is that it’s rooted in storytelling, a natural, non-threatening medium for children, where there are no right or wrong answers.

If you’re interested in training, in learning more about how the SSAP works or how it could support your own practice, I’d be glad to talk. There’s always more to learn about in the stories children tell. Join our next SSAP training starting on 29 September – find out more here.

We also offer SSAP as a bespoke training, tailored to meet the training needs of teams and organisations across a range of sectors. Enquire about commissioning SSAP for your team here.