Emotional regulation is a critical focus in clinical and therapeutic settings. While many interventions address coping skills or behavior management, few provide a clear, developmentally appropriate framework to help individuals understand and manage their internal states. The Zones of Regulation®, created by occupational therapist Leah Kuypers, offers exactly that. The Zones framework organizes emotions and energy levels into four color-coded zones, making abstract internal experiences more concrete and accessible.
How Clinicians Are Using The Zones
From outpatient clinics and school-based services to in-home therapy and residential care, The Zones is being widely used to support
regulation goals. It integrates well into existing treatment plans and offers structure for emotional regulation skill building. Clinicians often introduce The Zones language during sessions and reinforce it through visuals, direct instruction, and practice routines. When caregivers and schools also use the framework, clients benefit from greater consistency across environments.
What the Research Shows
Emerging research using The Zones in clinical and therapeutic settings shows promising outcomes. A feasibility study by Peters et al. (2024) examined the use of The Zones in occupational therapy with autistic youth. Over ten weeks, children participated in weekly sessions combining Zones-based instruction with equine therapy. Results showed high fidelity and satisfaction, along with significant reductions in emotional reactivity, irritability, and hyperactivity.
In another study, Nowell et al. (2019) tested a parent-assisted group intervention for young children with autism that blended The Zones with other structured supports. Participants made sustained gains in emotional regulation and social communication, and caregivers reported high satisfaction with the program’s content and impact.
Real-World Impact
Clinical sites like Nemours Children’s Hospital have also implemented The Zones with success. Their eight-week outpatient program for children receiving behavioral health support saw improvements in emotional vocabulary, regulation strategy use, and caregiver-child communication. The structured sessions and home supports helped families apply what they learned across settings.
Download the White Paper
Learn more in our white paper, which includes research, case studies, and clinical strategies. Download the white paper here!
