The concept of systemic puppet therapy proposed by the authors is described. Therapeutic work with puppets is a promising method of psychological assistance as part of rehabilitation processes. Its insufficient use is due to its low structurality. The phased application of morphological analysis and synthesis made it possible to streamline the known and develop new effective methods of puppet therapy. The proposed systemic puppet therapy is an ordered polymodal set of static (lining on the table or on the floor of a puppet arranged set) and dynamic (presenting history on behalf of the puppet or staging a performance) methods, individual and group methods, face-to-face and remote forms of work, algorithms for their choice.The size, material and design of puppets, quantitative and qualitative composition of their therapeutic set are justified. Methods of puppet therapy of different degree of structuring and depth of exposure for patients with different level of intelligence are described, including category and scope of application of the technique, instructions to the patient, plan of results discussion,transformation procedure providing therapeutic effect. Implementing a polymodal approach, after working with puppets, patients painted, composed and analysed works of literature andart. The field of puppet therapy intersected with the fields of drama-, mask- and art therapy, body-oriented and verbal therapy, psychodrama and system arrangements. Puppet therapy content included work with feelings and emotions, with the process of communication and social roles, with verbal and non-verbal diagnostics and self-diagnostics, with personal features and a system of relationships,with values and needs, with existential problems of patients. Systemic puppet therapy is applicable to a wide range of nosological categories, therapeutic situations, physical condition, intellectual level, gender and age characteristics of patients.The conditions and examples of application of techniques in the National Medical Research Centre of Rehabilitation and Balneology with the tasks of correcting unproductive attitudes and the system of patient relations, correcting perceptions of oneself; capacity-building and resource search; development of a compliance installation and active participation in rehabilitation are given.