Play Therapy Group Research Articles

Play Therapy and Psychoeducational School-Based Group Interventions: A Comparison of Treatment Effectiveness

This study focused on using a single case research design (SCRD) to compare the effectiveness of a child-centered group play therapy intervention to a psychoeducational group intervention (skillstreaming), and a group that received no intervention for 6 weeks. A group of 10 young children (kindergarten and Grade 1) were randomly assigned to 1 of the 3 groups. We found that children participating in the CCGPT intervention were 4.18 times more likely to have a decrease in total problem behavior across the 6-week period compared to children in the skillstreaming group, and 1.61 times more likely than children in the wait-list group.

Efektivitas Penurunan Stres Hospitalisasi Anak dengan Terapi Bermain dan Terapi Musik

Introduction: Hospitalization in pediatric patients may caused an anxiety and stress in all age levels. Several techniques can be applied to reduced hospitalization stress in children, such as playing therapy and music therapy. The objective of this study was to analyze the difference of effectiveness between both therapies in reducing the hospitalization stress in 4-6 years old children. Method: A quasy-experimental pre-posttest design was used in this study. There were 18 respondents, divided into three groups, i.e. group one receiving playing therapy, group two receiving music therapy and the last group as control group. Data were collected by using observation sheet before and after intervention to recognize the hospitalization stress. Data were analyzed by using Wilcoxon Signed Rank Test and Mann Whitney U Test with significance level of α<0.05. Result: Result showed that playing therapy and music therapy had significant effect to reduce the hospitalization stress with p=0.027 for play therapy, p=0.024 for musical therapy, and p=0.068 for control. Mann Whitney U Test revealed that there were no difference in the effectiveness of play therapy and musical therapy in reducing the hospitalization stress with p=0.009 for play therapy and control group, p=0.012 for music therapy and control group, and p=0.684 for playing therapy and musical therapy. Discussion: It can be concluded that play therapy and musical therapy are equally effective to reduce the hospitalization stress in children. It’s recommended for nurses in pediatric ward to do playg therapy and musical therapy periodically.

Behold the Tree: An Exploration of the Social Integration of Boys on the Autistic Spectrum in a Mainstream Primary School through a Dramatherapy Intervention

This article examines the process of a dramatherapy group with three boys on the autistic spectrum who attended a mainstream school. The boys were part of a mixed group where their neuro-typical peers were both group participants and witnesses. The main body of the article focuses on eight sessions based around the theme of ‘the tree’ which proved to be a turning point for all three boys when with growing confidence they were able to express their emotional needs. Thoughts are shared on ‘theory of mind’ and why the lack of this quintessential quality for those on the autistic spectrum places severe limitation on their social functioning.

Creating the Role: How Dramatherapy Can Assist in Re/Creating an Identity with Recovering Addicts

This article focuses on the use of role with two individuals in group dramatherapy treatment after active addiction. With current studies evidencing the success of the 12-step programme, this case study looks at psychodynamic dramatherapy after 12-step based primary treatment for alcohol and drug addiction. Once the role of the addict is removed, the symptom roles of ‘liar’, ‘failure’ and ‘the depressed’ are often left. Once a member of Narcotics Anonymous/Alcoholics Anonymous the role of ‘recovering addict’ is inserted and the individual is accepted into the recovery community. The multiple case study research focuses on methodology that enables improving resilience and self worth. The study uses the application of role in dramatherapy to identify, express and begin to reconfigure roles and sub-roles. It gives an honest account of personal challenges in relation to the (im)possibilities of brief therapy. Through two qualitative multiple case studies, the research focuses on two individuals in a group setting who differ in identity-related circumstances into addiction, the therapeutic process and how a psychodynamic dramatherapy role method can assist in the (re)creation of identity post addiction.

Comparison Study of Art Therapy and Play Therapy in Reducing Anxiety on Pre-School Children Who Experience Hospitalization

Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.

The Effect of Entonox, Play Therapy and a Combination on Pain Relief in Children: A Randomized Controlled Trial

Pediatric pain is often undertreated/neglected due to time constraints, difficulties in timing of oral analgesics, fear of side effects of opioids and anxiolytics, and apprehension of additional pain in the use of local anesthetic injections. In this study, the researcher was prompted to choose rapidly acting interventions that were low dose and allowed the child to stay alert, suitable for a quick discharge. The purpose of this study was to evaluate the effects of Entonox, play therapy, and a combination to relieve procedural pain in children aged 4-15 years. The study was designed as a randomized controlled trial; the subjects were divided into four groups using a sequential allocation plan from 123 total subjects. Group A received Entonox, Group B received play therapy, Group C received both Entonox and play therapy, and Group D received existing standard interventions. The study was vetted by the departmental study review committee. The pain level was assessed using FLACC scale for children aged 4-9 years and the Wong Bakers Faces Pain Scale for children aged 10-15 years; scores ranged from 0 to 10. All the data were analyzed using SPSS 16.0 with descriptive statistics and, inferential statistics. The mean pain scores were as follows: Entonox group, 2.87; Play therapy group, 4; combination group, 3; and control group, 5.87. When statistical testing was applied, a significant reduction in the pain score in all the three experimental groups when compared to the control group was found (p = .002), but not in the pain score among the three experimental groups (p = .350). The findings of this study indicated that all three interventions were effective in lowering pain scores when compared to the control group. Play therapy is as potent as Entonox in relieving procedural pain, though there was no additive effect on pain relief when play therapy and Entonox were combined. A protocol for age-related choice between play therapy and Entonox administration was introduced as a standing order in the Pediatric Surgery department for acute procedural pain relief.

Effect of Child-Centered Play Therapy on Performance Anxiety and Academic Achievement

This study of normal functioning first graders examined the effectiveness of child-centered play therapy (CCPT) on performance anxiety and academic achievement. The experimental group received biweekly, 30-minute play therapy sessions for eight weeks. Findings indicated that the first grade students participating in this study (n = 29) demonstrated a statistically significant increase on the Early Achievement Composite of the Young Children’s Achievement Test (Hresko, Peak, Herron, & Bridges, 2000) when compared with children in the waitlist control group (n = 30). No significant difference was found for the Woodcock Johnson III Total Brief Achievement between groups. Additional findings of the analysis indicated that from pretest to posttest the play therapy (PT) group and the waitlist control (WC) group scored statically significantly lower mean scores on the performance anxiety cluster of the Revised Children’s Manifest Anxiety Scale, Second Edition (Reynolds & Richmond, 2008). Results support the use of CCPT as an intervention for academic achievement.

Telling Stories: Dramatherapy and Theatre in Education with Boys who Have Experienced Parental Domestic Violence

This article examines the effects of parental domestic violence on children and presents a case study of a group work project with primary school aged boys. This piece of work was a joint project between two dramatherapists and Leeds Theatre in Education Company and develops the dramatherapy group into an improvised performance. It considers how the different styles of work complemented each other and enabled the boys to begin to express their emotions in a profound manner through the medium of drama. It examines the relationship between the boys and their mothers and suggests that dramatherapy is a valuable approach in breaking cyclical domestic violence.

Roundabout and the Big Lottery: A Four Year Dramatherapy Project for Older Adults

In recent years there has been growing awareness of the needs of the ageing population in the UK. Dramatherapy is being increasingly used as a creative means of engaging with and supporting older adults, who often experience increased physical frailty, sensory impairment and/or dementia. This article explores a project that took place over a period of four years offering group dramatherapy in different London boroughs. The article covers the aims, setting up and delivery of the project and evaluation methods. Vignettes and case studies highlight specific interventions and responses, and along with outcomes, show the overall benefit of the project to the clients and organisations involved.

Drama therapy with older people with dementia—Does it improve quality of life?

This article describes a pilot study that aimed to evaluate the effect of drama therapy on the quality of life (QoL) of elderly people with mild to moderate dementia, using a mixed method (quantitative and qualitative) approach.Study participants (N=13; age range 61–88 years; 1 female) were Australians of European descent, principally with Alzheimer's disease, living in the community in an east-coast Australian context. The drama therapy group (N=4) was compared with a group of participants (N=9) who watched movies over a four-month period. All participants were assessed for QoL using the quantitative Quality of Life Alzheimer's Disease (QoL-AD) scale of Logsdon, Gibbons, McCurry, & Teri (1999, Journal of Mental Health and Aging 5, 21) prior to and following 16 group meetings. Qualitative data were generated and examined using phenomenological methods including recording and transcribing body language and dialogue, as well as narrative, ethnography, group themes and metaphor.Although not statistically significantly different, the average QoL-AD score increased for the drama therapy group while it decreased for the movie group. Qualitative findings established an unambiguous participant ability to express ideas and feelings through drama therapy as well as an unveiling of conscious awareness of participants’ own wellbeing and QoL. The findings also indicate the potential worth of a future larger study along the lines exemplified here.

SY27-1 * EFFECTIVENESS AND UNIQUENESS OF DRAMA THERAPY THROUGH TEAM TREATMENT

In the US and Europe, Drama Therapy (DT) has been evidenced to be effective for addicts' treatment. The case here is its first application in Japan. While the cognitive and verbal approach is often known to be difficult for this population, DT, encompassing verbal, physical and emotional interventions, can elicit clients' inner world more truthfully. Their hidden or suppressed selves find a better outlet through dramatic expressions and acting. Under DT, clients attain a new perspective on their relationships with others. Past, present, and future selves are deeply and actively transformed, rendering clients ability to achieve total selves and self-esteem. Also, most clients retain a high level of sobriety. DT's group dynamics has many-fold effects on individuals and the group. A client's exploration into different selves is always witnessed by peer participants, who, in turn, reflect back their support and understanding, thus strengthening them both. Finally, all of the process and procession is conducted in a playful atmosphere, created by the Drama Therapist, giving validation to all individuals. This playfulness is a key for liberation, integration and transformation without pain and with much deeper insight. The team treatment of DT presented here may be the first trial in the world.

Silenced in Childhood: A Survivor of Abuse Finds her Voice through Group Dramatherapy

This article follows the story of Bella, a woman in her mid-thirties. Haunted by memories of sexual child abuse, she suffers from Post-Traumatic Stress Disorder, depression and anxiety. Bella's diagnosis is Borderline Personality Disorder, with a long history of serious self-harm and hospitalisation. Her creative journey began on a secure ward for women with BPD, where she attended my weekly Dramatherapy Group for seven months. We then worked together for a further 18 months at a secure step-down unit for women with challenging psychiatric disorders. Now living in the community, Bella is keen to share how Dramatherapy helped her towards recovery, together with 1:1 psychology, DBT and the support of a local church group. Her name and all location details have been disguised. Dramatherapy gave Bella the freedom to play like a child, whilst metaphor offered her a symbolic new language through which to understand and vocalise her feelings. Her journey is an emotional rollercoaster, revealing the potential for group Dramatherapy for adults who have survived the trauma of child abuse and are still fighting for freedom. Bella's courage and determination are inspiring and excerpts of her poetry are interspersed throughout the article, together with references to relevant literature.

When the Child Proof Cap has Been Left off the Medicine Bottle – Dramatherapy with Young People Affected by Parental Drug and Alcohol Problems

Young people affected by drug and alcohol use in their family face profound challenges. This paper looks at how young people are affected by their parents’ drug and alcohol problems and how dramatherapy can offer a space for them to engage with problems such as conflicted loyalties, neglect, abandonment, rage, isolation and premature responsibility. It draws on four years of experience offering individual and group dramatherapy to young people, and current approaches to the problem from psychology, social work, psychotherapy and the arts therapies. Each help to understand and illustrate the uses of a psychological and dramatic space to engage with the diverse problems parental drug and alcohol use create for a child.

An Investigation of the Therapeutic Potential of Stories in Dramatherapy with Young People with Autistic Spectrum Disorder

Stories are vehicles for understanding, expressing and communicating concepts important to individual and cultural identity. In autistic spectrum disorder (ASD) pretence and the ability to act ‘as if’ is impaired. Might Dramatherapy, through stories, have potential, not only to teach, practise and improve social skills and functioning but also offer an imaginative frame to enable processing of personal psychological material? A 10 session Dramatherapy group was evaluated in a special school. ‘Theory of Mind’ tests were completed. Qualitative methodology was used to structure the investigation. Three students with ASD were recruited. In the group, all engaged in imaginative play and used imaginative structures in stories. All completed the group and completed the Theory of Mind tests correctly. All in the group were able to use stories in the Dramatherapy group. These data refute the hypotheses of an absolute inability to pretend and ability to use story, inherent in some constructions of autism. All clients were able to use their imagination through story and all underwent a journey. This study suggests that Dramatherapy using stories presents a real and exciting set of possibilities for engaging young people with ASD in a positive therapy, likely to benefit their emotional, psychological and social development.

Adolescence, Asperger's and Acting: Can Dramatherapy Improve Social and Communication Skills for Young People with Asperger's Syndrome?

This article examines the structures and processes of a Dramatherapy group with young people with Asperger's syndrome, and autistic spectrum disorder. It focuses on a narrative constructed around the story of one adolescent's journey from being an isolated individual with severe social and communication difficulties, to a confident and communicative young man. Practice-based evidence of the broader group picture in the form of individual outcomes is presented through the assessment, evaluation and final outcomes of all the group participants.

Dramatherapy focusing on maternal insightfulness: A preliminary report

This study aimed to enlist the child development studies literature and Dramatherapy practice to create an intervention program for mothers of children at risk due to inadequate parental care. Thus, we created a manualized treatment of Dramatherapy focusing on maternal insightfulness. Maternal insightfulness refers to the capacity to see things from the child's point of view, and is considered as a crucial step for therapeutic change in the context of mother–child relationship. We created a 10-week Dramatherapy group intervention focusing on the core concepts of maternal insightfulness: insightfulness, separateness, complexity and acceptance, and we used dramatic means to explore and experience these components of maternal insightfulness. We used the insightfulness assessment interview (IA) pre- and post-intervention to evaluate the changes that occurred. In this preliminary report we describe the intervention and illustrate with a specific example the positive changes that occurred following it.

Unspoken Depths: Dramatherapy and Dementia

In the dual role of therapist and researcher, working in an NHS Day Hospital with a small group of clients with moderate dementia, my question was simple, yet perplexing: What could I learn from the paradox between the joyful energy of my Dramatherapy group and the intense sadness and confusion that seemed to exist on the periphery? A qualitative, heuristic approach was the most appropriate in respect of ethics and practicality. By using vignettes – in which client names were changed – as opposed to detailed case studies, I required neither written nor ongoing verbal consent – though spoke informally about it with my clients and their carers throughout the process. I followed the six stages of heuristic research described by Clark Moustakas and gathered data using the tools and techniques recommended. I created a personal log book and collated my official session notes on 20 clients seen between January and October 2009. Through the analysis of data, key themes arose: Fear and Stigma, Anger, and Self-Identity. This article may be most relevant to those working creatively with this client group, who find themselves confronted by a paradox of emotions, forced to confront personal fears and limitations. Whilst the need for further research is evident, my small and subjective study meets the minimal requirements of BADth's EPB/PBE guidelines (Dokter and Winn) and could compliment larger-scale studies using both quantitative and qualitative methods.

Dramatherapy and Spirituality in Dementia Care

Dramatherapy lends itself seamlessly to a person-centred approach, particularly important for elderly people who are nearing the end of their lives. The dramatherapy group affords a holding environment where existential issues and key life questions can be worked with creatively. Although their expression may sometimes seem chaotic (as in dementia), elderly people are often the guardians or holders of much end-of-life wisdom. By means of story, metaphor, play and improvisation, cultural questions and answers can assist with celebration, reminiscence, pleasure and grieving, and ultimately the transition to a dignified and spiritually meaningful death. In this way, the spirituality of the person with dementia can be explored and accepted. Spirituality has informed theatre and drama throughout history, and the healing properties of the arts are referred to in the histories of many societies. In contemporary western culture, especially that of the last 50 years, there has been a growth of consciousness that creative activity can contribute to people's health and well-being and that the area of spirituality is integral, and perhaps even central, to psycho-social health and a sense of well-being. In this paper, selected dramatherapy literature is reviewed, that supports the contention that the practice of these therapies is an effective means of assisting elderly people afflicted with moderate-to-severe dementia to value their ageing process. Arts therapies may assist them to cope with the grief and loss their ageing may entail, as they lose friends and physical and mental capacity, in a society where elderly people are marginalised. Case studies and theoretical examples are presented to show how group work can be structured so that issues of elderly people with dementia can be addressed in a creative way.

Towards a Purposeful Ending: A Study Exploring the Impact of Dramatherapy on the Quality of Life of People Suffering from Dementia

The aim of this study was to explore the effects of Dramatherapy on people suffering from dementia. The work was a small scale quantitative study carried out over 12 weeks comparing the experience of a Dramatherapy group with an activity group. The subjects lived in the same care home and were randomly assigned to the groups. Audits assessing quality of life measures were carried out at regular intervals. The study found that the clients receiving Dramatherapy showed significant improvements in quantitative measures of attentiveness and engagement compared with those taking part in the activity group. The results identified a cumulative benefit which suggests increasingly positive outcomes for longer term Dramatherapy.

Children and trauma: A narrative-based playgroup

The purpose of this paper is to present an eight-segment narrative-based playgroup prepared for children, especially young children, who have experienced trauma. This project addresses the children's trauma narratives. This project is based on the premise that a play therapy group allows a safe space to explore each child's experience of personal trauma. In the safe space, children experience preferred ways of relating a problem by practicing the use of externalization, which separates persons from problems. Furthermore, the mental health practitioners implement narrative approaches with the specific intention of avoiding retraumatization.