Play Therapy Sessions Research Articles

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.

Dramos terapijos metodų taikymas ergoterapijos studijų metu

The article reveals the experience of application of drama therapy during occupational therapy studies. Drama therapy is presented as one of the fields of art therapy. The experiences of group involvement during drama therapy lectures, while developing a process drama, are discussed, and a personal view of students towards the impact of drama therapy is analysed. The questionnaire survey, conducted during empirical research, and the assessment of monitoring process demonstrated that students feel and perceive the impact of drama therapy methods. Group development of process drama helped to reveal themselves and to use personal creativity, when looking for the best solutions under non-standard circumstances. Responses to questionnaire questions show that the expectations and views towards drama therapy changed, while feeling the creative mood of group during sessions. All surveyed students acknowledged that they had experienced good emotions, had felt closer, had known something new about themselves, while taking part in drama therapy sessions. Thus, it might be stated that interactive drama methods and development of process drama is a suitable method for integrated learning of important subjects, when preparing for practice of occupational therapist.

Using Drama Therapy and Storytelling in Developing Social Competences in Adults with Intellectual Disabilities of Residential Centers

The paper approaches the problematic of the adults with severe intellectual disability who are institutionalized for a long time in residential centres. The subjects included in our study are aged between 20 and 42 years old and have been institutionalized from early ages. The long-term institutionalization effects are reflected in language development, social abilities, mental sanity, progressive personality transformation. The most known phenomenon associated with the effects of institutionalization is “hospitalism phenomenon” manifested through passiveness, apathy, lack of interest. As the subjects we are studying show this panoply of characteristics, specific to children abandoned in state institutions, we’ve set ourselves to make the effects of drama therapy sessions and storytelling relevant for the social competencies of adults with severe intellectual disability, institutionalized in residential centres. For this, we used Innsbruck Social Competence Questionary for Adults with learning difficulties or mental disabilities (I-S-K-I-E). The therapy sessions have been constructed following the base structure: the warm-up, main event and closure. The results revealed an increase in social and communication skills (in the field of language acquisition) and a decrease in disturbed behavior. Creative work sessions offered alternative ways of communication for the nonverbal adults and opportunities to work in group. Through art, an adult with severe intellectual disability can explore the physical and social environment, address past and current emotional issues, can create a role and reach a state of satisfaction from imaginary events.

The Effect of Play Therapy on Symptoms of Oppositional Defiant Disorder in Boys Aged 5 to 10 Years Old

This study has been conducted with the aim of examining the effect of play therapy on symptoms of oppositional defiant disorder (ODD) in boys aged 5 to 10 years old in Tehran in 2014. The present study is quasi-experimental with the pretest-posttest control group design and random assignment of participants. From among the boys’ elementary schools and preschools located in districts 6 and 7 of Tehran, 30 persons were selected as the final participants through structured clinical interview based on the criteria indicated in DSM-IV-TR, and were selectively divided into two control and experimental groups. The participants in experimental group were provided with 12 sessions of play therapy. In order to collect the data in pretest and posttest, the Persian standardized version of oppositional defiant disorder rating scale (ODDRS) of Hommersen et al. (2006) which has a desirable validity and reliability was used. The data obtained from pretest and posttest in two groups was analyzed with the help of analysis of covariance. The analysis results indicated that there is a significant difference (F=20.74 and p<0.001) between experimental group and control group in posttest in symptoms of oppositional defiant disorder. In addition, the measure of effect size indicated that 84% of the difference between two groups in related to experimental intervention. According to the data obtained, it can be said that play therapy is effective in reducing symptoms of oppositional defiant disorder in boys aged 5 to 10 years old.

Dramatherapy with Women Survivors of Domestic Abuse: A Small Scale Research Study

The aim of this inquiry was to ascertain the efficacy of a multi-modal model of short-term dramatherapy with women who had suffered domestic abuse. A small-scale study was carried out to compare women who received individual dramatherapy with women who received individual key worker intervention. The 15 women were assigned to either the experimental or the control group. The experimental group received up to 12 weekly dramatherapy sessions with a qualified dramatherapist and the control group received 12 weekly key worker sessions with an experienced domestic violence substance misuse worker. The CORE system was used for both groups to provide pre- and post-intervention scores to assess change. The findings from this study revealed that the women who received dramatherapy presented significant improvements in their CORE Outcome Measure (CORE-OM) scores compared to women who attended key worker sessions. Women in the control group also showed improvements but not to the same extent.

Mentalization and play therapy processes between two therapists and a child with Asperger’s disorder.

The British Association of Play Therapists (BAPT) provides a definition of play therapy (PT) that emphasizes humanistic ideals such as using nondirective play techniques to enable the child’s inner resources to bring about growth and change. These therapeutic change processes have never been submitted to empirical testing, partly because of the paucity of valid, reliable instruments to assess child psychotherapy process. Identifying empirically supported change processes is crucial to discovering which change processes work for which child. For example, children with Asperger’s disorder have deficits in mentalization—the ability to interpret behaviors of self and others as motivated by underlying mental states. Would a mentalization-informed PT approach or a traditional PT approach be more effective in treating such patients? The Child Psychotherapy Q-Set (CPQ) is a 100-item instrument that assesses the processes within a psychotherapy session. Items reflect a wide range of therapist attitudes and behaviors, patient attitudes and behaviors, and interactions between therapist and patient. To characterize PT process, 24 BAPT play therapists were asked to use the CPQ to rate the prototypical PT session based on their knowledge of PT operationalized by the BAPT definition. Findings indicated that according to these 24 raters, a therapist who is sensitive to the child’s feelings and level of development characterizes British PT. Two therapists treating a child with Asperger’s disorder over 2 years decreased their session adherence to PT

Exploring core processes facilitating therapeutic change in Dramatherapy: A grounded theory analysis of published case studies

Limited research studies examining the core processes involved in facilitating change within Dramatherapy exist. Many papers rely on individual accounts of clinical work and, taken in isolation, potential contributions of these studies remain unrecognised. This research took a grounded theory approach to synthesise individual accounts of Dramatherapy in the literature in order to develop a theory of the core processes at work. A systematic review using an electronic and hand search of key journals identified published articles that contained ‘thick’ descriptions of Dramatherapy sessions. Grounded theory methodology was implemented to generate a theory of the core processes using a systematically applied set of methods linking analysis with data collection. Thirteen eligible papers were identified. The theory constructed from the data proposed a meta-processes model of change. These meta-processes included working in the ‘here and now’, ‘establishing safety’, ‘working alongside’ ‘offering control and choice’ and being ‘actively involved’. The implications of the findings are discussed as are areas for development and future research.

Making Sense: Dramatherapy with Adults with Asperger's Syndrome

In search of effective treatment approaches, a service for adults with Asperger's Syndrome funded two brief Dramatherapy pilots comprising individual Dramatherapy sessions for four individuals. This article records and reflects on the results of these pilots. By considering the diagnosis and reviewing the four interventions the article demonstrates that in order to work with the problems presented by Asperger's Syndrome, work must begin with the person so as to release agency with which to approach the problem. Where this is not readily manageable for the individual, Dramatherapy's rich resources become key to the client connecting with themselves, the therapy and their sense of agency.

Thinking Differently About the Kids: An Innovative Approach to Improve Care Provided to Pediatric Patients Undergoing External Beam Radiation Therapy

AimThis article reports the changes made from 2009–2012 to the external beam radiation therapy (EBRT) preparation and treatment process provided to pediatric patients at the Tom Baker Cancer Center (TBCC) Calgary, Alberta, Canada. BackgroundThe number of pediatric patients referred for EBRT at the TBCC doubled between the years 2008 (15 patients) and 2011 (30 patients). This increase in patient numbers prompted the staff of radiation therapists to evaluate the department's EBRT preparation and treatment process for pediatric patients. Data SourcesA literature search was performed to obtain data and research findings that described pediatric care processes adopted by EBRT programs in Canada and other countries. A pediatric working group (PWG) was assembled at the TBCC, which identified two areas for internal review and evaluation. The PWG critically reviewed the process of determining the delivery of treatment under sedation versus nonsedation and reviewed and evaluated the current play therapy and educational tools used to reduce the anxiety of children and parents concerning EBRT. ConclusionsThe presence of a radiation therapist at each new patient pediatric consult resulted in positive effects in the management of the patient's journey through EBRT. The application of the Pediatric Care Pathway Assessment Tool at the time of consult helped to identify patients requiring sedation versus nonsedation for treatment. The implementation of play therapy sessions before the start of treatment in combination with the use of audiovisual aids during EBRT reduced the requirement of sedation for treatment. A time motion log was found to be an appropriate tool for measuring the amount of time a patient spends in the department and helped to validate the placement of the patient on the sedation or non-sedation pathway.

보육기관에서의 놀이치료가 유아의 문제 행동, 자아지각, 사회적 상호작용 및 놀이치료 과정에서 유아의 반응 변화에 미치는 영향

The study was performed at a childcare center based play therapy to help ameliorate the problems of infants in the borderline, self-concept, social interaction, infant`s response changes observed during play therapy. The subjects of this study consisted of twenty eight infants between the ages of 4 to 5 years who exhibited behavior problems. All subjects were located in the Seoul. The play therapists were sent to the child care center, and conducted 16 sessions of play therapy to infants exhibiting problem behaviors. In summary, the results indicated the following. First, childcare center based play therapy was effective in improving infants` behavior problems in the borderline areas outlined above. Second, childcare center based play therapy had a positive effect on the self-concept of infants. Third, childcare center based play therapy had a positive effect on the social interaction among the infants. Finally, there was significant difference in the responses of infants during childcare center based play therapy.

A way of being in the playroom: Experience-expression congruence model (EECM).

Congruence, in conjunction with unconditional positive regard and empathic understanding, is considered one of the fundamental attitudinal conditions that must be internally experienced and externally expressed by play therapists in order to facilitate growth in child-centered play therapy. The experience-expression congruence model (EECM) helps play therapists understand the nature of congruence, recognize the impact of congruence in play-therapy sessions, and intentionally use the therapist’s awareness of congruence to benefit the client. The EECM is a two-phase model that challenges play therapists to consider their own personal levels of authenticity and implications for working with children in play therapy.

Role of Pediatricians in Fostering Resilience in Parents of Children with Autism Spectrum Disorders

From the Saint Louis University School of Medicine; and Sisters of Saint Mary A rich literature exists on best practices for screening, diagnosing, and managing children with autism. With its 2012 release of Autism: Caring for Children with Autism Spectrum Disorders: A Resource Toolkit for Clinicians, and Autism Spectrum Disorders: What Every Parent Needs to Know, the American Academy of Pediatrics has supplemented their current standards of care by providing both pediatricians and parents with comprehensive, up to date information on the screening, diagnosis, assessment, and treatment of autism. Underlying the presentation of factual data is the strong message to parents of hope and connection to others who have similar experiences. Both books acknowledge the tremendous stress parents of children with autism experience, and focus on how parents and pediatricians can partner effectively to optimize developmental outcomes. But do these essential resources go far enough? It has been well documented that parents and caregivers of children with autism often face tremendous emotional strains, changes in lifestyle, and economic hardship associated with caring for their children. Current best treatment practices frequently entail lengthy, time consuming interventions across service sectors, as well as extensive advocacy efforts on the part of the parent. Many of the empirically supported treatments for children with autism include parents in the therapeutic process, making them essential to the continuity, maintenance, generalization, and outcomes of treatment. One of the most empirically supported interventions, Applied Behavior Analysis, requires a parent’s strict daily compliance. Other treatments such as Floortime or Developmental Individual Differences Relationship Based Models, require parents to implement play therapy sessions with their child several times per day. The child’s home becomes another place for implementing therapeutic services. Unfortunately, little attention is paid to evaluating the parent’s ability to implement the intervention and to bolstering parental resilience—the dynamic process of being able to parent effectively in the face of having a child with autism. Historically, resilience has been studied on an individual level, but more recent research and practice have applied the construct to the social ecological system in which the child resides, specifically parental functioning. Resilience is a superordinate construct encompassing 2 distinct components: significant adversity and positive adaptation. Within this definition, risk is defined in terms of statistical probabil-

Improving the quality of Farsi speech and the academic performance of Azeri-Farsi bilingual students through attending drama therapy sessions

This paper investigates the effects of drama therapy on enhancing the linguistic performance and academic achievement of Azeri-Farsi bilinguals who speak Farsi as a second language. To that end, thirty-seven male bilingual students of Azeri and Farsi (age: 9.32±1.12 years) were randomly assigned to an experimental group (N=18) and a placebo group (N=19). The experimental group participated in 90-min drama therapy sessions twice or thrice a week for three weeks. During this period, the members of the placebo group were engaged in effortless activities. The MANCOVA results revealed the positive effect of drama therapy on the Mean Length of Utterances and the Speed of Speech in bilingual students, but it showed no effect on the Number of Utterances, Type-Token Ratio, and the Academic Average. In conclusion, we will discuss the possible factors that mediate such effects and indicate a number of directions for future research.

Functional Hoarseness in Children: Short-Term Play Therapy With Family Dynamic Counseling as Therapy of Choice

Children with nonorganic voice disorders (NVDs) are treated mainly using direct voice therapy techniques such as the accent method or glottal attack changes and indirect methods such as vocal hygiene and voice education. However, both approaches tackle only the symptoms and not etiological factors in the family dynamics and therefore often enjoy little success. The aim of the "Bernese Brief Dynamic Intervention" (BBDI) for children with NVD was to extend the effectiveness of pediatric voice therapies with a psychosomatic concept combining short-term play therapy with the child and family dynamic counseling of the parents. This study compares the therapeutic changes in three groups where different procedures were used, before intervention and 1 year afterward: counseling of parents (one to two consultations; n = 24), Brief Dynamic Intervention on the lines of the BBDI (three to five play therapy sessions with the child plus two to four sessions with the parents; n = 20), and traditional voice therapy (n = 22). A Voice Questionnaire for Parents developed by us with 59 questions to be answered on a four-point Likert scale was used to measure the change. According to the parents' assessment, a significant improvement in voice quality was achieved in all three methods. Counseling of parents (A) appears to have led parents to give their child more latitude, for example, they stopped nagging the child or demanding that he/she should behave strictly by the rules. After BBDI (B), the mothers were more responsive to their children's wishes and the children were more relaxed and their speech became livelier. At home, they called out to them less often at a distance, which probably improved parent-child dialog. Traditional voice therapy (C) seems to have had a positive effect on the children's social competence. BBDI seems to have the deepest, widest, and therefore probably the most enduring therapeutic effect on children with NVD.

Benefits of Dramatherapy for Autism Spectrum Disorder: A Qualitative Analysis of Feedback from Parents and Teachers of Clients Attending Roundabout Dramatherapy Sessions in Schools

Objective. To investigate parent/carer and teacher feedback on dramatherapy provided by Roundabout dramatherapists for children and young people with Autism Spectrum Disorder (ASD) in schools. Design. A qualitative study of written feedback from parents/carers collected after treatment had finished. Methods. Forty-two comments on dramatherapy were analysed using Interpretative Phenomenological Analysis (IPA). Results. Five themes emerged from the data and were reported using verbatim quotes under the following headings: Feelings: a safe place to explore; Peers: being included and making friends; Social skills: role play provides a short cut to learning about and practising social skills; Structure: predictability lessens anxiety; and Families: supporting the whole system. There were no negative comments about the dramatherapy treatment recorded on the feedback forms. Conclusion. The findings revealed overwhelming support from parents/carers and teachers for the use of dramatherapy for children and young people with ASD. These results are encouraging and indicate that further study of dramatherapy treatment is warranted in order to build the evidence base for such interventions in this client group.

아동중심놀이치료에서의 아동과 치료자 반응 관찰척도 개발

This study was conducted in order to develop an observation scale for analyzing the responses of child and therapist in child-centered play therapy in terms of item discrimination, validity, and reliability. The observation scale was developed on the basis of child-centered play therapy literature, the author`s experience of child-centered play therapy, the observation of video tapes of play therapy session, and discussions with child-centered play therapy experts. The participants in this study were 54 children aged from 4 to 9 years old who have emotional and behavioral problems, and 7 therapists who consult with the children. The reliability of factors, as measured by inter-rater reliability and Cronbach`s`, ranged from .72 to .77. The results of factor analysis identified 2 factors and 21 items associated with the reponses of the children, and 2 factors and 19 items associated with the responses of the therapists. The significant factors identified were as follows; (1) the child`s response style; (2) the child`s response content (adaptability, initiation, structuring, flexibility); (3) the therapist`s response style, and (4) the therapist`s response content (facilitative response, structuring, nonfacilitative response). In conclusion, these results demonstrated that the observation scale provides a valid and reliable means of analyzing the responses of child and therapist in child-centered play therapy.

Use of Play Therapy in Educating Asthmatic and Diabetic Pediatric Patients: A Pilot Clinical Project at a Private Tertiary Setting in Karachi, Pakistan

Play therapy is one of the strategies to address behavioural issues among sick and hospitalized children diagnosed with chronic diseases. In the Pakistani Pediatric settings, where pediatric hospitalized patients diagnosed with chronic disease are not commonly told about their treatment regimen, noncompliant behaviour and adjustment issues are common. Considering this gap, a pilot play therapy project was initiated at the inpatient and outpatient pediatric settings of a private tertiary care hospital in Karachi, Pakistan. This project aimed at introducing play therapy as an educational strategy for Diabetic and Asthmatic children to make them aware about their disease process, management plans, and life style modifications. After the play therapy sessions, it was noticed that these children who were previously fearful, anxious, and had no knowledge about their disease process, were able to verbalize about their disease and to demonstrate the correct technique of inhaler use and insulin administration on dolls and then on self.

Attachment-Based Play Therapy for Iranian Children and Parenting 1Stress of Their Mothers

Many children are exposed to traumatic experiences each year. The objective of this study was to examine the effect of attachment based play therapy on children with history of traumatic experiences and having developmental traumatic disorder (DTD) and parenting stress of their mothers. Fourteen children who were diagnosed as having DTD based on Vander Kolk criteria, were selected from child psychiatry clinics in Mashhad, Iran. Their parents permitted to be involved in this study. Patients were divided to 2 groups of intervention and control groups in waiting list. Mothers of all children completed Yule's scale and evaluation of children's stress parenting stress index-short form (PSI-SF) for evaluation of parents' stress. Ten sessions of play therapy were conducted for intervention groups. Then all mothers completed the tests again.Results revealed that there were not any significant differences in age, sex, grade of children and in the age and education of mothers in the 2 groups (P>0.05). Also, scores of Yule's scale, PSI-SF and parental distress at base- line did not have any significant differences in 2 groups (P=0.10, P=0.34 and P=0.58 respectively). After play therapy these tests in the intervention group were significantly different from the control group (P<0.001, P=0.01 and P=0.01 respectively). The differences in scores of difficult child subscale between 2 groups, before and after intervention were not significant (P=0.86, P=0.14 respectively). The differences in scores of malfunction in child-parent relation before and after treatment were significant in intervention group (P=0.01) but there were not meaningful differences in control group (P=0.52). It can be concluded that attachment based developmental play therapy reduced the stress of children and their mothers.

The Scientific Contribution of the Clinical Method in Educational Applications: A Case Study

After a review of the principles of the clinical method for relevant applications in educational issues, the paper focuses on the clinical observations of a case study centred on aggressive behaviour (bullying). The advanced clinical treatment enhances the importance of processes of mental representation and symbolization as necessary requisites for allowing the socially compatible satisfaction of individual needs. A case study is reported in order to better clarify the criteria and technical devices that must be applied in order to obtain positive results. We describe the aggressive behaviour of a three-year-old child of a particular family and educational environment. The child focused overt attacks on other persons, animals and objects. Play therapy sessions brought to light a typical lack of symbolic representation in drawing and play activities. We list and explain several technical interventions which helped this child to gradually develop these abilities, improving cognitive and social attitudes, reducing and elaborating aggressiveness. A relatively short course of therapy (7 months, a total of 50 sessions) enabled this boy to enter a path of normal development. We also discuss the school’s primary role in the prevention of aggressive behaviour with a specific didactic program for facilitating processes of mental representation and symbolization.

The effectiveness of cognitive-behavioural play therapy on the symptoms of attention-deficit/hyperactivity disorder in children aged 7–9 years

Attention-deficit/hyperactivity disorder (ADHD) is considered to be the most prevalent disorder of childhood and adolescence, and a variety of methods have been used in its diagnosis and treatment. This study was conducted to study the efficacy of play therapy on the symptoms of ADHD in children aged 7-9 years. Using a clinical trial design, we selected 30 study participants among individuals who had been referred to the Ebne-sina hospital, child and adolescent outpatient clinic, Mashhad, Iran, and who had been diagnosed with ADHD by psychiatrists. The 30 study participants were then divided into two groups, experimental and control, based on similar characteristics (Birth order, parents' educational level, parents' occupation and average of last year school marks). Pre-tests (the Rutter Parental Questionnaire and the Rutter Children Behaviour Questionnaire for teachers) were performed prior to play therapy, and all patients in both groups had been receiving medication. Following play therapy, post-tests were also conducted for both groups. Eight sessions of sham play therapy has been performed for case group. (Cognitive-behavioural play therapy has not been performed basically.) All results were evaluated using an independent t test and a comparative test. Play therapy appeared to significantly reduce the symptoms of ADHD. The significant differences found between the experimental and control groups indicate that play therapy could be used as an effective treatment method for children with ADHD.