The effectiveness of child-centered play therapy on overt anxiety and behavioral problems in maladjusted children

Authors
mahla salajgheh
hamid molaie
Abstract
The present study aimed to determine the effectiveness of child-centered play therapy on overt anxiety and behavioral problems in maladjusted children. The research method was a quasi-experimental design with a pretest-posttest design with a control group. The statistical population included all second-year male and female students of primary school in District 2 of Kerman in the second semester of the 1403-1404 academic year, totaling 8,500 people. Among them, 36 maladjusted children were selected through purposive sampling (based on the parent form of the Dekhanchi Children's Adaptation Questionnaire, 1377) and randomly assigned to two experimental and control groups (18 people in each group). Reynolds and Richmond's Children's Overt Anxiety Questionnaire (1978) and Quay and Patterson's Behavioral Problems Questionnaire (1987) were used to collect data. Child-centered play therapy intervention based on the Exline approach (1969) was implemented in 10 60-minute group sessions for the experimental group; while the control group did not receive any intervention. Data were analyzed using univariate analysis of covariance (ANCOVA). The results showed that child-centered play therapy significantly reduced overt anxiety and behavioral problems in children in the experimental group compared to the control group (p<0.05). Overall, the findings support the efficacy of child-centered play therapy as an appropriate psychological intervention for improving anxiety symptoms and behavioral problems in maladjusted children.
Keywords
Child-centered play therapy
overt anxiety
behavioral problems
maladjusted children
1-Yang, X., et al. (2021). "Global, regional and national burden of anxiety disorders from 1990 to 2019: results from the Global Burden of Disease Study 2019." Epidemiology and Psychiatric Sciences 30: e36.
2- Cheng, P., et al. (2020). "Depression prevention in digital cognitive behavioral therapy for insomnia: Is rumination a mediator?" Journal of affective disorders 273: 434-441.
3- Aggarwal, N. K. (2023). "Classification, selfhood, and culture in the Diagnostic and Statistical Manual of Mental Disorders and the Psychodynamic Diagnostic Manual." Ethos 51(4): 339-354.
4- Götze, H., et al. (2020). "Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis." Supportive Care in Cancer 28: 211-220.
5- Organization, W. H. (2017). "Depression and other common mental disorders: global health estimates."
6- Rosas-MatÃas, J., et al. (2019). "Frecuencia de depresión y ansiedad no diagnosticadas en pacientes con diabetes mellitus tipo 2 que acuden a la consulta externa de un hospital general de Lima, Perú." Revista de Neuro-Psiquiatría 82(3): 166-174.
7- American Psychiatric Association, D. and D. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5, American psychiatric association Washington, DC.
8- Yilmaz, T. (2019). RUHSAL BOZUKLUKLARIN TANISAL VE SAYIMSAL EL KİTABININ (DSM) SON İKİ BASKISI ARASINDAKİ DEĞİŞİKLİKLERİN İNCELENMESİ: 1-19.
9- Clark, D. A. and A. T. Beck (2011). Cognitive therapy of anxiety disorders: Science and practice, Guilford Press.
10- Jones, S., et al. (2019). "The development and validation of a measure of eating disorder-specific interpersonal problems: The Interpersonal Relationships in Eating Disorders (IR-ED) Scale." Psychological assessment 31(3): 389.
11- Zeynel, Z. and T. Uzer (2020). "Adverse childhood experiences lead to trans-generational transmission of early maladaptive schemas." Child abuse & neglect 99: 104235.
12- Khosravani, V., et al. (2019). "Early maladaptive schemas in patients with schizophrenia and non-patients with high and low schizotypal traits and their differences based on depression severity." Comprehensive psychiatry 88: 1-8.[Persioan]
13- Siahmoshtei, J., et al. (2021). "A preliminary study: designing and validating projective images of Young’s early maladaptive schema (EMS) domains." BMC psychology 9: 1-15.
14- Masley, S. A., et al. (2012). "A systematic review of the evidence base for schema therapy." Cognitive behaviour therapy 41(3): 185-202.
15- Bakhsh, L. M., et al. (2015). "A comparative study of attachment styles and early maladaptive schemas among tonekabon patients with generalized anxiety disorder and patients with major depression." Indian Journal of Fundamental and Applied Life Sciences 5: 1943-1951. [Persioan]
16- Depression, W. (2017). "Other common mental disorders: global health estimates." Geneva: World Health Organization 24(1).
17- Delattre, V., et al. (2004). "Les schémas précoces dysfonctionnels : étude chez des patients adultes souffrant d’un trouble anxieux." L'Encéphale 30(3): 255-258.
18- Pittig, A., et al. (2018). "The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research." Neuroscience & Biobehavioral Reviews 88: 117-140.
19- Ghasemi, K. O. B. R. A., & Elahi, T. A. H. E. R. E. H. (2019). The relationship between early maladaptive schemas and illness anxiety: The mediating role of experiential avoidance. Teach Train Res, 13(3), 47-55. [Persioan]
20-ghaseminejad, N. and s. m. tabatabaei (2023). "The effectiveness of schema therapy on primary maladaptive schemas and illness perception in people with generalized anxiety disorder." Journal of Health and Care. [Persioan]
21- Beck, J. S. (2020). Cognitive behavior therapy: Basics and beyond, Guilford Publications.
22- Hawke, L. D. and M. D. Provencher (2013). "Early Maladaptive Schemas: Relationship With Case Complexity in Mood and Anxiety Disorders." Journal of Cognitive Psychotherapy 27(4).
23- Young, J. E., et al. (2006). Schema therapy: A practitioner's guide, guilford press.
24- Young, J. (1998). "Young Schema Questionnaire: Short Form." Cognitive Therapy Center.
25- Waller, G., et al. (2001). "Psychometric properties of the long and short versions of the Young Schema Questionnaire: Core beliefs among bulimic and comparison women." Cognitive Therapy and Research 25: 137-147.
26- Zohreh, S., Maryam, A., Seyedkazem, R. Z. T., and Namieh, A. (2008). Factor analysis of the short version of Young's Schema Questionnaire in an Iranian non-clinical sample. Quarterly Journal of Clinical Psychology. ." [Persioan]
27-Naeinian, M., Shairi, M., Sharifi, M., Hadian, H., and Mehri, M. (2011). Investigating the reliability and validity of the Generalized Anxiety Disorder Short Scale (GAD-7). Clinical Psychology and Personality, 9(1), 41–50. ." [Persioan]
28- Pour, T., Basharpour, A., & Esmaeili, A. (2021). The effectiveness of emotion regulation training on emotion processing and panic symptoms in women with panic disorder. Clinical Psychology, 13(3), 88–79. ." [Persioan]
29-Broadbent, E., et al. (2006). "The brief illness perception questionnaire." Journal of psychosomatic research 60(6): 631-637.
30-BAGHERIAN, S. R., et al. (2008). "Relationship between history of myocardial infraction and cognitive representation of myocardial infraction." [Persioan]
31- Hedley, L. M., Hoffart, A., & Sexton, H. (2001). Early maladaptive schemas in patients with panic disorders with agoraphobia. Journal of Cognitive Psychotherapy, 15(2), 131-142.
32-Delattre, V., Servant, D., Rusinek, S., Lorette, C., Parquet, P. J., Goudemand, M., & Hautekeete, M. (2004). The early maladaptive schemas: a study in adult patients with anxiety disorders. L'encephale, 30(3), 255-258.
33-Pinto-Gouveia, J., Castilho, P., Galhardo, A., & Cunha, M. (2006). Early maladaptive schemas and social phobia. Cognitive Therapy and Research, 30, 571-584.
34-Atalay, H., Atalay, F., & Bağdaçiçek, S. (2011). Effect of short-term antidepressant treatment on early maladaptive schemas in patients with major depressive and panic disorder. International journal of psychiatry in clinical practice, 15(2), 97-105.
35- Hawke, L. D., & Provencher, M. D. (2013). Early maladaptive schemas: Relationship with case complexity in mood and anxiety disorders. Journal of cognitive psychotherapy, 27(4), 359-369.
36- Mairet, K., Boag, S., & Warburton, W. (2014). How important is temperament? The relationship between coping styles, early maladaptive schemas and social anxiety. International Journal of Psychology and Psychological Therapy, 14(2), 171-190.
37- Shorey, R. C., Elmquist, J., Anderson, S., & Stuart, G. L. (2015). The relationship between early maladaptive schemas, depression, and generalized anxiety among adults seeking residential treatment for substance use disorders. Journal of psychoactive drugs, 47(3), 230-238.
38-yalmaz ,t.(2019) ruhsal bozuklarin tanisal ve sayimsal el kitabinin (dsm)son iki baskisi arasindak degisiklerin incelenmeesi:1-19.
39-zeynaly,z.and t .user (2020).”adverse childhood experiences lead to trans-generational transmission of early maladaptive schemas.”child abuse &neglect 99:104235.
40-Mammad, K., Ahami, A., Azzaoui, F. Z., Boulbaroud, S., Idrissi, W., Karjouh, K., & Fofana, L. (2017). Diagnosis of anxiety disorders in university students through the early maladaptive schemas and Beck’s inventory. Psychology, 8(13), 2114-2125.
41-Zohreh, S., Maryam, A., Seyedkazem, R.Z.T., and Namieh, A. (2008) Factor analysis of the short version of Young's Schema Questionnaire in a non-clinical sample. Quarterly Journal of Clinical Psychology. [Persioan]
42- Farokhzadian, A. A., Rezaei, F., & Sadeghi, M. (2020). Mediating role of emotional schemas in the relationship between childhood traumas and generalized anxiety disorder. Clinical psychology and personality, 17(2), 89-101. [Persioan]
43-Nicol, A., Mak, A. S., Murray, K., Walker, I., & Buckmaster, D. (2020). The relationships between early maladaptive schemas and youth mental health: A systematic review. Cognitive Therapy and Research, 44, 715-751.
44-Ebrahimi Sadr, F., & Bakhshipour, A. (2022). Correlation between Early Maladaptive Schemas with Automatic Negative Thoughts and Health Anxiety among School Students. International Journal of School Health, 9(4), 264-268. [Persioan]
45- Renner, V., Henker, J., Joraschky, P., Keller, A., & Petrowski, K. (2024). Originalbeiträge (Originals). High Young schema levels predict manualized confrontation therapy outcome in patients with panic disorder/Der Einfluss von Schemata nach Young auf das Therapieergebnis von Patienten mit Panikstörung. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 70(3), 212-227.
46-Kwak, K. H., & Lee, S. J. (2015). A comparative study of early maladaptive schemas in obsessive–compulsive disorder and panic disorder. Psychiatry research, 230(3), 757-762.