Effectiveness of family based intervention and play therapy on the parenting style of mothers and clinical symptoms in children with separation anxiety disorder

Authors
1 Assistant professor, Dept. of Psychology & Education of Exceptional Children, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
2 M.A in Psychology & Education of Exceptional Children, Faculty of Psychology and Education, University of Tehran
3 PhD student of Psychology in Psychology and Education of Exceptional Children, Islamic Azad University, Science and Research Branch, Tehran, Iran.
4 M.A in Psychology& Education of Exceptional Children, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
Abstract
Separation anxiety is a kind of disorder that has a direct relationship with parenting style. Family based intervention and play therapy is a comprehensive program including training sessions for parents which focus on improving interpersonal relationships, establishing a healthy and positive interaction in the family, controlling family anger, investigating communication barriers in marital relationships, educating children and providing play therapy for children. Objective of the present study was to investigate the effectiveness of family based intervention and play therapy in parenting style and stress of mothers and clinical symptoms of children with separation anxiety disorder. Present research is a semi-experimental study in which there were two groups of 14 subjects along with pre-test and post-test. Statistical population of the present study included all clients of a counseling centers in Tehran city who has been diagnosed with separation anxiety disorder. Therefore, to select some samples, availability sampling method was used. Analysis of the research data with multivariate covariance analysis method showed that there was a significant difference between the parenting style and stress of mothers and clinical symptoms of children with separation anxiety disorder in both experimental and control group. This intervention had a significant effect on the parenting style of mothers and the reduction of parenting stress and it also reduced clinical symptoms in children with separation anxiety disorder.
Keywords

1. Rapee R. Anxiety disorders in children and adolescents: nature, development, treatment and prevention. 2012.
2. Hill C, Waite P, Creswell C. Anxiety disorders in children and adolescents. Paediatrics and Child Health. 2016;26(12):548-53.
3. Merikangas KR, He J-p, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry. 2010;49(10):980-9.
4. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry: Lippincott Williams & Wilkins; 2011.
5. Herren C, In-Albon T, Schneider S. Beliefs regarding child anxiety and parenting competence in parents of children with separation anxiety disorder. Journal of behavior therapy and experimental psychiatry. 2013;44(1):53-60.
6. Zolog TC, Ballabriga MCJ, Bonillo-martin A, Canals-sann J, Hernandezmartinez C, Romero-acosta K, et al. Somatic complaints and symptoms of anxiety and depression in a school-based sample of preadolescents and early adolescents. Functional impairment and implications for treatment. Journal of Cognitive and Behavioral Psychotherapies. 2011.
7. Brand S, Wilhelm FH, Kossowsky J, Holsboer-Trachsler E, Schneider S. Children suffering from separation anxiety disorder (SAD) show increased HPA axis activity compared to healthy controls. Journal of psychiatric research. 2011;45(4):452-9.
8. Weersing VR, Rozenman MS, Maher-Bridge M, Campo JV. Anxiety, depression, and somatic distress: Developing a transdiagnostic internalizing toolbox for pediatric practice. Cognitive and behavioral practice. 2012;19(1):68-82.
9. Lazarus RS, Dodd HF, Majdandžić M, de Vente W, Morris T, Byrow Y, et al. The relationship between challenging parenting behaviour and childhood anxiety disorders. Journal of affective disorders. 2016;190:784-91.
12. Baumrind D. Effective parenting during the early adolescent transition. Family transitions. 1991;2(1):1.
13. Sanders MR, Turner KM, Markie-Dadds C. The development and dissemination of the Triple P—Positive Parenting Program: A multilevel, evidence-based system of parenting and family support. Prevention Science. 2002;3(3):173-89.
14. Dean C, Myors K, Evans E. Community-wide implementation of a parenting program: the South East Sydney Positive Parenting Project. Australian e-Journal for the Advancement of Mental Health. 2003;2(3):179-90.
15. Webster-Stratton C, Reid M. Adapting the Incredible Years, an evidence-based parenting programme, for families involved in the child welfare system. Journal of Children's Services. 2010;5(1):25-42.
16. Cann W, Rogers H, Matthews J. Family Intervention Services program evaluation: A brief report on initial outcomes for families. Australian e-Journal for the Advancement of Mental Health. 2003;2(3):208-15.
17. Sanders M. Triple P: A multi-level system of parenting intervention: Workshop participant notes. The University of Queensland: Brisbane, Australia. 2005.
19. Mousavi R, Moradi A, Mahdavi Hersini E. The Effectiveness of Structural Family Therapy On Treating Children's Separation Anxiety Disorder. psychological studies. 2007;3(2):7-28.
20. Creasey G, Reese M. Mothers' and fathers' perceptions of parenting hassles: Associations with psychological symptoms, nonparenting hassles, and child behavior problems. Journal of Applied Developmental Psychology. 1996;17(3):393-406.
21. Schwebel DC, Roth DL, Elliott MN, Chien AT, Mrug S, Shipp E, et al. Marital conflict and fifth-graders’ risk for injury. Accident Analysis & Prevention. 2012;47:30-5.
22. McKee L, Colletti C, Rakow A, Jones DJ, Forehand R. Parenting and child externalizing behaviors: Are the associations specific or diffuse? Aggression and violent behavior. 2008;13(3):201-15.
23. Kaslow F, Lebow J. Comprehensive handbook of psychotherapy: Vol. 4. Integrative/eclectic. New York: Wiley; 2002.
24. Malekpour M, Aghababaei S, Hadi S. Effectiveness of Family, Child, and Family-Child Based Intervention on ADHD Symptoms of Students with Disabilities. International Journal of Special Education. 2014;29(2):29-34.
25. Van Noppen BL, Steketee G. Individual, group, and multifamily cognitive-behavioral treatments. Focus. 2004.
26. Athy AL. Effects of a trained therapy dog in child-centered play therapy on children's biobehavioral measures of anxiety. 2005.
27. Wethington HR, Hahn RA, Fuqua-Whitley DS, Sipe TA, Crosby AE, Johnson RL, et al. The effectiveness of interventions to reduce psychological harm from traumatic events among children and adolescents: a systematic review. American journal of preventive medicine. 2008;35(3):287-313.
28. Lotfi Kashani F, Vaziri S. Abnormal Child Psychology. 2004.
29. Thompson CL, Rudolph LB, Henderson DA. Counseling children: Brooks/Cole Pacific Grove, CA; 2000.
30. Ahadi H, Banijamali S. Development Psychology. Tehran, Pardis. 2006.
32. Spence SH, Barrett PM, Turner CM. Psychometric properties of the Spence Children’s Anxiety Scale with young adolescents. Journal of anxiety disorders. 2003;17(6):605-25.
34. Berry JO, Jones WH. The parental stress scale: Initial psychometric evidence. Journal of Social and Personal Relationships. 1995;12(3):463-72.
35. Mockford C, Barlow J. Parenting programmes: some unintended consequences. Primary Health Care Research & Development. 2004;5(3):219-27.
36. McMahon RJ, Forehand RL. Helping the noncompliant child: Family-based treatment for oppositional behavior: Guilford Press; 2005.
38. Danger S, Landreth G. Child-centered group play therapy with children with speech difficulties. International Journal of Play Therapy. 2005;14(1):81.
39. Poorbafrani M, Etemadi O, Jazayeri R. The effect of strong parenting skills training on reducing daughter conflict with mother and increasing adolescent girl's mental health. Journal of Research in Psychological Health. 2014;8(2):31-40.
40. Sanders MR, Ralph A, Sofronoff K, Gardiner P, Thompson R, Dwyer S, et al. Every family: A population approach to reducing behavioral and emotional problems in children making the transition to school. The Journal of Primary Prevention. 2008;29(3):197-222.
41. Johnson MA, Stone S, Lou C, Ling J, Ciaassen J, Austin MJ. Assessing parent education programs for families involved with child welfare services: Evidence and implications. Journal of evidence-based social work. 2008;5(1-2):191-236.