Volume 29, Issue 7 (10-2022)
RJMS 2022, 29(7): 238-248 |
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Research code: 01
Ethics code: 01
Clinical trials code: 01
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Pishdar S, Samavi S A, Jahantigh H. The Effectiveness of Play Therapy Based on the Cognitive-Behavioral Approach and Parent Management Training on the Behavioral Problems of Children with Attention Deficit/Hyperactivity Disorder. RJMS 2022; 29 (7) :238-248
URL: http://rjms.iums.ac.ir/article-1-8436-en.html
URL: http://rjms.iums.ac.ir/article-1-8436-en.html
Master's degree in clinical psychology, Bandar abbas branch, Islamic Azad university, Hormozgan, lran. , se.pishdar@gmail.com
Abstract: (721 Views)
Background & Aims: Disruptive behavior disorders include a set of complex behavioral problems that include thoughtlessness and recklessness, inability to postpone the gratification of desires, disturbance, and harassment, and lack of sufficient control over behavior. During the last 100 years, many explanations have been provided to describe the problematic behaviors of children with attention-deficit/hyperactivity disorder. Since the views about this disorder and its causes are still evolving, therefore experts have not been able to determine specific and unique biological-medical causes in this field. Still, the findings indicate that this disorder is multifactorial and one of its consequences is behavioral problems. Behavioral problems are defined as the inability to adapt. It has been stated that many of those at risk of emotional-behavioral problems or have these problems show defects in social behavior. In this regard, behavioral problems were divided into two general categories: internalized and externalized. Internalizing problems are more focused on the individual, are more controlled, cause less harm to others, and include things like depression, anxiety, withdrawal, and physical complaints. On the other hand, externalizing problems are described as behaviors that are directed more towards others than the individual himself. These behaviors include aggression, bullying, delinquent behaviors, theft, lying, disobedience, etc. In general, externalized problems are unacceptable because they violate social interests and cause harm to others. The results show that when children have hyperactivity disorder and behavioral problems, their parents are more likely to experience more stress. This stress can also be associated with the use of ineffective parenting methods in parents and with consequences such as increasing problematic behaviors, low self-esteem in children, and family conflicts. At the same time, therapists teach children whose social or emotional skills are weak and unaffected, adaptive behaviors with the help of treatments such as cognitive-behavioral therapy. Since cognitive therapies are based on the belief that cognitions, emotions, and behaviors are interactive and reciprocal in nature, cognitive approaches meet the needs of these children who show characteristics such as deficits in self-regulation and problems in attention and memory. They are very compatible. Cognitive-behavioral play therapy includes cognitive-behavioral interventions in the play therapy program. Game activities as well as verbal and non-verbal communication are used to solve the child's problems. Cognitive-behavioral play therapy is widely used to treat children's emotional and behavioral problems because this type of therapy responds to children's unique and diverse developmental needs. Most children under the age of 11 do not have the developed capacity for abstract thinking, which is a prerequisite for meaningful verbal expressions, and understanding complex issues, motivations, and emotions. Since the levels of abstract thinking in children are not high, they cannot express their feelings and emotions. This lack of skill in emotional expression, especially negative emotions, threatens the child's mental and behavioral health and creates behavioral problems for him. Therefore, the game is a tool that the child uses to express himself. Cognitive-behavioral play therapy, which is part of direct play therapy methods, combines traditional play therapy techniques with cognitive-behavioral techniques. These interventions put a lot of emphasis on the child's involvement in the treatment, and the therapist helps the child to benefit from the treatment by providing the necessary measures in terms of development. Cognitive-behavioral play therapy provides strategies for more adaptive development of thoughts and behaviors and teaches new strategies to deal with situations and emotions, and the child is able to deal with maladaptive ways of coping with Replace more compatible. The unstable and punitive interactions of parents with children cause their attachment insecurity, which is caused by the lack of proper communication skills and is among the risk factors that expose children to behavioral disorders. Therefore, in the treatment of parent education, goals such as improving the quality of parent-child relationships, reducing behavioral problems and increasing social behaviors, increasing parenting skills, including positive discipline, and reducing parental stress are pursued. Based on the above information and the importance of appropriate interventions for behavioral disorders in children with hyperactivity in childhood, as well as the importance of social skills for these children, as well as the lack of studies in Iran that show the effectiveness of the two methods of parent training programs and cognitive-behavioral play therapy. To investigate and compare the behavioral development and reduction of problems related to it in hyperactive children, the present study aims to compare the effectiveness of cognitive-behavioral game therapy and parent education programs on reducing behavioral problems in children with attention-deficit/hyperactivity disorder the activity of Bandar Abbas city was carried out.
Methods: It was a semi-experimental research with a pre-test and post-test design with experimental and control groups. All male children diagnosed with attention-deficit/hyperactivity disorder who were referred to one of the psychological service centers of Bandar Abbas in 1401 constituted the statistical population of this study, among them available through sampling method. 45 people were selected and assigned to three equal groups of 15 people. In addition to the demographic information checklist form made by the researcher, data collection was done using Rutter's Behavioral Problems Questionnaire form for parents. Data analysis was done with descriptive statistics methods (mean and standard deviation), parametric statistical assumptions test, and covariance analysis with SPSS statistical software version 26.
Results: The results showed that the behavioral problems of the experimental groups were significantly reduced compared to the control group. Also, the results of Benferroni's post hoc test showed that despite the effectiveness of two methods on behavioral problems, cognitive-behavioral game therapy was more beneficial in reducing behavioral problems.
Conclusion: It seems that cognitive-behavioral play therapy and parent training are both effective in developing the behavioral skills of children with attention-deficit/hyperactivity disorder and can be used in clinical interventions. In general, it can be stated that play therapy is based on a cognitive-behavioral approach that focuses on the child's thoughts, feelings, imaginations, and environment as a framework for the child's participation in therapy, emphasizing issues such as control, mastery, and feeling responsible for changes. It provides behavior. By including cognitive elements, children may become active participants in changes, and this leads to the reduction and control of behavioral problems as much as possible. This study also faced limitations. Among the limitations of this study, we can mention the data collection tool, the non-random sampling method, the impossibility of conducting a follow-up period, and the statistical population being limited to a group of boys. It is suggested to carry out this study in future studies in girls with hyperactivity and in other cities with different family cultures. Also, conducting the study in the follow-up phase can lead to more reliable results regarding the stability of the effectiveness of interventional methods.
Methods: It was a semi-experimental research with a pre-test and post-test design with experimental and control groups. All male children diagnosed with attention-deficit/hyperactivity disorder who were referred to one of the psychological service centers of Bandar Abbas in 1401 constituted the statistical population of this study, among them available through sampling method. 45 people were selected and assigned to three equal groups of 15 people. In addition to the demographic information checklist form made by the researcher, data collection was done using Rutter's Behavioral Problems Questionnaire form for parents. Data analysis was done with descriptive statistics methods (mean and standard deviation), parametric statistical assumptions test, and covariance analysis with SPSS statistical software version 26.
Results: The results showed that the behavioral problems of the experimental groups were significantly reduced compared to the control group. Also, the results of Benferroni's post hoc test showed that despite the effectiveness of two methods on behavioral problems, cognitive-behavioral game therapy was more beneficial in reducing behavioral problems.
Conclusion: It seems that cognitive-behavioral play therapy and parent training are both effective in developing the behavioral skills of children with attention-deficit/hyperactivity disorder and can be used in clinical interventions. In general, it can be stated that play therapy is based on a cognitive-behavioral approach that focuses on the child's thoughts, feelings, imaginations, and environment as a framework for the child's participation in therapy, emphasizing issues such as control, mastery, and feeling responsible for changes. It provides behavior. By including cognitive elements, children may become active participants in changes, and this leads to the reduction and control of behavioral problems as much as possible. This study also faced limitations. Among the limitations of this study, we can mention the data collection tool, the non-random sampling method, the impossibility of conducting a follow-up period, and the statistical population being limited to a group of boys. It is suggested to carry out this study in future studies in girls with hyperactivity and in other cities with different family cultures. Also, conducting the study in the follow-up phase can lead to more reliable results regarding the stability of the effectiveness of interventional methods.
Keywords: Attention Deficit/Hyperactivity Disorder, Cognitive-Behavioral Play Therapy, Parent Training, Behavioral Problems
Type of Study: Research |
Subject:
Clinical Psychiatry
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