Razi Journal of Medical Sciences

fa مقایسۀ اثربخشی بازی‌درمانی به دو شیوۀ تراپلی و فیلیال‌ بر رفتارهای مقابله‌ای دانش‌آموزان Comparison of the Effectiveness of Play Therapy in Two Methods of Theraplay and Filial روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: دانشآموزان دارای ناتوانیهای یادگیری همواره جزء گروههای رایج با نیازهای خاص به حساب میآیند که به توجه آموزشی بیشتری نیاز دارند. هدف پژوهش حاضر مقایسۀ اثربخشی بازی‌درمانی به دو شیوۀ تراپلی و فیلیال‌ بر رفتارهای مقابله‌ای دانش‌آموزان 12-10 سال با اختلال یادگیری در شهر اصفهان بود. روش کار: برای انجام پژوهش آزمایشی حاضر که با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل و دورۀ پیگیری انجام شد از بین دانش‌آموزان با اختلال یادگیری که در سال 1400 به یکی از کلینیک‌های روان‌شناختی شهر اصفهان مراجعه کرده بودند بر اساس جدول مورگان به صورت در دسترس 54 نفر انتخاب و به صورت تصادفی به دو گروه آزمایش و یک گروه گواه (هر گروه 18 نفر) تقسیم شدند. سپس آزمودنیهای گروه آزمایش 10 هفته و هفتهای یک ساعت مداخله مورد نظر خود را دریافت کردند. همچنین قبل، بلافاصله بعد و دوره پیگیری 2 ماهه تمام آزمودنیها پرسشنامه رفتارهای مقابله‌ای هرناندز (2008) را تکمیل شد. نهایتا داده‌ها با استفاده از تحلیل واریانس با اندازه‌گیری مکرر تحلیل شدند. یافته‌ها: نتایج نشان داد دو شیوۀ بازی‌درمانی تراپلی و فیلیال‌تراپی روی ابعاد رفتارهای مقابله‌ای شامل انحراف از مشکل، کنار آمدن با مشکل و کنار آمدن ویرانگر تاثیر پایدار داشتند (01/0>P). اما میزان اثربخشی دو شیوه بازی‌درمانی روی ابعاد رفتارهای مقابله‌ای تفاوت معنی‌داری نداشته است (05/0<P). نتیجه‌گیری: نتیجه‌ آنکه هر دو روش بازی درمانی علی‌رغم ساختارهای متفاوت تاثیر یکسانی دارند چون هر دو بر رابطۀ والد- فرزند متمرکز هستند که دلبستگی کودک را تحت تاثیر قرار می‌دهند Background & Aims: Children with learning disabilities do not have problems with intelligence and motivation and are not lazy or deaf and dumb. In fact, most of them are as smart as others and are healthy in terms of brain, but this difference affects the way they receive and process information (4). Researches have mentioned three factors of children's characteristics, family aspects and social environment as the main and influential factors in the occurrence of children's disabilities (5). Therefore, methods that can simultaneously affect more aspects of these factors will have more and more stable therapeutic effects. Play therapy is one of these lasting and effective methods (6). Among the new methods of play therapy that are used for children with behavioral or functional problems are therapy and philial therapy. The results of various researches support the effectiveness of therapy on depression (8), anxiety (9) and behavioral problems (7) in children. In fact, this approach is a combination of interpersonal theories of human development, such as object relations theory, Balbi and Inworth's attachment theory (10). On the other hand, filial therapy, as a play therapy method, is a structured and direct theory for working with parents and children (11). Filial therapy is designed as a treatment program for children with emotional problems. In this intervention approach, children play with their caregivers and find out that they are lovable and important (12). These methods simultaneously affect the family environment, the quality of the parent-child relationship, and the psychological characteristics of children, this multifacetedness highlights the therapeutic importance of this method. One of the psychological characteristics in children that may help students with learning disorders or deepen their problems when facing stressors is coping behaviors. Coping behaviors or skills refer to cognitions that control stressful situations and become more specific along with the growth of children and adolescents (14). Therefore, the researcher is trying to answer the question of whether there is a difference between the effectiveness of play therapy in two ways, therapeutic and filial, on students' coping behaviors or not? Methods: The method of the current research was semi-experimental with a pre-test-post-test-follow-up plan with a control group. For this purpose, the statistical population of the present study includes 183 male and female students with learning disabilities in Isfahan city, 54 students (30 boys and 24 girls) with learning disabilities without mental disabilities, neurodevelopmental disorders, and obvious physical and sensory motor disorders with mothers without obvious clinical symptoms. They were selected as available for cooperation. Then they were randomly assigned to two experimental groups and one control group (18 people in each group). In the previous stages, immediately after and 2 months follow-up, they completed the Hernandez (2008) Coping Behavior Questionnaire. Also, to check and diagnose the learning disorder, the clinical interview was used based on the diagnostic criteria of DSM-5, which was conducted by a child psychiatry specialist. And the teenager took place. In the following, the Terapoly play therapy group gave its program based on the guide of Booth and Jerenberg (2019) to the first experimental group of 10 one-hour sessions (once a week for 10 weeks) and the filial therapy group gave its program based on the guide of Brighton et al. (2006). and Kalam et al. (2013) conducted 10 one-hour sessions (once a week for 10 weeks) to the second experimental group. Finally, the data were analyzed using software version 26 and using the multivariate analysis of covariance method. Results: The results showed that the mean scores of all three components of coping behaviors, including deviation from the problem, coping with the problem, and destructive coping, had a significant difference over time. Table 3 shows the results of intersubject analysis. Based on this table, the average scores for the dimension of deviation from the problem (F = 8.98 and P = 0.001), the dimension of coping with the problem (F = 6.91 and P = 0.002) and the dimension of destructive coping (42 F=83 and P=0.001) were obtained, which indicates that there was a significant difference between the experimental and control groups. The results showed that filial therapy and therapy play therapy has been effective in improving the coping behaviors of students with learning disabilities. Also, based on the results of Table 4, there was no significant difference between the average of all three components of coping behaviors in the two experimental groups in the post-test phase (P<0.001), which shows that both methods equally affect the components of deviation from the problem and coping with the problem. and destructive coping have been effective. The results of the Bonferroni test in Table 5 show that the average scores of the components of deviation from the problem, coping with the problem, and destructive coping in the post-test and follow-up stages are significantly different from the pre-test stage, but there was no significant difference between the average scores of the post-test and follow-up stages. It indicates that the average scores in the post-test and follow-up stage have changed compared to the pre-test stage and managed to maintain this change. Conclusion: The results of this research showed that therapy and filial therapy methods are effective in improving coping behaviors of students with learning disabilities. In explaining this finding, it can be said that both therapy and filial therapy methods have been able to leave a positive impact on the improvement of dimensions related to the coping behaviors of students with learning disabilities with a different structure (19). Because Teraplay is a type of short-term interactive play therapy that focuses on attachment-based games in the form of active games to create better relationships between parents and children. The therapist takes more responsibility for the progress of play sessions, as characterized by more attachment, empathic behavior, interactive play, interpersonal eye and body contact (24). Thus, in the present study, both parents and therapists helped the children in the test groups to strengthen their self-esteem and sense of competence and self-efficacy by providing playful challenges. Challenges caused frustration for children who learned how to face challenges and stress with the help of play (25). On the other hand, the emotional release capability of play is another explanation for the effect of parent-child play therapy, which helps children externalize their emotions in a completely safe and comfortable manner, and finally, these capabilities, when used in the context of parent-child play therapy are used to help not only children, but also mothers who have been placed in the role of coach and play therapist during play therapy to help their children get rid of the stresses and pressures of everyday life (16).   بازی‌درمانی, تراپلی, فیلیال‌تراپی, رفتارهای مقابله‌ای, اختلال یادگیری Play Therapy, Therapy, Philial Therapy, Coping Behaviors, Learning Disorder 198 207 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7468-1&slc_lang=fa&sid=1 Behnaz Pakravan بهناز پاکروان 3900319475328460072456 0009-0001-2775-0587 No MA Student, Department of Psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran دانشجوی ارشد، گروه روانشناسی عمومی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران Reza Ahmadi رضا احمدی rozgarden28@yahoo.com 3900319475328460072457 3900319475328460072457 Yes Assistant Professor, Department of Psychology , Shahrekord Branch, Islamic Azad University, Shahrekord, Iran استادیار، گروه روانشناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران