Effectiveness Of Individual Play Therapy On Oppositional-Defiant Disorder Symptoms Among Children

Abstract

Given the importance of childhood disorders, the purpose of this study was to evaluate the effectiveness of individual play therapy on Oppositional-Defiant Disorder symptoms among children. A quasi-experimental research design type using a cluster sampling method was employed. The study sample included 30 girls and boys aged 6 to 10 years with Oppositional-Defiant Disorder symptoms referred to psychological consultation centres in the city of Ahvaz. Using simple random selection, the study sample was divided into an individual play therapy group (15 individuals) and a control group (15 individuals). The Child Behavior Checklist and Teacher Report Form ( Achenbach & Rescolar, 2001 ) were used as measurement instruments. In addition, a clinical interview with parents was conducted to confirm the presence of the symptoms. The subjects were exposed to individual play therapy interventions during 8 sessions (each lasting 45 minutes) on a weekly basis and then evaluated in three stages including pre-intervention, post-intervention, and two months after the completion of sessions in a follow-up form. The SPSS software (version 18) and multivariate analysis of covariance (MANCOVA) were used for data analysis. The results of the multivariate analysis of covariance indicated that Oppositional-Defiant Disorder symptoms reported by parents and teachers in the individual play therapy group significantly decreased at the post-test stage compared with those in the control group. Furthermore, the results were consistent after the two-month follow-up evaluation. These findings showed that individual play therapy could reduce symptoms of Oppositional-Defiant Disorder among children. Therefore, it is recommended that therapists use this therapy in treating children affected with this disorder.

Keywords: Effectivenessoppositional-defiant disorderindividual play therapy

Introduction

Childhood is among the most significant stages of life wherein an individual’s personality is

established and shaped. Most of behavioral inconsistencies and disorders in adolescents and adults

originate from negligence of childhood behavioral and emotional problems as well as lack of proper

guidance in the processes of growth and development (Cartwright-Hatton, 2005). Disruptive Behavior

Disorder (DBD) is a stable pattern of repetitive behaviors in which social rights of others or major age-

specific norms and rules are being violated. This disorder brings about social and educational

dysfunctions and it is the most common mental syndrome diagnosed in childhood (Lemmens et al., 2006).

Oppositional-Defiant Disorder (ODD) is placed on the category of the DPDs that are among the

largest group of disorders referred to mental health clinics for children (Costin et al., 2004). The ODD is

the sustainable pattern of negative, aggressive, and impolite behaviors in the absence of a serious

violation of social norms or the rights of others displayed through factors such as rage, quarrels with

adults, intentional defiance, deliberate activities hurting others, irritability, sensitivity, quick annoyance

by others’ actions, anger, tantrums, vindictiveness, and revenge (Diagnostic and Statistical Manual of

Mental Disorders, 2013). Children with the ODD symptoms usually are not endowed with academic

achievement (Burt et al., 2001); they are also weak in interpersonal relationships and suffer from attention

problems and defects in their executive functions. Such children are mainly deprived of cognitive, social,

and emotional skills (Hommersonn et al., 2006).

Due to the fact that experts are aware that mental health interventions are essential for primary

school children in order to provide primary prevention and care as well as mental health development

(Charron & Parns, 2004) and because of the growing problems caused by ODD in children and family

life, numerous researchers have investigated treatment methods for this disorder (Turner & Sanders,

2006). It should be noted that the ODD treatment is mainly based on medications, parental training, and

blended learning (parents and children training) (Morshed, Davoudi, & Babamiri, 2015).

One of the increasingly used treatment methods for the ODD is play therapy. Play therapy is a

structured approach which establishes learning processes as well as natural and normal communications

of children (Carmichael, 2006). In this way, therapists teach further adjustment behaviors to children with

poor social and emotional skills (Pedro-Carroll & Reddy, 2005).

In line with treatments for adults, the effects of maladaptive beliefs and attitudes are emphasized in

cognitive-behavioral play therapy (CBPT) (Spence, Donvan, & Berchmn, 2000). In this respect;

therapists help children to identify, modify, or build their cognition. In addition to assisting children to

identify their cognitive distortions, they are also taught how to substitute adaptive thinking with a

maladaptive one (Gallagher, Robin, & McCloskey, 2004). Such a treatment procedure has been

developed for primary and preschool children because this age group is assumed to be active members in

changing their own behaviors (Morshed, Davoudi, & Babamiri 2015).

Problem Statement

2.1.Children with ODD symptoms are abandoned by their peers and they are poor in terms of

academic performance. They are also at the risk of delinquency in adolescence as well as

expulsion (Charisa & Sung-Young, 2006).

2.2.Considering that the use of play therapy has been less investigated in terms of its effect on

improvement of cognitive, social, and emotional skills among children affected with the ODD,

the present study was conducted to evaluate the effects of the CBPT on reducing the symptoms

of ODD.

Research Questions

Purpose of the Study

Research Methods

The statistical population of this study included all boys and girls aged 6 to 10 years with

symptoms of the ODD who had been referred to consultation and treatment centers in the city of Ahvaz.

Out of the given population, 30 subjects were selected (they had obtained scores above the cutoff point -

equal to or higher than 4 - according to the results of their oppositional-defiant indices in the CBCL).

Raven’s Progressive Matrices (1938) for children were also administered to determine the normality of

intelligence among the selected children. Furthermore, parents were invited to participate in a 30-minute

clinical interview by the researcher to achieve the final accurate diagnosis. 30 randomly selected children

were divided into two groups: experimental or individual play therapy group (n=15) and control group

(n=15). Absence in more than one treatment session was considered as an exclusion criterion which was

not met by any subjects in this study. The subjects were evaluated at pre-intervention and post-

intervention stages, and two months after the intervention by using the following instruments:

Findings

This chapter presents the results of the data analysis to examine the identified hypotheses related to

the results. Both descriptive and inferential statistics were applied to answer the research questions of the

present study.

Conclusion

This chapter includes discussion of the results based on the evidence from prior investigation and

conclusion of the study.

Acknowledgments

We are grateful to the teachers and parents who cooperated and spent time to present report based on children’s state in this study.

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