Effect of Group Play Therapy on Emotional/Behavioral Problems of Children With Attention Deficit Hyperactivity Disorder Aged 6-12 Years

Abstract

Objective: One of the most significant issues in children with attention deficit hyperactivity disorder (ADHD) is emotional/behavioral problems, which disrupt their social communication at home and school. Some of these problems include social problems, rule-breaking behavior, and aggressive behavior. These problems, if left untreated in childhood, can cause problems in adulthood such as substance abuse, insubordination in the workplace, shorter stay at a job, and more anti-social acts. Nowadays, the use of play therapy for children with ADHD has become common. It is an active approach that allows the children to express their feelings through play. In group play therapy, children are asked to evaluate their personality according to their peers’ reactions. The study investigates the effect of group play therapy on emotional/behavioral problems in children with ADHD aged 6-12 years. Materials & Methods: This is a randomized controlled trial. The study population consists of all children with ADHD referred to the Dostdaran Koodak Occupational Therapy Clinic in Isfahan City, Iran. Of these, 28 children aged 6-12 years (average age: 8 years), including 8 girls and 20 boys, were selected using a convenience sampling technique. First, the study objective was explained to the parents, and children were then randomly assigned into the intervention and control groups. Considering error (d)=3, with 95% confidence level and 80% test power, the sample size was determined 14 for each group. The intervention group received 12 sessions of group play therapy (2 sessions per week, each for 45-60 minutes), besides two sessions of individual occupational therapy per week. However, the control group received two sessions of occupational therapy per week only. The emotional/behavior problems of subjects in both groups were assessed before and after the intervention using the CBCL. Data analysis was performed in SPSS V. 21 software using the Shapiro-Wilk test and ANCOVA. Results: After the group play therapy, there was a significant decrease in the scores of emotional/behavioral problems, including social issues, aggressive behavior, and rule-breaking behavior, as well as in the overall score (P˂0.001). Conclusion: Group play therapy can be used as a complementary method with other common occupational therapies for reducing the emotional/behavioral problems in children with ADHD.