published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (M. Nurs.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 118-126).

The study reported here attempts to demonstrate the utility of group play therapy as a method of reducing aggression in preadolescent aged boys. Previous research has attempted to demonstrate the value of play therapy as a method of dealing with a variety of emotional and behavioral problems.

The problem with which this investigation was concerned was that of determining the efficacy of child-centered group play therapy with pre-kindergarten and kindergarten children with speech difficulties as an intervention strategy for improving specific speech problems in the areas of articulation, receptive language, and expressive language. A second purpose was that of determining the efficacy of child-centered group play therapy in improving self-esteem, positive social interaction, and in decreasing anxiety and withdrawal behaviors among pre-kindergarten and kindergarten children with speech difficulties. The experimental group consisted of 11 children who received 25 group play therapy sessions one time a week in addition to their directive speech therapy sessions. The comparison group consisted of 10 children who received only their directive speech therapy sessions. The Goldman Fristoe Test of Articulation, the Peabody Picture Vocabulary Test - Revised, and the Clinical Evaluation of Language Fundamentals - 3 were used to measure receptive and expressive language skills. The Burks' Behavior Rating Scale was used to measure symptoms of anxiety, withdrawal, poor self-esteem, and poor social skills as observed by parents and teachers. Twelve hypotheses were tested using ANCOVA and Eta Squared. Child-centered group play therapy was shown to have a large practical significance in helping children improve their expressive language skills. Child-centered group play therapy was shown to have a medium practical significance in increasing children's receptive language skills. Small sample size may have contributed to the lack of statistical significance as calculated by the analysis of covariance. Child-centered group play therapy was shown to have a small yet positive impact upon children's articulation skills and anxiety. Although not significant at the .05 level, these results indicate a slightly larger increase in articulation skills and a slightly larger decrease in symptoms of anxiety among those children who received group play therapy as compared to those who did not. Child-centered group play therapy was shown to have a mixed effect upon children's self-esteem, withdrawal behaviors, and positive social interactions. This study supports the use of child-centered group play therapy as an effective intervention strategy for children with speech difficulties to improve expressive and receptive language skill development.

This study was designed to determine the effectiveness of group activity therapy as a school based intervention with fourth and fifth grade preadolescents with learning disabilities experiencing behavior problems. The group activity therapy intervention followed humanistic principles and was designed to address the cognitive and social emotional needs of this population. The preadolescents were provided a variety of developmental appropriate materials and activities to encourage self expression and group interaction. The 24 volunteer preadolescents were randomly assigned to the experimental group (n=12) and to the control group (n=12). The treatment group preadolescents were divided into groups of three and participated in group activity therapy one hour per week for 12 weeks. The participants were assigned to groups according to individual needs and personality traits. The control group received no treatment during the study. Pre and post test data were collected from parents using the Child Behavior Checklist (CBC) and the Behavior Assessment Scale for Children (BASC). Analysis of Covariate (ANCOVA) was utilized to determine statistical significance between the treatment group and the control group on the post-test means for each hypothesis. In each case, the post-test specified in each hypothesis was used as the dependent variable and the pre-test as the covariate. Specifically, the preadolescents in the treatment group showed statistically significant decreases in total behavior problems on the BASC (p=.05) and decreases in internalizing problems on both the BASC and CBC (p=.03, p=.05, respectively). While not statistically significant, positive trends were noted on the CBC total behavior scale (p=.08) and on the CBC externalizing scale (p=.09). In addition, Cohen's d effect size was calculated for each hypothesis and post hoc analysis of the subscales to determine practical significance of the treatment on the experimental group when compared to the control group. A large treatment effect size was found on the BASC (d=.91) and CBC (d=.82) total behavior problems scales and on the BASC (d=1.03) and CBC (d=.90) internalizing problems scales. A moderate to large treatment effect size (d=.78) was found on the CBC externalizing problems scale and a medium treatment effect size (d=.53) was found on the BASC externalizing problems scale. Qualitative data was also examined to determine clinical significance of the intervention. This study determined that group activity therapy is an effective intervention for preadolescents diagnosed with a learning disability.

Early childhood is a critical period during which children develop social-emotional competence that will affect future success. Developing social-emotional assets is of importance for kindergarten children because of their concurrent cognitive and social changes as well as the experience of transitioning from home to school environment. A growing number of schools have adopted social-emotional learning (SEL) programming to focus on fostering children’s prosocial behaviors through direct instruction and engaging activities in classroom settings. However, some researchers have proposed that learning should capitalize on children’s natural interests rather than adult-determined agendas. Based on theoretical assumptions regarding potential effectiveness of child-centered group play therapy (CCGPT) as a treatment modality, I sought to explore the effects of CCGPT on social-emotional assets of kindergarten children utilizing parent and teacher reports across pretest, posttest, and one-month follow-up. Additionally, given that group sizes have been inconsistent and rarely explored across previous studies, I investigated the therapeutic aspect of group sizes in CCGPT outcome by comparing 2-member and 3-member CCGPT groups. Forty-three participants with mean age of 5.14 were recruited from three elementary schools, including 19 Hispanic, 14 Caucasian, and 10 African American. Twenty-one participants were randomly assigned to the intervention group receiving a mean of 15.32 CCGPT sessions over 8 weeks, and 22 participants were assigned to the waitlist control group. Six mixed between-within ANOVAs were conducted applying an alpha level of .05 to interpret statistical significance and η2 calculation to assess practical significance. Results indicated a statistically significant interaction effect on SEARS-P Total score, F (2, 72) = 4.533, p = .014, with medium effect size of η2 = .101. Post Hoc analyses indicated a non-statistically significant interaction effect on SEARS-P Self-Regulation/Responsibility subscale with a small effect, F (1.868, 67.248) = 1.776, p = .179, η2 = .043; a statistically significant interaction effect on SEARS-P Social Competence subscale with a medium effect, F (1.696, 61.049) = 3.413, p < .05, η2 = .079; and a statistically significant interaction effect on SEARS-P Empathy subscale with a medium effect, F (1.439, 51.79) = 4.592, p < .05, η2 = .106. Thus, participants in the CCGPT group showed a non-significant increase in the ability to self-regulate emotions and to take responsibility for actions and a significant increase in competence to interact socially with others and in empathy for others. Teacher reports did not show statistically significant results with a small effect, F (2, 70) = .917, p = .404, η2 = .013. Results on group sizes indicated that no statistical differences were detected between two-member and three-member groups with no effect, F (1.493, 25.377) = .039, p = .942, η2 = .001. Moreover, the results on follow-up supported that a certain level of the effects of CCGPT lasted one month after the intervention. Overall, children seemed to benefit from CCGPT, and CCGPT may be considered a viable treatment for enhancing kindergarten children’s social-emotional development.

This study was designed to determine the effectiveness of intensive sibling group play therapy in: (a) improving the self-concept of child witnesses of domestic violence; (b) reducing internalizing behavior problems, such as withdrawal, somatic complaints, anxiety and depression, of child witnesses of domestic violence; (c) reducing externalizing behavior problems, such as aggression and delinquency, of child witnesses of domestic violence; and (d) reducing overall behavior problems of child witnesses of domestic violence. A second objective of this study was to compare the effectiveness of intensive sibling group play therapy and intensive individual play therapy on the above identified dimensions.

A randomized controlled trial study was conducted to test the effectiveness of 16 sessions of the modalities of individual and group child-centered play therapy (CCPT) on improving social-emotional assets, including self-regulation/responsibility, social competence, and empathy. Participants were 56 students in four urban elementary schools in north central Texas, referred by teachers for disruptive or problematic behavior: 10 female and 46 male; ages 5 to 10 years with mean age 7.12; and 21 identifying as Hispanic, 17 as White, 8 as Multiracial, 1 as Asian, and 9 unspecified. Teachers and parents completed the Social and Emotional Assets and Resilience Scale (SEARS; Merrill, 2011) at pre- and post-treatment. With a significance criterion of p< .05, teacher reports provided no statistically significant results. However, parent reports indicated a statistically and practically significant interaction effect with a medium to large effect size, indicating a substantial improvement in children's scores from pre- to post-test attributed to group assignment. Mean differences indicated substantial gains in overall social-emotional assets, according to Total scores, in both individual and group treatment conditions as compared to the waitlist control group. Additionally, both individual and group play therapy was correlated with significant improvement with a large effect for the constructs of self-regulation/responsibility and social competence, with the group condition having a larger effect than the individual condition. Regarding empathy, neither modality resulted in significant improvement, though individual CCPT resulted practically in a large effect. These results indicate CCPT may provide a developmentally appropriate treatment for clinicians working with children in schools and in the community to foster their social and emotional competencies.

Thesis (PhD (Education))-University of Pretoria, 2008. / Includes bibliographical references.

The number of children in classrooms is constantly increasing, causing shy children to become more invisible in the classroom. Thompson&Rudolph (2000: 542) indicate that shyness and withdrawal are attempts to avoid participation in one’s surroundings. The researcher is of the opinion that if shyness is not adequately addressed during middle childhood, it can continue to limit the potential of shy people. Shyness is not generally considered as problematic behaviour for children in their middle childhood. Shyness inhibits children to express themselves. They rarely participate in class and usually hold an irrational negative view of themselves. There is a need for shy children to be able to express themselves, in order to gain optimally from the school setting. Play therapy is based on developmental principles and thus provides, through play, developmentally appropriate means of expression and communication (Landreth&Bratton, 1999:5). Group therapy complements the normal developmental tasks that further children’s capacities for social interaction and intimacy. The researcher conducted intervention research. Many facets of intervention research are both qualitative and quantitative in nature, depending on the distinctive elements of the particular research project (De Vos, 2002a:368). Due to both the qualitative and quantitative nature of intervention research, the researcher employed Creswell’s dominant-less-dominant model in order to accommodate both research approaches. The goal of this study was to explore the impact of group play therapy on the social skills of shy children in their middle childhood. The researcher conducted a one-group pretest-posttest design in order to measure “shyness” as well as social skills before and after intervention. Seeing that the quantitative paradigm answered the research question of this research project, it was utilized as the dominant approach. Through comparing the pre-test and post-test scores, the researcher realized that group play therapy has a positive impact on the social skills of shy children. The unstructured observation provided the researcher with a better insight into the phenomena of shyness, and represented the qualitative approach. By combining the two research approaches, the researcher was able to achieve the outlined goal and objectives of this study. Further research into effective implementation of group play therapy to address shyness in the middle childhood years is recommended. / Dissertation (MSD (Play Therapy))--University of Pretoria, 2005. / Social Work and Criminology / unrestricted