The effect of behavioral activation play therapy in adolescents with depression: A study protocol for a randomized controlled trial.

BACKGROUND: Depression is a common psychological problem in adolescents worldwide. Although the World Health Organization recommends that members of this population engage in physical activity to reduce depressive symptoms, compliance with this recommendation is often low. Furthermore, although behavioral activation (BA) is recommended as a treatment for adolescents with depression, the reported effect size is small. Compared with traditional exercises, gamified physical activity (GPA) can be particularly appealing to adolescents because it is perceived as an enjoyable experience. In this study, we integrated BA and GPA to create behavioral activation play therapy (BAPT). We designed a clinical trial to investigate the feasibility, acceptability, and effectiveness of this treatment in adolescents with depression. METHODS: This study is a randomized controlled trial (RCT) with a three-arm, assessor-blinded design, conducted to validate the effectiveness and applicability of BAPT for treating adolescent with depression. We will recruit 258 participants and randomly assign them to a BAPT group, BA group, or GPA group using a ratio of 1:1:1. Based on conventional strategies for treatment and care, the three groups will receive nine BAPT sessions, nine BA sessions, or nine GPA sessions, respectively. We will compare the outcomes of the BAPT with those of the BA and GPA interventions. DISCUSSION: This is the first RCT to explore the effectiveness and applicability of BAPT in adolescents with depression. This study will provide evidence that may help to decrease depressive symptoms in adolescents, and will demonstrate the treatment effectiveness in terms of increasing levels of physical activity, reducing the rate of non-suicidal self-injury behaviors, and improving sleep quality. We will also assess the presence of side effects and the treatment adherence of patients receiving BAPT. TRIAL REGISTRATION: Trial registration: Chinese Clinical Trial Registry, ChiCTR2300072671. Registered on 20 June 2023.

Effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral problems in elementary school boys: a preliminary randomized controlled trial.

This study aimed to examine the effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral issues in elementary school boys. A randomized controlled trial design (pretest-posttest with a control group) was utilized. Thirty elementary school boys with school refusal issues were randomly assigned to intervention (n = 15) and control (n = 15) groups. The intervention group received ten sessions of cognitive-behavioral group play therapy. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire and Rutter's Children's Behavior Questionnaire were used as assessment tools. Mean scores for anxiety-based school refusal and behavioral problems in the intervention group showed a significant decrease (p < 0.001). Cognitive-behavioral group play therapy is a practical approach to reducing anxiety levels and behavior problems in children with anxiety-based school refusal in primary school grades.

Analysis of initial sandplay characteristics among university students with different levels of loneliness.

BACKGROUND AND OBJECTIVE: Loneliness is detrimental to mental health, with university students at higher risk of feeling lonely than other population groups. The mental health of college students is a hot topic at present. Despite numerous studies exploring interventions for loneliness among university students. However, little research has explored early psychological manifestations of university students with different levels of loneliness. Despite numerous studies exploring interventions for loneliness among university students, little research has explored early psychological manifestations of university students with different levels of loneliness. Initial sandplay is a good tool to reveal psychological activity. Therefore, our study aims to explore the characteristics of initial sandplay application among university students with different levels of loneliness. METHODS: We recruited 60 volunteers from a university to perform a sandplay experiment from January to April 2021. The UCLA Loneliness Scale measured the levels of loneliness. These 60 participants were divided into the experimental group (n = 30) and control group (n = 30) according to their levels of loneliness. The experimental group included participants with a scale score of more than 44. Other participants with a scale score of less than 44 belong to the control group. We recorded their sandplay artwork and statistically analyzed it by the Sandplay Process Record Form. Group comparisons were performed using the t-test or Wilcoxon rank-sum test for continuous variables, and the chi-square test or Fisher's exact test for categorical variables. The logistic regression analysis by forward stepwise method was conducted to analyze the sandplay theme features for loneliness. RESULTS: Regarding the sandplay tools, the experimental group used fewer transportation tools (t=-3.608, p < 0.01) and more natural elements (t = 2.176, p < 0.05) than the control group. Moreover, the experimental group created more natural scenes (χ2 = 4.310, p < 0.05) and used less of the lower left (χ2 = 4.593, p < 0.05) and lower right (χ2 = 5.934, p < 0.05) spaces. With regards to sand changes, the experimental group was less likely than the control group to make substantial changes (χ2 = 5.711, p < 0.05) and more likely to make almost no changes (χ2 = 4.022, p < 0.05). In terms of the themes, the experimental group was more likely to exhibit sandplay artwork themes of emptiness (χ2 = 8.864, p < 0.05) and neglect (χ2 = 6.667, p < 0.05), and less likely to show themes of energy (χ2 = 5.079, p < 0.05). In the logistic regression analysis of the sandplay themes, emptiness (OR = 5.714, 95%CI: 1.724-18.944, p = 0.003) and neglect (OR = 7.000, 95%CI: 1.381-35.479, p = 0.010) were demonstrated a nominal association with high levels of loneliness among both groups (F = 16.091, p < 0.01, ΔR2 = 0.193), but failed to pass the Bonferroni testing correction (p threshold < 0.0025). CONCLUSION: University students with higher degree of loneliness do not like to drastic changes and prefer to use natural elements in element selection, while the control group likes to drastic changes and prefers to use transportation tools in element selection. Regression analysis of sandplay theme features revealed emptines and neglect may as significant associated factors for loneliness. We propose sandplay characteristics can help identify university students with different levels of loneliness during psychological evaluations. Therefore, it is important that the school and healthcare systems assist college students in identifying the loneliness through initial sandplay and carrying on the necessary psychological counseling to the lonely student population.

Effect of group sand play therapy on psychopathologies of adolescents with delinquent behaviors.

Prior research has established adolescent vulnerability to delinquent behavior. This single-arm, noninterventional, observational study investigated the effect of sand play therapy on the psychopathologies of adolescents with delinquent behavior. A total of 68 adolescents participated in the study. Participants were treated with 8 weekly sessions of sand play therapy, lasting 50 minutes each and conducted in groups of 3 to 4 members. The psychopathologies of depression, anxiety, self-esteem, impulsiveness, characteristics of attention-deficit hyperactivity disorder (ADHD), and impulsiveness were measured using self-reporting scales. Following therapy, depression (t = 3.28; P = .002; ES = 0.399) and anxiety (t = 4.00; P < .001; ES = 0.485) decreased significantly with moderate effect size. ADHD characteristics (t = 2.73; P = .008) and impulsiveness (t = 2.73; P = .009) also decreased significantly with effect size of 0.330 and 0.327, respectively. Self-esteem (t = -2.06, P = .043; ES = 0.251) was found to have significantly increased. The high-risk group within each psychopathology showed significantly higher improvement than the low-risk group. Results showed that group sand play therapy is effective in improving internalizing problems such as depression and anxiety, as well as externalizing problems of ADHD features and impulsiveness among adolescents with deviant behaviors.

Sandplay Therapy as a Complementary Treatment for Children with ADHD: A Scoping Review.

ADHD is a prevalent neurodevelopmental disorder that affects children's behavior, academic performance, and social interactions. This review aims to evaluate the existing evidence for Sandplay therapy, a nonverbal psychodynamic approach, as a complementary treatment for children with ADHD. Ten studies suggest Sandplay therapy improves ADHD symptoms, such as hyperactivity, impulsivity, and inattention, through symbolic expression, play, and mindfulness. Despite its promise, ethical and practical considerations, including therapist training and treatment cost, must be addressed. Further research is needed to determine long-term effectiveness and optimal patient population for this treatment, which may benefit children unresponsive to or experiencing side effects from traditional treatments.

The effectiveness of play therapy in children with leukemia: A systematic review.

PROBLEM: Leukemia is the most common form of childhood cancer worldwide. Children living with leukemia experience various problems because of the disease's progression, harmful effects of treatment, and prolonged hospitalization process. To increase their well-being and alleviate their problems, these children require ongoing support. One solution that both parents and professionals can use is play therapy. This systematic review aimed to identify the type and effectiveness of play therapy in children living with leukemia. ELIGIBILITY CRITERIA: We searched PubMed, Scopus, ScienceDirect, and ProQuest databases. Additionally, we performed manual searches on Google Scholar, Google Web, and grey literature. Inclusion criteria comprised: 1) Studies that implemented play therapy on leukemia children, 2) Full-text articles available in English or Indonesian languages from January 2000 to December 2021 and updated until July 2023, and 3) Intervention studies employing quasi-experimental or randomized controlled trial (RCT) designs. SAMPLE: From 1099 articles, 16 studies were selected. Several forms of play therapy were found, including pretend, music, art, and sand play therapy. RESULTS: Of the sixteen studies in this systematic review, fifteen demonstrated beneficial effects on psychological issues, particularly anxiety, despair, stress, and physical problems (fatigue and pain). CONCLUSION: Play therapy effectively alleviates some physical and psychosocial problems in children living with leukemia. IMPLICATION: Nurses can utilize play therapy as an intervention for children living with leukemia. Additionally, comparative research is recommended with a similar research strategy concerning studies with the same design. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022318549.

Jungian Analysis of the Chinese Mythological Image of Sun Wukong.

This paper examines the symbolism of the cultural image Sun Wukong (the Monkey King), a Chinese legendary hero, and how it influenced an eight-year-old boy's psychic development. Through an analysis of Sun Wukong's life from his birth to attaining Buddhahood, a three-phase healing process is identified in Sun Wukong's tale and the psychotherapeutic process: "naming and initiating," "nurturing and taming," and "transforming and transcending," proposed by Dr. Heyong Shen. Sandplay visually highlighted these key clinical changes in conscious awareness and developmental behaviour influencing the boy's individuation process. Images found either in cultural traditions or spontaneously emerging from the unconscious in individuals are of significance in human life, offering pathways to psychic healing and development. Further, myths and cultural resources used in clinical work demonstrate that having cultural competency is invaluable in Jungian analysis. Pathogenic and health-maintenance factors of culture can be explored in future clinical practice and research.

Cet article étudie le symbolisme de l'image culturelle d'un héros légendaire chinois; Sun Wukong (le roi singe). L'article explore comment cette image a influencé le développement psychique d'un garçon de huit ans. À travers une analyse de la vie de Sun Wukong depuis sa naissance jusqu'à ce qu'il atteigne la bouddhéité, un processus de guérison en trois phases est identifié dans le conte de Sun Wukong et dans le processus psychothérapeutique, et proposé par le Dr Heyong Shen : « nommer et initier ¼, « apprivoiser et nourrir ¼ et « transformer et transcender ¼. La thérapie par le jeu de sable a ensuite mis en évidence visuellement ces changements cliniques clés dans la prise de conscience et le comportement développemental, qui ont influencé le processus d'individuation du garçon. Les images trouvées dans les traditions culturelles ou qui émergent spontanément de l'inconscient chez les individus sont importantes dans la vie des êtres humains : elles fournissent des voies de guérison et de développement psychiques. De plus, les mythes et les ressources culturelles utilisés dans le travail clinique montrent que la compétence culturelle est inestimable dans l'analyse jungienne. Les facteurs pathogènes et les facteurs de maintien de la santé - présents dans la culture - peuvent être explorés dans la pratique clinique et la recherche futures.

Este artículo explora el simbolismo de la imagen cultural de Sun Wukong (el Rey Mono), un héroe legendario chino, y cómo influyó en el desarrollo psíquico de un niño de ocho años. A través de un análisis de la vida de Sun Wukong desde su nacimiento hasta alcanzar la Budeidad, se identifica un proceso de curación en tres fases en el cuento de Sun Wukong y en el proceso psicoterapéutico: "nombrar e iniciar", "domar y nutrir" y "transformar y trascender", propuestos por el Dr. Heyong Shen. A continuación, el juego de arena puso de relieve visualmente estos cambios clínicos en la conciencia y en el desarrollo del comportamiento, influyendo en el proceso de individuación del niño. Las imágenes que se encuentran tanto en las tradiciones culturales, como las que que emergen espontáneamente del inconsciente de los individuos son importantes en la vida humana, ya que ofrecen vías para la curación psíquica y el desarrollo. Además, los mitos y los recursos culturales utilizados en el trabajo clínico demuestran que tener competencia cultural es inestimable en el análisis junguiano. Los factores patógenos y de mantenimiento de la salud de la cultura pueden explorarse en la práctica clínica y la investigación futuras.

Eye movement verification and evaluation of initial sandplay picture system for internet addiction symptoms in Chinese adolescents.

BACKGROUND: Sandplay therapy is a psychotherapeutic technique, based on the psychoanalytic theory of the unconscious. Nearly a century after it was developed, sandplay can now be applied for the initial diagnosis tools for sand players. The goal of the current research is to demonstrate the role of sandplay in identifying internet-addicted adolescents in China. The study aims to evaluate the reliability and validity for sandplay as a diagnosis and evaluation tool for internet addiction symptoms, and to verify the consistency that exists between results based on sandplay pictures and those based on the Pathological Internet Usage Scale for Adolescents (APIUS). METHODS: The research was conducted with a 2 × 2 mixed factorial design - two types of participants (addicts and non-addicts) and two types of sandplay pictures (pictures for addicts and pictures for non-addicts). An absolute recognition-judgment paradigm was used along with eye movement evaluations to evaluate the existing initial sandplay picture system for internet addiction symptoms (22 sandplay pictures, 11 related to addicts and 11 related to non-addicts, respectively). Sixty Chinese adolescents were selected as the participants (30 as addicts and 30 as non-addicts) according to the APIUS. RESULTS: (1) The initial sandplay pictures for internet addicts are clearly preferred by Chinese internet-addicted adolescents, which are more familiar and easier to process; (2) Such pictures have a higher level of emotional arousal and cognitive resonance for the addicts; (3) Track and heat maps indicate that young internet addicts mainly fixate on the initial sandplay pictures for internet addicts. CONCLUSION: This initial sandplay picture system can be used to screen and identify young Chinese internet addicts based on symptoms, and the evaluation results are consistent with those based on the APIUS.

Taking outside in, turning inside out: Exploring social dimensions and psychotherapeutic process in the play therapy of a young girl in foster care.

This paper, a collaborative effort, describes the work of A Home Within (AHW), a volunteer community-based organization providing pro-bono long term psychotherapy to current and former foster youth. We provide a brief description of the treatment model, present a report of treatment conducted by an AHW volunteer, and discuss further reflections on the societal context of our psychoanalytically-informed work. In-depth psychotherapeutic process from the treatment of a young girl in a pre-adoptive foster placement elucidates the psychotherapeutic possibilities when a psychoanalytic treatment model is accessible to current and former foster youth, usually deprived of this form of treatment due to overburdened, underfunded community mental health systems in the U.S. Open-ended psychotherapy afforded this traumatized child an unusual opportunity to work through past relational traumas in order to form new and more secure attachment relationships. We reflect further on the case from the vantage points of both the psychotherapeutic process and the greater societal context of this community-based program.

"Un barril sin fondo" / "A bottomless barrel" / "Un tonneau sans fond" / "Um barril sem fundo

Belcebú es la historia de un niño con las marcas de la violencia que se perpetúa transgeneracionalmente. Su nombre remite a marcas identitarias confusas y ambivalentes. Ser demonio o exorcista. Ser exceso o restricción. Ser de la abuela o de mamá. Ser un niño o (no ser) un robot. Ser un peso o un sostén. Es también la historia del juego elaborativo en pandemia y con modalidad virtual. Y,por último,es la historia del alcance del analista frente a un contexto de mucha vulnerabilidad AU

Belcebu is the story of a boy with the singsof violence that are perpetuated transgenerationally. His name refers to confusing and ambivalent identity marks. To be a demon or an exorcist. To be excess or restraint. To be from grandma or from mom. To be a child or (not to be) a robot. To be a burden or a support.It is also the story of elaborative play during a pandemic and with virtual modality.And finally, it is the story of the analyst's reach in the face of a context of great vulnerability AU

Belzébuth est l'histoire d'un enfant marqué par la violence qui se perpétue de manière transgénération nelle. Son nom fait référence à des marques d'identitéconfuses et ambivalentes. Être un démon ou un exorciste. Être un excès ou une restriction. Être de grand-mère ou de maman. Être un enfant ou (ne pas être) un robot. Être un poids ou un support.C'est aussi l'histoire du jeu élaboratif dans une pandémie et avec une modalité virtuelle.Et enfin, c'est l'histoire de la portée de l'analyste dans un contexte de grande vulnérabilité AU

Belzebu é ahistória de uma criança com as marcas da violência que se perpetua transgeracionalmente. Seu nome remete a marcas identitárias confusas e ambivalentes. Ser um demônio ou exorcista. Ser excesso ou restrição. Seja da avó ou da mãe. Ser criança ou (não ser) robô. Sendo um peso ou um suporte.É também a história do jogo elaborativo em plena pandemia e com modalidade virtual.E, finalmente, é a história do alcance do analista em um contexto de grande vulnerabilidade AU

Comentario acerca del caso Belcebú / Commentary on the Beelzebub case / Commentaire sur le cas clinique de Belzébuth / Comentário sobre o caso Belzebu

A partir de la presentación del caso clínico de un niño de 10 años llamado Belcebú, atendido durante la pandemia de forma virtual a lo largo de un año y cuatro meses, se realiza un comentario teórico-clínico puntualizando los aspectos vinculados a:los enunciados identificatorios; el niño en la estructura familiar y, como aspecto más relevante, el lugar del juego producido en las sesiones, el que sostenido por la mirada posibilitadora de la analista, le permitió alniño elaborar y rescribir marcas identitarias,en pos de una subjetivación menos tanática AU

Based on the presentation of the clinical case of a 10-year-old boy named Belcebú, treated virtually during the pandemic for a yearand four months, a theoretical-clinical comment is made, pointing out the aspects related to: the identifying statements; the child in the family structure and, as a most relevant aspect, the place of the play produced in the sessions, which, supported by the analyst's enabling gaze, allowed the child to elaborate and rewrite identity marks, in pursuit of a less thanatic subjectivation AU

Sur la base de la présentation du cas clinique d'un garçon de 10 ans nommé Belcebú, traité virtuellement pendant la pandémie durant un an et quatre mois, un commentaire théorico-clinique est fait, soulignant les aspects liés:aux énoncés identifiants; l'enfant dans la structure familiale et, comme aspect le plus pertinent, la place du jeu produit dans les séances, qui, soutenu par le regard habilitant de l'analyste, a permis à l'enfant d'élaborer et de réécrire des marques identitaires, à la poursuite d'une subjectivation moins thanatique AU

A partir da apresentação do caso clínico de um menino de 10 anos chamado Belcebú, tratado virtualmente durante a pandemia por um ano e quatro meses, é feito um comentário teórico-clínico, apontando os aspectos relacionados: a os depoimentos identificadores; a criança na estrutura familiar e, como aspecto mais relevante, o lugar da brincadeira produzida nas sessões, que, amparada pelo olhar capacitador do analista, permitiu à criança elaborar e reescrever marcas identitárias, em busca de uma subjetivação menos tanática AU

La interpretación del sueño y sus similitudes con el juego: una técnica para aplicar en un dispositivo clínico de Françoise Dolto / Les similitudes dans l'interpretation du reve et du jeu: une technique applicable dans un lieu d'accueil enfant-parent / Dream interpretation ant its similarities with the play: a method to apply ina Dolto's maison verte project / A interpretação do sonho e suas semelhanças com a brincadeira: uma técnica para aplicar em um dispositivo clínico de Françoise Dolto

¿Cómo nos puede ayudar el método de la interpretación de los sueños a entender los elementos arcaicos presentes en el juego del niño de 0 a 4 años, en un dispositivo clínico inspirado en la Maison Verte creada por Françoise Dolto? En este artículo describiremos las similitudes entre el sueño y el juego del niño, particularmente con respecto al trabajo del sueño. Propondremos que los mismos mecanismos del sueño están presentes en el juego del niño como parte de un contenido manifiesto. Enseguida propondremos que es posible interpretar el contenido latente del juego trasponiendo el método de la interpretación de los sueños gracias a la información aportada por los padres que acompañen al niño. Para explicar esta técnica, examinaremos el ejemplo de juego de unos niños, tomado de un Lugar de Acogida de Niños y Padres que se adhiere a los principios de la Maison Verte AU

Comment la méthode d'interprétation des rêves peut-elle nous aider à comprendre les éléments archaïques présents dans le jeu des enfants de 0 à 4 ans, dans un dispositif clinique inspiré de la Maison Verte créée par Françoise Dolto? Dans cet article, nousdécrirons les similitudes entre le rêve et le jeu de l'enfant, notamment en ce qui concerne le travail du rêve. Nous proposerons que les mêmes mécanismes oniriques sont présents dans le jeu de l'enfant dans le cadre d'un contenu manifeste. Ensuite, nous proposerons qu'il est possible d'interpréter le contenu latent de ce jeu en transposant la méthode d'interprétation des rêves grâce aux informations fournies par les parents accompagnan l'enfant. Pour expliquercette technique, nous examinerons un exemple de jeu d'enfants, tiré d'un Lieu d'Accueil pour Enfants et Parents qui adhère aux principes de la Maison Verte AU

How can the dream interpretation method help us to understand the archaic elements present in the play of children from 0 to 4 years old, in a clinical device inspired by the Maison Verte project created by Françoise Dolto? In this article we will describethe similarities between the child's dream and play, particularly regarding to dream-work. We will propose that the same dream mechanisms are present in the child's play as part of a manifest content. Then we will propose that it is possible to interpret the latent content of this play by transposing the dream interpretation method thanks to the information provided by the parents. To explain this technique, we will examine an example of children's play, taken from a Dolto's Maison Verte Project AU

Como o método da interpretação dos sonhos pode nos ajudar a compreender os elementos arcaicos presentes nas brincadeiras das crianças de 0 a 4 anos, em um dispositivo clínico inspirado na Maison Verte criada por Françoise Dolto? Neste artigo, descreveremos as semelhanças entre o sonho e a brincadeira da criança, principalmente no que diz respeito ao trabalho onírico. Proporemos que os mesmos mecanismos oníricos estão presentes na brincadeira da criança como parte de um conteúdo manifesto. Imediatamente propomos que é possível interpretar o conteúdo latente desta brincadeira transpondo o método de interpretação dos sonhos graças às informações fornecidas pelos pais. Para explicar est técnica examinaremos um exemplo de brincadeira infantil, retirado de um Local de Acolhimento para Crianças e Pais que segue os princípios da Maison Verte AU

Effects of school sandplay group therapy on children victims of cyberbullying.

Cyberbullying among children is increasing every year, leading to serious public health problems. Victims suffer serious aftereffects such as depression and suicidal ideation; therefore, early and appropriate psychological intervention and the role of schools are emphasized. This study investigated the effects of school sandplay group therapy (SSGT) on children affected by cyberbullying. This study was designed as a parallel-group non-randomized controlled trial. The study subjects were 139 elementary school students (mean age 11.35 years; standard deviation, 0.479; age range 12-13 years) residing in Cheonan City, Korea, who were assigned to the intervention and comparison groups. The intervention group received 10 sessions of therapy on a weekly basis, for 40 minutes per session. No therapy was administered in the control group. The effectiveness of the intervention was assessed using the Children Depression Inventory, Suicidal Ideation Questionnaire-Junior, and Rosenberg Self-Esteem Scale. The assessment for the comparison group was performed concurrently with that of the intervention group. Data were analyzed using multivariate analysis of variance. In this study, the SSGT group showed a significant decrease in depression and suicidal ideation compared to the control group after sandplay group therapy (SGT), and a significant increase in self-esteem. It was confirmed that SSGT can mitigate the negative consequences of cyberbullying and strengthen protective factors. This suggests that the SSGT can be successfully used for crisis counseling.

Effects of Parent-Child Sandplay Therapy for preschool children with autism spectrum disorder and their mothers: A randomized controlled trial.

PURPOSE: To evaluate the effects of the Parent-Child Sandplay Therapy (PCST) Program on autism behaviors, social responsiveness and sleep quality among preschool children with autism spectrum disorder (ASD), and their mothers' parenting stress. DESIGN AND METHODS: A prospective, randomized controlled, parallel-group trial was employed. Fifty-two child-mother dyads were randomly assigned to an intervention group (n = 26) or a control group (n = 26) from February 2017 to February 2019. The intervention group was treated with a 20-week PCST Program plus an Applied Behavior Analysis-based program (ABA-based program), whereas the control group received only the ABA-based program. Outcome measures included the Autism Behavior Checklist total scores, Social Responsiveness Scale scores, Children's Sleep Habits Questionnaire scores, and Parenting Stress Index-Short Form scores, measured at baseline, post-intervention (20 weeks after baseline) and follow-up assessments (32 weeks after baseline). RESULTS: Finally, 43 dyads completed the study. The linear mixed model analysis resulted in a significant group*time interaction effect of ABC score (Est = 2.027, t = 3.277; p < 0.01), SRS score (Est = 3.377, t = 6.095; p < 0.01), PSI-SF score (Est = 3.873, t = 4.253, p < 0.01), and CSHQ score (Est = 3.158, t = 6.485; p < 0.05). CONCLUSION: Our findings suggested that the PCST Program could potentially improve social interaction and sleep quality of preschool children with ASD while decreasing parenting stress. PRACTICE IMPLICATIONS: The PCST Program was found to be a feasible and a promising treatment for children with mild-to-moderate ASD as well as for their parents. It was a nurse-led program, which could be integrated into the usual nursing care of children with autism spectrum disorder in special education schools. TRIAL REGISTRATION: Chinese Clinical Trials Registry, ChiCTR2100047699.

Effectiveness of web-based play therapy intervention in supporting the development of children with attention deficit/hyperactivity disorder.

The high prevalence of children with Attention Deficit/ Hyperactivity Disorder (ADHD) in Indonesia has become a concern for nursing because ADHD might emerge as neurological developmental problems if not treated early through appropriate intervention. This study aims to determine the effectiveness of web-based play therapy on the emotional, behavioural and social development of school-age children with ADHD. This study employs a quasi-experimental non-equivalent control group design with purposive sampling technique, and 126 children with ADHD (patients at a psychiatric hospital in Indonesia) as participants. The results show that play therapy is an effective intervention for the emotional, behavioural and social development of school-age children with ADHD (p = 0.048, p = 0.030, p = 0.030; α= 0.05). This study is recommended as a reference for optimising nursing care for children with ADHD using information technology in the form of web-based play therapy designed in line with the fundamentals of intervention for children with ADHD, using attractive features and flexible access.

What works? Lessons from a pretrial qualitative study to inform a multi-component intervention for refugees and asylum seekers: Learning Through Play and EMDR Group Traumatic Episode Protocol.

Almost half of the trials failed to recruit their targeted sample size of which 89% could be preventable. Successful implementation of mental health trials in a context of forcibly displaced individuals can be even more challenging. Mental health difficulties have the potential to impact parenting skills, which are linked to poor development in children, while parenting interventions can improve parents' mental health and parenting behaviors. However, the evidence on parenting interventions for refugees is limited. A parenting intervention, Learning Through Play Plus Eye Movement Desensitization and Reprocessing Group Treatment Protocol, has been designed to address parental mental health. This pretrial qualitative study, conducted with refugees, asylum seekers and professionals, aimed to explore their perceptions of the intervention and to identify barriers and recommendations for better engagement, recruitment, and delivery. Three themes were generated from thematic analysis: the content of the intervention, suggestions for improvement and implementation, and understanding the role of the facilitator. These themes provided insights into the issues that might predict the barriers for delivery of the intervention and offered several changes, including destigmatization strategies to improve engagement.

Children's Play-Work Occupation Continuum: Play-Based Occupational Therapy, Play Therapy and Playwork.

Introduction: Occupational therapists often use play-based approaches to facilitate children's occupational development and promote participation, for example, play-based occupational therapy, play therapy and playwork. However, where does play occupation fit, within these adult-guided play-based approaches in occupational therapy? Purpose: To examine and discuss the play-work occupation continuum of children to inform occupational therapy practice. Key Issues: Children's play occupations are free-selected, unstructured, internally-controlled, spontaneous and intrinsically-motivated. Yet, occupational therapists often utilize play as a therapeutic modality to support occupational development for occupations other than play. This use of play represents play-based work occupations as they are structured, externally-controlled, adult-guided, goal-focused and extrinsically-motivated. Play occupations then move from being authentic free-play to adult-guided play-based work occupations for children. Implications: When working with children and families, occupational therapists need to balance the use of self-selected, unstructured play occupations with the application of adult-guided, structured, goal-focused play-based work occupations.

The effectiveness of child-centered play therapy for executive functions in children with attention-deficit/hyperactivity disorder.

INTRODUCTION: Child-centered play therapy (CCPT) is a practical and recommended non-medication intervention for children with Attention-deficit/hyperactivity disorder (ADHD) but the mechanism in between is unclear. AIM: This study proposed to examine the effectiveness of CCPT on neuropsychological deficits and behavioral symptoms in ADHD. METHODS: Participants with ADHD diagnosis were referred from senior child and adolescent psychiatrists, and typical developmental children (TD) were recruited from community as a control group. All participants' executive functions were evaluated using Cambridge Neuropsychological Test Automated Battery. First of all, the participants were evaluated using Child Behavior Checklist (CBCL) by their parents. The ADHD participants were assigned into CCPT (ADHDc) and waitlist (ADHDw) group; and the ADHDc group then received CCPT weekly for 12 sessions, while the ADHDw continuously received their regular treatment (i.e., medication treatment or other alternative treatments) as usual. RESULTS: Total 52 participants were recruited (17 with ADHD and 35 typically developed children, TD). The results showed that overall the ADHD groups had worse neuropsychological performance and more behavioural disturbance than did the TD (ps < .05). After receiving the CCPT, the results showed that the ADHDc group had significant improvement in the cognitive flexibility (p < .05); while the ADHDw group had no changes.

Psicólogas(os) no sistema educacional de Boa Vista/Roraima: concepções, práticas e desafios / Psychologists in the educational system of Boa Vista/Roraima: conceptions, practices and challenges / Psicólogas(os) en el sistema educativo de Boa Vista/Roraima: concepciones, prácticas y retos

O objeto de estudo deste trabalho é a atuação de psicólogas(os) no campo da educação básica. Tivemos como objetivo investigar as práticas de atuação e os desafios enfrentados pelas(os) psicólogas(os) que trabalham na educação em Boa Vista (RR), com intuito de conhecer a inserção desses profissionais no sistema educacional. Trata-se de pesquisa qualitativa, orientada pelo referencial teórico-metodológico da Psicologia Escolar Crítica. Realizamos o processo de levantamento dos dados entre os meses de março e abril de 2018, por meio de entrevistas semiestruturadas, audiogravadas e transcritas. Encontramos 21 psicólogas e um psicólogo trabalhando em instituições educacionais e de ensino na cidade; a maioria atuava na educação básica; metade dos entrevistados ingressou por concurso público e a outra metade era contratada e comissionada; poucos(as) foram contratados(as) como psicólogos(as) escolares. Para a análise, selecionamos dez psicólogas(os) com mais tempo no cargo. Quanto às práticas de atuação, identificamos que 60% atuavam na modalidade clínica e 40% na modalidade clínica e institucional. Como desafios, encontramos melhoria das condições de trabalho; estabelecimento de relações hierárquicas e a dificuldade de fazer compreender as especificidades desse campo de trabalho; necessidade na melhoria das condições para formação continuada; atuação da(o) psicóloga(o) escolar enquanto ação institucional. Diante do exposto, compreendemos ser necessária uma mudança de paradigma na atuação das(os) psicólogas(os) que trabalham na educação na região, e a apropriação das discussões da área, principalmente, aquelas apresentadas pela Psicologia Escolar Crítica, vez que esta contribui para uma atuação que leve em conta os determinantes sociais, políticos, culturais e pedagógicos que constituem o processo de escolarização.(AU)

This work has as object of study the role of psychologists in the field of Basic Education. We aimed to investigate practices and challenges faced by psychologists who work in education in Boa Vista/RR, to know the insertion of these professionals in the educational system. This is a qualitative research, guided by the theoretical-methodological framework of Critical School Psychology. The data collection process was carried out between March and April 2018, with semi-structured, audio-recorded, and transcribed interviews. We found 21 female psychologists and one male psychologist working in educational institutions in the municipality; most worked in Basic Education; half of the interviewees had applied to work as government employee and the other half were hired and commissioned; few were hired as school psychologists. To carry out the analysis, we selected ten psychologists with more time in the position. Regarding the practices, we have identified that 60% worked in the clinical modality and 40% in the clinical and institutional modality. As challenges, we find the improvement in working conditions; the establishment of hierarchical relationships and the difficulty of making the specificities of this field of work understood; the need to improve conditions for continuing education; the practice of the school psychologist as institutional action. In view of the above, we understand that a paradigm shift in the performance of psychologists working in education in that region is necessary, and the appropriation of discussions in the area, especially those presented by Critical School Psychology, contributes to an action that considers social, political, cultural, and pedagogical determinants that constitute the schooling process.(AU)

Este trabajo tiene como objeto de estudio la actuación profesional de las(os) psicólogas(os) en la educación básica. Su objetivo es investigar las prácticas y retos que enfrentan las(os) psicólogas(os) que trabajan en la educación en Boa Vista, en Roraima (Brasil), con la intención de conocer la inserción de estos profesionales en el sistema educativo. Esta es una investigación cualitativa que se guía por el marco teórico-metodológico de la Psicología Escolar Crítica. Se recopilaron los datos entre los meses de marzo y abril de 2018, mediante entrevistas semiestructuradas, grabadas en audio y después transcritas. Las 21 psicólogas y un psicólogo trabajan en instituciones educativas de la ciudad; la mayoría trabajaba en la educación básica; la mitad de los entrevistados ingresaron mediante concurso público y la otra mitad era contratada y de puesto comisionado; pocos fueron contratados como psicólogos escolares. Para el análisis, se seleccionaron diez psicólogas(os) con más tiempo en el cargo. Con respecto a las prácticas, el 60% trabajaba en la modalidad clínica; y el 40%, en la modalidad clínica e institucional. Los retos son mejora de las condiciones laborales; establecimiento de relaciones jerárquicas y dificultad para comprender las especificidades de este campo de trabajo; necesidad de mejorar las condiciones para la educación continua; y actuación dela (del) psicóloga(o) escolar como acción institucional. En vista de lo anterior, es necesario el cambio de paradigma en la práctica profesional de las(os) psicólogas(os) que trabajan en la educación de la región y la apropiación de las discusiones del área, especialmente las presentadas por la Psicología Escolar Crítica, que contribuye a una acción que tiene en cuenta los determinantes sociales, políticos, culturales y pedagógicos que constituyen el proceso de escolarización.(AU)

Percepções de familiares sobre uma rede de cuidados de saúde mental infantojuvenil / Family perceptions about a children's mental health network / Percepciones familiares sobre una red de atención de salud mental infantojuvenil

Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)

This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)

Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)