Play Therapy for Children Exposed to Natural Disasters

Year 2025, Volume: 17 Issue: 1, 47 - 60, 31.03.2025

Gökçen Dalkılınç , Selin Okumuş , Berna Güloğlu

https://doi.org/10.18863/pgy.1431472

Abstract

Natural disasters occur with increasing frequency every year in our country and around the world. The largest forest fires, in recorded history, occurred in Türkiye in 2021, and the Kahramanmaraş earthquakes, called the disaster of the century, occurred in 2023. Between these dates, our country has struggled with disasters such as avalanches and floods, as well as earthquakes and fires. Due to their unexpected nature and devastating impact on individuals' lives, natural disasters can also have shocking effects on individuals' mental health. Undoubtedly, many people have been affected by these disasters. However, children are a risky group among those affected by natural disasters because their coping skills are limited and they have not yet achieved their independence. In addition, it is known that traumatic experiences in the first years of life negatively affect the individual's development. Therefore, it is thought that the psychological support provided to children after a natural disaster is important. In this sense, play therapy appears as one of the effective intervention methods in the psychological support service provided after natural disasters. The aim of this study was to enable mental health professionals working with children exposed to disaster to understand possible psychopathologies and to create a framework for the role of play therapy in intervening.

Keywords

Natural disaster, effects of natural disaster, play therapy

Doğal Afetlere Maruz Kalan Çocuklarda Oyun Terapisi

Abstract

Ülkemizde ve dünyada meydana gelme sıklığı her geçen yıl giderek artan doğal afetler gerçekleşmektedir. Türkiye’de 2021 yılında, kayıtlara geçen tarihin en büyük orman yangınları meydana gelmiş ve 2023 yılında yüz yılın afeti olarak adlandırılan Kahramanmaraş depremleri yaşanmıştır. Bu tarihler arasında ülkemizde, deprem ve yangınların yanı sıra, çığ ve sel gibi afetlerle de mücadele edilmiştir. Beklenmedik yapısı ve bireylerin yaşamındaki yıkıcı etkisi nedeniyle doğal afetler, bireylerin ruh sağlığı üzerinde de sarsıcı etkilere neden olabilmektedir. Şüphesiz, birçok insan bu afetlerden etkilenmiştir. Ancak baş etme becerilerinin kısıtlı olması ve henüz kendi bağımsızlıklarını elde edememiş olmaları nedeniyle çocuklar, doğal afetlerden etkilenen kişiler arasında riskli bir gruptur. Ayrıca, yaşamın ilk yıllarında yaşanan travmatik deneyimlerin bireyi gelişimsel açıdan da olumsuz etkilediği bilinmektedir. Dolayısıyla, doğal afet sonrası çocuklara sunulacak psikolojik desteğin önemli bir yeri olduğu düşünülmektedir. Bu anlamda oyun terapisi, doğal afet sonrası sunulan psikolojik destek hizmetinde etkili müdahale yöntemlerinden biri olarak karşımıza çıkmaktadır. Bu çalışmanın amacı, afete maruz kalmış çocuklarla çalışan ruh sağlığı uzmanlarının olası psikopatolojileri anlamalarını sağlamak ve müdahale etme konusunda oyun terapisinin rolüne ilişkin bir çerçeve oluşturmaktır.

Keywords

Doğal afet, afetin etkileri, oyun terapisi

References

• AFAD (2022a) Açıklamalı afet yönetimleri sözlüğü. https://www.afad.gov.tr/aciklamali-afet-yonetimi-terimleri-sozlugu (Accessed 04.03.2023).
• AFAD (2022b) Afet türleri. https://www.afad.gov.tr/afet-turleri (Accessed 04.03.2023).
• Agustini EN, Asniar I, Matsuo H (2011) The prevalence of long‐term post‐traumatic stress symptoms among adolescents after the tsunami in Aceh. J Psychiatr Ment Health Nurs, 18:543-549.
• Axline VM (2019) Oyun Terapisi (1969) (Çeviri Ed. M Baydoğan). Ankara, Panama Yayıncılık.
• Baggerly JN (2015). Play Therapy and Crisis İntervention with Children Experiencing Disasters. In Handbook of Play Therapy (Eds KJ O’connor, CE Schaefer, LD Braverman):455-470. Hoboken, NJ, Wiley.
• Baggerly JN, Exum HA (2007) Counseling children after natural disasters: guidance for family therapists. Am J Fam Ther, 36:79–93.
• Beck AT (1964) Thinking and depression: II. Theory and therapy. Arch Gen Psychiatry, 10:561-571.
• Beck AT (1976) Cognitive Therapy and the Emotional Disorders. New York, Meridian.
• Berkem M, Bildik T (2001) Depremin Marmara Üniversitesi Tıp Fakültesi Çocuk Psikiyatrisi Polikinliğine başvuru profili üzerine etkisi. Anadolu Psikiyatri Derg, 2:29-35.
• Bland SH, O'Leary ES, Farinaro E, Jossa F, Trevisan M (1996) Long-term psychological effects of natural disasters. Psychosom Med, 58:18-24.
• Bratton S, Landreth G (1995) Filial therapy with single parents: effects on parental acceptance, empathy, and stress. International Journal of Play Therapy, 4:61-80.
• Brymer M, Layne C, Jacobs A, Pynoos R, Ruzek J, Steinberg A et al. (2006) Psychological first aid. In Psychological First Aid Field Operations Guide, 2nd ed. Los Angeles, National Child Traumatic Stress Network.
• Buharalı S (2018) Çocukların sosyal uyum ve duygu düzenleme düzeylerinin gelişiminde çocuk merkezli oyun terapisinin etkililiği (Yüksek lisans tezi). İstanbul, Arel Üniversitesi.
• Bustelo M, Arends-Kuenning M, Lucchetti L (2012) Persistent Impact of Natural Disasters on Child Nutrition and Schooling: Evidence from the 1999 Colombian Earthquake. Bonn, Germany, Institute for the Study of Labor.
• Cırcır O, Tagay Ö (2022) Çocuk ve ergenlerde afet sonrası kayıp ve yas. In Eğitim Bilimleri ve Sosyal Bilimlerde Multidisipliner Araştırmalar (Eds F Çalışandemir, H Mertol). Ankara, Vizetek Yayınları.
• Cohen E, Gaddasi R (2018) The function of play for coping and therapy with children exposed to disaster and political violence. Curr Psychiatry Rep, 20:31.
• CSBB (2023) 2023 KahramanmaraşvVe Hatay Depremleri Raporu. Ankara, T. C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı.
• Çetin Dağlı S, Tunalı Çokluk S, Sert A, Yüksel A (2018) Van depremini yaşayan tıp- fakültesi öğrencileri üzerinde depremin uzun dönem etkileri. Van Tıp Dergisi, 25:296-301.
• Danese A, Smith P, Chitsabesan P, Dubicka B (2020) Child and adolescent mental health amidst emergencies and disasters. Br J Psychiatry, 216:159-162.
• Darga H (2023) 6 Şubat Kahramanmaraş depremlerinde çocukların yaşadıkları ve ebeveynlerinde tanık olduğu duygu durumları. Mehmet Akif Ersoy Üniversitesi Eğitim Fakültesi Dergisi, 68:213-248.
• Dawson KS, Joscelyne A, Meijer C, Tampubolon A, Steel Z, Bryant RA (2014) Predictors of chronic posttraumatic response in Muslim children following natural disaster. Psychol Trauma, 6:580-587.
• Doğan H (2022) Türkiye Meteorolojik Afetler Değerlendirmesi 2010-2021. Ankara, T.C. Çevre, Şehircilik ve İklim Değişikliği Bakanlığı Meteoroloji Genel Müdürlüğü.
• Drewes AA (2006) Play-based interventions. J Early Child Infant Psychol, 2:139-156.
• Dripchak V (2007) Posttraumatic play: Towards acceptance and resolution. Clin Soc Work J, 35:125–134.
• Dugan EM, Snow MS, Crowe SR (2010) Working with children affected by Hurricane Katrina: two case studies in play therapy. Child Adolesc Ment Health, 15:52-55.
• EFFIS (European Forest Fire Information System) (2022) Forest Fires in Europe, Middle East and North Africa. Luxembourg, Publications Office of the European Union,
• Ekşi A, Braun KL, Ertem-Vehid H, Peykerli G, Saydam R, Toparlak D et al. (2007) Risk factors for the development of PTSD and depression among child and adolescent victims following a 7.4 magnitude earthquake. Int J Psychiatry Clin Pract, 11:190-199.
• Ergenç İ (2008) Dilin beyindeki gerçekleşimi ve konuşma eylemi. https://acikders.ankara.edu.tr/pluginfile.php/30136/mod_resource/content/1/DBB302%20-%20Dil%20ve%20Beyin%20-%203.%20Hafta%20-%20Dil%20Sistemi.pdf (Accessed 27.05.2023).
• Freud S (1909) Analysis of A Phobia In A Five Year Old Boy. London, Hogart Press.
• Fu Y, Chen Y, Wang J, Tang X, He J, Jiao M et al. (2013) Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake. Child Adolesc Psychiatry Ment Health, 7:1.
• Gaskill R, Perry BD (2012) Child sexual abuse, traumatic experiences, and their impact on the developing brain. In Handbook of Child Sexual Abuse (Ed P Goodyear-Brown):30–47. Hoboken, NJ, Wiley.
• Gil E (2006) Helping Abused and Traumatized Children: Integrating Directive and Nondirective Approaches. New York, Guilford Press.
• Gomez CJ, Yoshikawa H (2017) Earthquake effects: Estimating the relationship between exposure to the 2010 Chilean earthquake and preschool children’s early cognitive and executive function skills. Early Child Res Q, 38:127-136
• Green BL, Korol M, Grace MC, Vary MG, Leonard AC, Gleser GC et al. (1991) Children and disaster: Age, gender, and parental effects on PTSD symptoms. J Am Acad Child Adolesc Psychiatry, 30:945-951.
• Guerney L (2000) Filial therapy into the 21st century. International Journal of Play Therapy, 9:1–17.
• Hall TM, Kaduson HG, Schaefer CE (2002) Fifteen effective play therapy techniques. Prof Psychol Res Pr, 33:515-522.
• Halmatov S (2021) Bilişsel Davranışçı Oyun Terapisi- Teknikler ve Uygulamalar. Ankara, Pegem Akademi.
• Hateli B 2021, The effect of non‐directive play therapy on reduction of anxiety disorders in young children. Couns Psychother Res, 22:1-7.
• Hug-Hellmuth H (1921) On the technique of child analysis. International Journal of Clinical Psychology, 2:287-305.
• Irkıçatal G (2014) Doğal afetlerin ilköğretim 5. sınıf öğrencilerinin yaptıkları resimler üzerine etkileri (Van ili Deprem Örneği) (Uzmanlık tezi). Ankara, Gazi Üniversitesi.
• Iwadare Y, Usami M, Suzuki Y, Ushijima H, Tanaka T, Watanabe K et al. (2014). Posttraumatic symptoms in elementary and junior high school children after the 2011 Japan earthquake and tsunami: symptom severity and recovery vary by age and sex. J Pediatr, 164:917-921.
• İşmen AE (2001) Deprem yaşantısına bağlı travma ve çocuklar üzerindeki etkileri. Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi, 1:80-104.
• Jensen R (2000) Agricultural volatility and investments in children. Am Econ Rev, 90:399-404.
• Jernberg A (1979) Theraplay: A New Treatment Using Structured Play for Problem Children and Their Families. San Francisco, Jossey-Bass.
• Jordan B, Perryman K, Anderson L (2013) A case for child-centered play therapy with natural disaster and catastrophic event survivors. International Journal of Play Therapy, 22:219-230.
• Kaduson H, Schaefer E (2001) 101 More Favorite Play Therapy Techniques. Northvale, NJ, Jason Aronson.
• Kılıç C, Ulusoy M (2003) Psychological effects of the November 1999 earthquake in Turkey: an epidemiological study. Acta Psychiatr Scand, 108:232-238.
• Kim MR (2018) The effect of filial therapy on somatized symptoms, parent-child interaction and parents’ empathy with child survivors of the 2015 Nepal earthquake. Journal of Symbols & Sandplay Therapy, 9:19-43.
• Kiye S, Yalçın İ (2021) Oyun terapisi ve oyun terapisinin gruplarda kullanımı. Buca Eğitim Fakültesi Dergisi, 51:287-303.
• Klein M (1955) The psycho-analytic play technique. In New Directions in Psycho-Analysis (Eds M Klein, P Heimann, R Money-Kyrle):3-22. New York, Basic Books.
• Kottman T (2013) Adleryan oyun terapisi. In Oyun Terapisinin Temelleri, 2. baskı (Ed C Schaefer) (Çeviri Ed. B Totarmış-Özkaya). Ankara, Nobel Akademik.
• Koukourikos K, Tsaloglidou A, Tzeha L, Iliadis C, Frantzana A, Katsimbeli A et al. (2021) An overview of play therapy. Mater Sociomed, 33:293–297.
• Kronenberg ME, Hansel TC, Brennan AM, Osofsky HJ, Osofsky JD, Lawrason B (2010) Children of Katrina: Lessons learned about postdisaster symptoms and recovery patterns. Child Dev, 81:1241-1259.
• La Greca AM, Silverman WK, Lai B, Jaccard J (2010) Hurricane-related exposure experiences and stressors, other life events, and social support: concurrent and prospective impact on children's persistent posttraumatic stress symptoms. J Consult Clin Psychol, 78:794-805.
• La Greca AM, Silverman WK, Vernberg EM, Prinstein MJ (1996) Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study. J Consult Clin Psychol, 64:712-723.
• Landreth G (2012) Play Therapy: The Art of the Relationship, 3rd ed. New York, Routledge.
• Landreth G, Bratton S (1999) Play therapy. Counseling and Human Development, 31:ED430172.
• Lenton PL (2020) The effectiveness of a group Theraplay and sunshine circles intervention on reducing behavioural difficulties resulting from early complex trauma (Master’s thesis). Christchurch, New Zealand, University of Canterbury.
• Lin YW, Bratton SC (2015) A meta‐analytic review of child‐centered play therapy approaches. J Couns Dev, 93:45-58.
• Liu M, Wang L, Shi Z, Zhang Z, Zhang K, Shen J (2011) Mental health problems among children one-year after Sichuan Earthquake in China: A follow-up study. PLoS One, 6:e14706.
• Mahmoudi-Gharaei J, Bina M, Yasami M, Emami A, Naderi F (2006) Group play therapy effect on bam earthquake-related emotional and behavioral symptoms in preschool children: A before-after trial. Iran J Pediatr, 16:137-142.
• Meewisse ML, Olff M, Kleber R, Kitchiner NJ, Gersons BP (2011) The course of mental health disorders after a disaster: Predictors and comorbidity. J Trauma Stress, 24:405-413.
• Moss WJ, Ramakrishnan M, Storms D, Henderson Siegle, A, Weiss WM, Lejnev I, Muhe L (2006) Child health in complex emergencies. Bull World Health Organ, 84:58-64.
• Mulherin MA (2001) The Masterson approach with play therapy: A parallel process between mother and child. Am J Psychother, 55:251-272.
• Mutch C (2013) Sailing through a river of emotions: Capturing children’s earthquake stories. Disaster Prev Manag, 22:445-455.
• Newman CJ (1976) Children of disaster: Clinical observations at Buffalo Creek. Am J Psychiatry, 133:306-312.
• Norton C, Norton B (2002) Reaching Children Through Play Therapy: An Experiential Approach, 2nd ed. Denver, White Apple Press.
• O’Connor K (1983) The Color-Your-Life technique. In Handbook of Play Therapy (Eds CE Schaefer, KJ O’Connor):251-258. New York, Wiley.
• Oaklander V (1982) The relationship of Gestalt therapy ot children. Gestalt Journal, 5:64-74.
• Ogawa Y (2004) Childhood trauma and play therapy intervention for traumatized children. Journal of Professional Counseling: Practice, Theory & Research, 32:19-29.
• Ohnogi AJ (2009) Using play to support children traumatized by natural disasters. In Mass Trauma and Emotional Healing around the World: Rituals and Practices for Resilience and Meaning-Making (Eds A Kalayjian, D Eugene): 2nd ed. New York, NY, Bloomsbury Publishing.
• Özdoğan B (2020) Çocuk ve Oyun: Çocuğa Oyunla Yardım, 7. Baskı. Ankara, Anı Yayıncılık.
• Öztekin GG (2023) Tek ebeveynli çocuklar ve ebeveynleri üzerinde çocuk-ebeveyn ilişki terapisi odaklı psikoeğitim programının etkisi (Doktora tezi). Erzurum, Atatürk Üniversitesi.
• Öztekin GG, Gençdoğan B (2023) A play therapy model focusing on parent training: child-parent relationship therapy. Psikiyatride Güncel Yaklaşımlar, 15:220-229.
• Öztekin GG, Gülbahçe A (2019) 3-10 yaş arasındaki gelişimsel problemleri olan çocuklarda ve ebeveynlerinde filial terapinin etkisinin incelenmesi. Uluslararası Türkçe Edebiyat Kültür Eğitim Dergisi, 8:2322-2340.
• Park CM (2018) A study on the images used in sandplay therapy by children who experienced the Gyeongju earthquake. Journal of Symbols & Sandplay Therapy, 9:27-48.
• Pertiwiwati E, Maulana İ, Zahra F, Yuliana I (2021) Play therapy as a method of trauma healing in PTSD children victims of flood disaster in West Martapura, South Kalimantan. Berkala Kedokteran, 17:125-132.
• Piyasil V, Ketuman P, Plubrukarn R, Jotipanut V, Tanprasert S, Aowjinda S et al. (2007) Post traumatic stress disorder in children after tsunami disaster in Thailand: 2 years follow-up. J Med Assoc Thai, 90:2370-2376.
• Porter ML, Hernandez-Reif M, Jessee P (2009) Play therapy: A review. Early Child Dev Care, 179:1025-1040.
• Razak NH, Johari KSK, Mahmud MI, Zubir NM, Johan S (2018) General review on cognitive behavior play therapy on childrens’ psychology development. International Journal of Academic Research in Progressive Education and Development, 7:134-147.
• Rogers CR (1951) Client-Centered Therapy: Its Current Practice, Implications, and Theory. Boston, MA, Houghton Mifflin
• Rusmana N, Hafina A, Suryana D (2020) Group play therapy for preadolescents: Post-traumatic stress disorder of natural disasters victims in Indonesia. Open Psychol J, 13:213-222.
• Ryan V, Wilson K (2000) Case Studies in Non-directive Play Therapy. London, Jessica Kingsley.
• Salo S, Flykt M, Mäkelä J, Lassenius-Panula L, Korja R, Lindaman S, Punamäki RL (2020) The impact of Theraplay® therapy on parent-child interaction and child psychiatric symptoms: a pilot study. Int J Play, 9:331-352.
• Sarimin DS, Tololiu TA (2017) Effectiveness of cognitive behavior therapy in comparison to CBT-Plus play therapy among with post-traumatic stress disorder in manado, Indonesia. Int J Res Med Sci, 5:1589-1593.
• Schaefer C (1999) The curative factors in play therapy. Journal for the Professional Counselor, 14:7–16.
• Schaefer CE (2013) Oyun Terapisi Temel Kavramlar ve Uygulamalar. In Oyun Terapisinin Temelleri (Ed CE Schaefer) (Çeviri Ed. B Tortamış- Özkaya):3-13: Ankara, Nobel Akademik Yayıncılık.
• Schottelkorb AA, Doumas DM, Garcia R (2012) Treatment for childhood refugee trauma: A randomized, controlled trial. International Journal of Play Therapy, 21:57–73.
• Shelby J (1997) Rubble, disruption, and tears: helping young survivors of natural disaster. In The Playing Cure (Eds HG Kaduson, D Cangelosi, C Scahefer). Northvale, NJ, Jason Aronson.
• Shen YJ (2002) Short-term group play therapy with Chinese earthquake victims: Effects on anxiety, depression, and adjustment. International Journal of Play Therapy, 11:43–63.
• Speier, A. H. (2000). Disaster Relief and Crisis Counseling. Psychosocial Issues for Children and Adolescents in Disasters (Eds D Nordbose), 2nd ed. Rockville, MD, Center for Mental Health Services.
• Şensoy P, Melek İ (2023) Çocuk merkezli oyun terapisinin öfke problemi olan çocuklar üzerindeki etkisi. Aydın Sağlık Dergisi, 9:185-205.
• Tanaka E, Tennichi H, Kameoka S, Kato H (2019) Long-term psychological recovery process and its associated factors among survivors of the Great Hanshin-Awaji Earthquake in Japan: a qualitative study. BMJ Open, 9:e030250.
• Teber M (2015) Çocuk merkezli oyun terapisinin çocuklarda görülen davranış sorunlarının çözümüne etkisi (Yüksek lisans tezi). Gaziantep, Hasan Kalyoncu Üniversitesi.
• Terr LC (1991) Childhood traumas: An outline and overview. Am J Psychiatry, 148:322-334.
• Theraplay Oyun ve Aile Terapileri Derneği (2023) Theraplay nedir? http://www.theraplayturkiye.org/theraplay-nedir/ (Accessed 11.06.2023).
• Triasari L, Yusuf A, Retno S, Triyana PD, Abidin Z (2020) Play therapy to reduce traumatic stress in earthquake-affected children in North Lombok, West Nusa Tenggara. International Journal of Nursing and Health Services, 3:133-140.
• Tsai KY, Chou P, Chou FHC, Su TTP, Lin SC, Lu MK et al. (2007). Three-year follow-up study of the relationship between posttraumatic stress symptoms and quality of life among earthquake survivors in Yu-Chi, Taiwan. J Psychiatr Res, 41:90-96.
• UNICEF (1989) Birleşmiş Milletler Çocuk Haklarına Dair Sözleşme. New York, United Nations.
• Usta G (2023) Dünya’da meydana gelen afetlerin istatistiksel olarak analizi (1900-2022). Gümüşhane Üniversitesi Sosyal Bilimler Dergisi, 14:172-186.
• Van der Kolk B, McFarlane A, Weisaeth L (1996) Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society. New York, Guilford Press.
• VanFleet R, Sniscak CC (2003) Filial therapy for children exposed to traumatic events. In Casebook of Filial Therapy. (Eds R VanFleet, L Guerney):113-138. Boiling Springs, PA, Play Therapy Press.
• Wang Y, Xu J, Lu Y (2020) Associations among trauma exposure, post-traumatic stress disorder, and depression symptoms in adolescent survivors of the 2013 Lushan earthquake. J Affect Disord, 264:407-413.
• Warsini S, West C, Ed GD, Res Meth GC, Mills J, Usher K (2014) The psychosocial impact of natural disasters among adult survivors: An integrative review. Issues Ment Health Nurs, 35:420-436.
• Winnicott DW (1971) Playing and Reality. New York, Routledge.
• WMO (2021) Atlas of Mortality and Economic Losses from Weather, Climate and Water-related Hazards (1970-2019). Geneva, World Meteorological Organization (WMO)
• Yang P, Yen CF, Tang TC, Chen CS, Yang RC, Huang MS et al. (2011) Posttraumatic stress disorder in adolescents after Typhoon Morakot-associated mudslides. J Anxiety Disord, 25:362-368.
• Yule W, Bolton D, Udwin O, Boyle S, O'Ryan D, Nurrish J (2000) The long-term psychological effects of a disaster experienced in adolescence: I: The incidence and course of PTSD. J Child Psychol Psychiatry, 41:503-511.
• Zhang W, Liu H, Jiang X, Wu D, Tian Y (2014) A Longitudinal study of posttraumatic stress disorder symptoms and its relationship with coping skill and locus of control in adolescents after an earthquake in China. PLoS One, 9:e88263.