Engelli Kardeşinin Gölgesinde Yaşamak: Ebeveynlerin Gözünden Deneyimsel Oyun Terapisi Sürecinin Değerlendirilmesi

Öz

Bu araştırmada, engelli kardeşi olan 4-10 yaş arası çocuklarla gerçekleştirilen deneyimsel oyun terapisinin çocukların değişim ve gelişim sürecine yansımalarının ebeveynlerin algısına dayalı ortaya konulmasını amaçlamıştır. Ebeveynlerin görüşlerini derinlemesine incelemeye yönelik olarak fenomenolojik desenin kullanıldığı araştırma kapsamında, Down Sendromu, Otizim Spektrum Bozukluğu ve/veya Gelişimsel Geriliği bulunan engelli kardeşe sahip 6 çocukla, 8 ile 24 oturum arasında değişen deneyimsel oyun terapi süreci gerçekleştirilmiştir. Araştırma verileri oyun terapisi sürecinin sonunda her bir çocuğun ebeveyni ile yapılan bireysel görüşmelere dayalıdır. Verilerin analizinde tümevarım analizinden yararlanılmıştır. Araştırma sonuçlarına göre çocuğun oyun terapisine getirilme gerekçesi, çocuğun yaşadığı değişim ve gelişim, oyun terapi sürecini kolaylaştıran durumlar, oyun terapi sürecini zorlaştıran durumlar olmak üzere dört ana temaya ve bu temalara bağlı 15 alt temaya ulaşılmıştır. Sonuçlar çocuğun oyun terapisine getirilme gerekçesi kapsamında ebeveynlerin çocuğun engelli kardeşiyle ilişkilerini düzenleme, davranış problemlerinin üstesinden gelme, akran ilişkilerini düzenleme, duygusal rahatlamayı destekleme ve çocuk için bir meşguliyet oluşturma beklentilerinde olduğunu göstermiştir. Bulgular çocuğun yaşadığı değişim ve gelişim bağlamında aile içi ilişkiler ile akran ilişkilerinin güçlendiğini ve oyun terapi sürecinin çocuğun davranış problemlerinin üstesinden gelmesini desteklediğini ortaya koymuştur. Son olarak araştırma bulguları aile içinde yeterli sosyal desteğin, oyun terapisi sürecinin sistematikliğinin ve birtakım bağlamsal faktörlerin oyun terapi sürecini kolaylaştırdığını ortaya koyarken, yetersiz sosyal desteğin, aile içi bazı faktörlerin, oyun terapi sürecinin yetersiz yapılandırılmasının ve bazı bağlamsal faktörlerin ise oyun terapi sürecini zorlaştırdığı göstermiştir. Araştırma sonuçları deneyimsel oyun terapisinin engelli kardeşi olan çocukların değişimini ve gelişimini desteklediğini, bu olumlu etkinin engelli kardeşle, diğer aile üyeleriyle ve sosyal çevreyle ilişkilere yansımalarının olduğunu göstermiştir.

Anahtar Kelimeler

• Engelli kardeşi olan çocuk
• deneyimsel oyun terapisi
• oyun terapisi
• fenomenolojik desen

Living in the Shadow of a Sibling with Disabilities: Experiential Play Therapy from the Perspective of Parents

Öz

Based on the perceptions of parents, this study aimed to investigate the impact of experiential play therapy on the growth and development of children aged 4-10 years who have siblings with disabilities. A phenomenological design was used to examine parents' views in depth, following the completion of an experiential play therapy process ranging from 8 to 24 sessions carried out with 6 children with siblings with Down Syndrome, Autism Spectrum Disorder, and/or Developmental Disability. Individual interviews were conducted with the parents at the end of the play therapy process, which were analyzed using inductive analysis. The results revealed 15 sub-themes grouped under four main themes, which are the reason for bringing the child to play therapy, the change and development experienced by the child, factors helping the facilitation of the play therapy process, and hindrances to the play therapy process. The reasons for bringing the child to play therapy included parents’ expectations of regulating the child's relations with the sibling with the disability, addressing behavioral problems, improving peer relations, providing emotional support, and keeping the child occupied. In the context of the change and development experienced by the child, family relationships and peer relationships were strengthened and the play therapy process supported the child to overcome behavioral problems. Finally, the findings of the study showed that there are certain factors that facilitate or complicate the play therapy process. While adequate social support within the family, the systematicity of the play therapy process, and some contextual factors facilitated the process, inadequate social support, some factors within the family, inadequate structuring of the play therapy process, and some contextual factors made the process difficult. The results showed that experiential play therapy supported the change and development of children with siblings with disabilities and that this positive effect was reflected in the relationships with the sibling with disabilities, other family members, and the social environment.

Anahtar Kelimeler

• Siblings of children with disabilities
• experiential play therapy
• play therapy
• phenomenological design

Kaynakça

1. Akdoğan, R. (2016). A holistic approach to cope with depression and hopelessness for parents of special needs children. International Journal of Early Childhood Special Education, 8(2), 134-150. https://doi.org/10.20489/intjecse.284594
2. Association for Play Therapy (2023, October 28). Association overview. https://www.a4pt.org/page/AboutAPT
3. Axline, V. M. (1947). Play therapy; the inner dynamics of childhood. Houghton Mifflin.
4. Axline, V. (1974). Play therapy. Ballantine Books.
5. Baş, T. ve Akturan, U. (2008). Nitel araştırma yöntemleri: Nvivo 7.0 ile nitel veri analizi. Seçkin Yayıncılık.
6. Bekeç, M. (2018). Deneyimsel oyun terapisinin dikkat eksikliği ve hiperaktivite bozukluğu tanısı olan 6-11 yaş arasındaki çocukların duygu ve davranışları üzerindeki etkisinin incelenmesi. [Yayımlanmamış yüksek lisans tezi, Üsküdar Üniversitesi]. YÖK Ulusal Tez Merkezi. https://tez.yok.gov.tr/UlusalTezMerkezi/ adresinden 03.08.2020 tarihinde erişilmiştir.
7. Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, 36, 376–390. https://doi.org/doi:10.1037/0735-7028.36.4.376
8. Çelik, M. (2017). Deneyimsel oyun terapisinin çocuk evlerinde kalmakta olan 3-10 yaş grubu çocukların çocukluk çağı travma sonrası duygusal stres düzeyine etkisinin incelenmesi. [Yayımlanmamış yüksek lisans tezi, Üsküdar Üniversitesi]. YÖK Ulusal Tez Merkezi. https://tez.yok.gov.tr/UlusalTezMerkezi/ adresinden 14.08.2020 tarihinde erişilmiştir. Çimşir, E., & Akdoğan, R. (2021). Childhood Emotional Incest Scale (CEIS): Development, validation, cross-validation, and reliability. Journal of Counseling Psychology, 68(1), 98–111. https://doi.org/10.1037/cou0000439

9. Creswell, J. W. (2012). Qualitative inquiry & research design: Choosing among five approaches. SAGE Publications.
10. Darling, C. A., Senatore, N., & Strachan, J. (2012). Fathers of children with disabilities: Stress and life satisfaction. Stress and Health, 28(4), 269-278. https://doi.org/10.1002/smi.1427
11. Emerson, E., & Giallo, R. (2014). The well-being of siblings of children with disabilities. Research in Developmental Disabilities, 35(9), 2085-2092. https://doi.org/10.1016/j.ridd.2014.05.001
12. Findler, L., Jacoby, A. K., & Gabis, L. (2016). Subjective happiness among mothers of children with disabilities: The role of stress, attachment, guilt, and social support. Research in Developmental Disabilities, 55, 44–54. https://doi.org/10.1016/j.ridd.2016.03.006.
13. Gau, S. S. F., Chou, M. C., Chiang, H. L., Lee, J. C., Wong, C. C., Chou, W. J. & Wu, Y. Y. (2012). Parental adjustment, marital relationship, and family function in families of children with autism. Research in Autism Spectrum Disorders, 6(1), 263-270. https://doi.org/10.1016/j.rasd.2011.05.007
14. Granat, T., Nordgren, I., Rein, G., & Sonnander, K. (2012). Group intervention for siblings of children with disabilities: A pilot study in a clinical setting. Disability and Rehabilitation, 34(1), 69-75. https://doi.org/10.3109/09638288.2011.587087
15. Gray, D. E. (2002). ‘Everybody just freezes. Everybody is just embarrassed’: Felt and enacted stigma among parents of children with high-functioning autism. Sociology of Health & Illness, 24(6), 734-749. https://doi.org/10.1111/1467-9566.00316
16. Harris, H. (2008). Meeting the needs of disabled children and their families: Some messages from the literature. Child Care in Practice, 14(4), 355-369. https://doi.org/10.1080/13575270802267796
17. Hartley, S. L., Barker, E. T., Seltzer, M. M., Floyd, F., Greenberg, J., Orsmond, G. & Bolt, D. (2010). The relative risk and timing of divorce in families of children with an autism spectrum disorder. Journal of Family Psychology, 24(4), 449-457. https://doi.org/10.1037/a0019847
18. Hoffman, C. D., Sweeney, D. P., Hodge, D., Lopez-Wagner, M. C. & Looney, L. (2009). Parenting stress and closeness: Mothers of typically developing children and mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 24(3), 178-187. https://doi.org/10.1177/1088357609338715
19. Hsiao, Y. J. (2018). Parental stress in families of children with disabilities. Intervention in School and Clinic, 53(4), 201-205. https://doi.org/10.1177/1053451217712956
20. Jensen, S. A., Biesen, J. N., & Graham, E. R. (2017). A meta-analytic review of play therapy with emphasis on outcome measures. Professional Psychology: Research and Practice, 48(5), 390–400. https://doi.org/10.1037/pro0000148
21. Kao, B., Romero‐Bosch, L., Plante, W., & Lobato, D. (2012). The experiences of Latino siblings of children with developmental disabilities. Child: Care, Health and Development, 38(4), 545-552. https://doi.org/10.1111/j.1365-2214.2011.01266.x
22. Knell, S. M. (2009). Cognitive behavioral play therapy: Theory and applications. In A. A. Drewes (Ed.), Blending play therapy with cognitive behavioral therapy: Evidence-based and other effective treatments and techniques (pp. 117–133). John Wiley & Sons, Inc.
23. Kottman, T., & Meany-Walen, K. (2016). Partners in play: An Adlerian approach to play therapy. John Wiley & Sons.
24. Kruse, J. D., & Arendt, J. (2019). Control, corruption, and destruction, Oh My! The role of villains in experiential play therapy. In Using Superheroes and Villains in Counseling and Play Therapy (pp. 48-73). Routledge.
25. Küçük, E. E. & Alemdar, D. K. (2017). Life satisfaction and psychological status of mothers with disabled children: A descriptive study. Community Mental Health Journal, 1-5. https://doi.org/10.1007/s10597-017-0135-6.
26. Lamorey, S. (1999). Parentification of siblings of children with disability or chronic disease. burdened children: Theory, research, and treatment of parentification. Sage Publications, 75-91.
27. Levante, A., Martis, C., Del Prete, C. M., Martino, P., Pascali, F., Primiceri, P., ... & Lecciso, F. (2023). Parentification, distress, and relationship with parents as factors shaping the relationship between adult siblings and their brother/sister with disabilities. Frontiers in Psychiatry, 13, 1-9. https://doi.org/10.3389/fpsyt.2022.1079608
28. Levine, S. K. (2009). Trauma, tragedy, therapy: The arts and human suffering. Jessica Kingsley Publishers.
29. Lobato, D. J. (1995). Brothers, sisters, and special needs: information and activities for helping young children with chronic illnesses and developmental disabilities. PH Brookes.
30. McKenzie Smith, M., Pinto Pereira, S., Chan, L., Rose, C., & Shafran, R. (2018). Impact of well-being interventions for siblings of children and young people with a chronic physical or mental health condition: A systematic review and meta-analysis. Clinical child and family psychology review, 21, 246-265. https://doi.org/10.1007/s10567-018-0253-x
31. Meany‐Walen, K. K., Bratton, S. C., & Kottman, T. (2014). Effects of Adlerian play therapy on reducing students' disruptive behaviors. Journal of Counseling & Development, 92(1), 47-56. https://doi.org/10.1002/j.1556-6676.2014.00129.x
32. Mental Health America (2023, Nisan 12). Children's mental health. https://www.mhanational.org/issues/childrens-mental-health
33. Meyer, D.J. & Vadasy, P.F. (2003). Sibshops: Workshops for siblings of children with special needs (5th ed.). Paul H. Brookes.
34. Montes, G. & Halterman, J. S. (2007). Psychological functioning and coping among mothers of children with autism: A population-based study. Pediatrics, 119(5), e1040-e1046. doi:10.1542/peds.2006-2819.
35. Moyson, T., & Roeyers, H. (2011). The quality of life of siblings of children with autism spectrum disorder. Exceptional Children, 78(1), 41-55.
36. Norton, B., Ferriegel, M., & Norton, C. (2011). Somatic expressions of trauma in experiential play therapy. International Journal of Play Therapy, 20(3), 138–152. https://doi.org/10.1037/a0024349 .
37. Norton, C. C., & Norton, B. E. (2002). Reaching children through play therapy: An experiential approach. White Apple Books.
38. Norton, C. C., & Norton, B. E. (2006). Experiential play therapy. In C. E. Schaefer & H. G. Kaduson (Eds.), Contemporary play therapy: Theory, research, and practice (pp. 28–54). Guilford Press.
39. Patton, M. Q. (2014). Qualitative research & evaluation methods: Integrating theory and practice. Sage publications.
40. Ray, D. (2011). Advanced play therapy: Essential conditions, knowledge, and skills for child practice. Taylor & Francis.
41. Resch, J. A., Mireles, G., Benz, M. R., Grenwelge, C., Peterson, R., & Zhang, D. (2010). Giving parents a voice: A qualitative study of the challenges experienced by parents of children with disabilities. Rehabilitation Psychology, 55(2), 139–150. https://doi.org/10.1037/a0019473
42. Roper, S. O., Allred, D. W., Mandleco, B., Freeborn, D., & Dyches, T. (2014). Caregiver burden and sibling relationships in families raising children with disabilities and typically developing children. Families, Systems, & Health, 32(2), 241–246. https://doi.org/10.1037/fsh0000047
43. Scherer, N., Verhey, I., & Kuper, H. (2019). Depression and anxiety in parents of children with intellectual and developmental disabilities: A systematic review and meta-analysis. PloS one, 14(7), e0219888.
44. Schippers, A., & Van Boheemen, M. (2009). Family quality of life empowered by family‐oriented support. Journal of Policy and Practice in Intellectual Disabilities, 6(1), 19-24. https://doi.org/10.1111/j.1741-1130.2008.00195.x
45. Shivers, C. M., Jackson, J. B., & McGregor, C. M. (2019). Functioning among typically developing siblings of individuals with autism spectrum disorder: A meta-analysis. Clinical Child and Family Psychology Review, 22, 172-196. https://doi.org/10.1007/s10567-018-0269-2
46. Staunton, E., Kehoe, C., & Sharkey, L. (2023). Families under pressure: Stress and quality of life in parents of children with an intellectual disability. Irish Journal of Psychological Medicine, 40(2), 192-199. https://doi.org/10.1017/ipm.2020.4
47. Tashakkori, A. & Teddlie, C. (2010). Sage handbook of mixed methods in social & Behavioral research (2nd Ed.). Sage.
48. Tomeny, T. S., Barry, T. D., Fair, E. C., & Riley, R. (2017). Parentification of adult siblings of individuals with autism spectrum disorder. Journal of Child and Family Studies, 26, 1056-1067. https://doi.org/10.1007/s10826-016-0627-y
49. Tümlü, C. (2019). Özel gereksinimli çocuğa sahip ailelerle psikolojik danışma. Nilüfer, Ş. Özabacı (Ed.) içinde, aileye ve eğitime ilişkin sorunlar ve çözümler (s.116-154). Pegem Akademi Yayınları.
50. Tümlü, C., & Akdoğan, R. (2019a). Looking at life through a different window: group counselling for the mothers of disabled children. International Journal for the Advancement of Counselling, 41(2), 252-271.
51. Tümlü, C., & Akdoğan, R. (2019b). Otizmli çocuk ebeveynlerinde evlilik doyumunun dinamikleri: Bir karma çalışma. Anadolu Journal of Educational Sciences International, 9(1), 129-162.
52. Tümlü, C., & Eraslan Çapan, B. (2018). Engelli çocuğa sahip ebeveynlerin duygusal sağırlık ve psikolojik iyi oluş düzeylerinin incelenmesi. Kalem Eğitim ve İnsan Bilimleri Dergisi, 8(2), 493-518.
53. Ülker Tümlü, G., Akdoğan, R., & Türküm, A. S. (2017). The process of group counseling based on reality therapy applied to the parents of children with disabilities. International Journal of Early Childhood Special Education, 9(2), 81-98. https://doi.org/10.20489/intjecse.368465
54. Ülker Tümlü, G. & Akdoğan, R. (2022). Persistence in the face of ecological challenges: a phenomenological study of parents of children with disabilities in Turkey. International Journal for the Advancement of Counselling, 44, 17-38. https://doi.org/10.1007/s10447-021-09453-x
55. Watson, L. R. (2021). A feasibility controlled trial of an eight-session group intervention for typically developing siblings of children who have an ASD (Doctoral dissertation, University of Surrey).
56. Woodgate, R. L., Ateah, C. & Secco, L. (2008). Living in a world of our own: The experience of parents who have a child with autism. Qualitative Health Research, 18(8), 1075-1083. https://doi.org/10.1177/1049732308320112
57. Woolf, C., Muscara, F., Anderson, V. A., & McCarty, M. C. (2016). Early traumatic stress responses in parents following a serious illness in their child: A systematic review. Journal of Clinical Psychology in Medical Setting, 23(1), 53–66. https://doi.org/10.1007/s10880-015-9430-y.
58. Zucker, A., Chang, Y., Maharaj, R., Wang, W., Fiani, T., McHugh, S., ... & Jones, E. A. (2022). Quality of the sibling relationship when one sibling has autism spectrum disorder: A randomized controlled trial of a sibling support group. Autism, 26(5), 1137-1152. https://doi.org/10.1177/1362361321104213