The Effect of Play Therapy on Anxiety and Life Skills in Children: A Meta-Analysis Study

Öz

Objective: This study was conducted to determine the effect of play therapy on anxiety and life skills in children. Material-method: The scans in the study were provided through the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Scıence, Science Direct, and YÖK Thesis Center databases from June-September 2023. As a result of the searches, 17 studies on anxiety and 5 studies on life skills were included. Results: In this meta-analysis, it was determined that play therapy was highly effective on anxiety (SMD: 1.339, 95% CI: -1.745- 0.934; Z= 6.468, p = 0.000, I2= 75.22%) and life skills (SMD: 3.049, 95% CI: 1.614- 4.484; Z= 4.165, p = 0.000, I2= 88.81%). The studies showed a heterogeneous distribution, and there was no bias in the publication bias analysis. Conclusion: Play therapy has very positive effects on anxiety and life skills in children and positively affects the mental health of individuals.

Anahtar Kelimeler

• play therapy
• child
• anxiety
• life skills
• meta-analysis

Oyun Terapisinin Çocuklarda Kaygı ve Yaşam Becerileri Üzerine Etkisi: Bir Meta Analiz Çalışması

Öz

Amaç: Bu çalışma, çocuklarda uygulanan oyun terapisinin kaygı ve yaşam becerileri üzerine etkisini ortaya koymak amacı ile yapılmıştır. Materyal-metod: Çalışmadaki taramalar Ekim-Aralık 2023’de Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Scıence, Science Direct ve YÖK Tez Merkezi veri tabanları üzerinden sağlanmıştır. Taramalar sonucunda araştırmaya kaygı ile ilgili 17 yaşam becerileri ile ilgili 5 çalışma dâhil edilmiştir. Bulgular: Bu meta-analizde oyun terapisinin kaygı üzerinde (SMD: 1.339, %95 CI: -1.745- 0.934; Z= 6.468, p = 0.000, I2= %75.22) ve yaşam becerileri (SMD: 3.049, %95 CI: 1.614- 4.484; Z= 4.165, p = 0.000, I2= %88,81) üzerinde yüksek düzeyde etkin olduğu belirlenmiştir. Araştırmaların heterojen bir dağılım gösterdiği ve yapılan yayım yanlılığı analizlerinde yanlılığın olmadığı görülmüştür. Sonuç: Oyun terapisi çocuklarda kaygı ve yaşam becerileri üzerinde oldukça olumlu etkiler yaratmakta ve bireylerin ruh sağlığını olumlu yönde etkilemektedir.

Anahtar Kelimeler

• oyun terapisi
• çocuk
• kaygı
• yaşam becerileri
• meta-analiz

Kaynakça

1. Akdenizli, C. (2016). The effect of creative drama on the social life skills and receptive language development of individuals with mental disabilities. (Master's thesis). Izmir, Dokuz Eylül University.
2. Akhmetzhan, S., Aubakirova, R.Z., Kostyunina, A.A., Mishchenko, M.V. & Shevchenko, N.B. (2020). Development of social intelligence in preschool children by art therapy: A case study of Oyna Educational Centre. International Journal of Learning, Teaching and Educational Research,19(5):276–288. doi: 10.26803/ijlter.19.5.17.
3. Altok, M. (2022). The effect of creative drama-based life skills training program on the life skills levels of 5-6-year-old children. (Master's thesis) Antalya, Akdeniz University.
4. Anderoğlu, S. (2021). The effect of therapeutic play applied during peripheral intravenous catheterization on children's pain and anxiety levels and parents' anxiety levels. (Master's thesis). Istanbul, Haliç University.
5. Ataseven, H. (2019). Examination of the effect of the language development supportive play activities program on the language development and daily life skills of 5-6-year-old refugee children. (Master's thesis). Konya, Selcuk University.
6. Ayan, G. & Şahin, Ö.Ö. (2023). Effect of therapeutic play-based training program on pre- and post-operative anxiety and fear: A study on circumcision surgery in Turkish Muslim children, Journal of Pediatric Urology. 19, 431, https://doi.org/10.1016/j.jpurol.2023.04.032.
7. Begg, C.B. & Mazumdar, M. (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50,1088-1101.
8. Bilir, Z.T. (2019). The effect of the life skills program on the life skills, self-perceptions, and social-emotional adjustment levels of five-year-old children. (Doctoral dissertation). Ankara, Hacettepe University.

9. Bozdağ, F. & Gözen, D. (2023). The effect of medical clown intervention applied to children on anxiety in the preoperative period: A systematic review. Ordu University Journal of Nursing Studies, 6(3), 759-769. DOI:10.38108/ouhcd.1143032.
10. Bratton, S. & Ray, D. (2000). What the research shows about play therapy. International Journal of Play Therapy, 9(1), 47-88.
11. Can, F.G. (2020). The effect of therapeutic play applied before intrathecal chemotherapy on fear, anxiety, and pain in children. (Doctoral dissertation). Erzurum, Atatürk University.
12. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New Jersey: Lawrence Erlbaum Associates, Inc. Retrieved from http://books.google.com.tr/
13. Coşkuntürk, A.E. (2015). The effect of interactive therapeutic play education program on the anxiety level of children who will have heart surgery and their mothers. (Master's thesis). Istanbul, Haliç University.
14. Çal, R. (2017). A systematic review on the effectiveness of school-based interventions on mental health symptoms of children or adolescents after war or natural disaster. Talim: Journal Of Education In Muslim Societıes And Communities
15. Çelik, B. (2021). The effect of preoperative therapeutic play on the level of anxiety and fear in play-age children. (Master's thesis). Karaman, Karamanoğlu Mehmetbey University.
16. Demirer, E. (2021). Examination of the effect of child-centered play therapy on the level of anxiety in children. (Master's thesis). Istanbul, Istanbul Commerce University.
17. Deniz, E.A. (2019). Investigation of the effect of child-centered play therapy on the development of social skills in children with autism. (Master's thesis). Konya, Necmettin Erbakan University.
18. Egger, M., Smith, G.D., Schneider, M. & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. Bmj. 315(7109), 629-634.
19. Grissom, R.J. & Kim, J.J. (2012). Effect sizes for research: a broad practical approach, 2nd Edition. Mahwah, NJ: Lawrence Erlbaum Associates.
20. İşler, Z. (2022). The effect of education given with therapeutic play on anxiety before peripheral vascular access to pediatric surgical patients. (Master's thesis) Zonguldak, Bülent Ecevit University.
21. Kaya, E. (2005). Comparison of the effectiveness of play therapy in mentally handicapped children. (Master's thesis). Ankara, Hacettepe University.
22. Kırkan, Ç. (2022). The effect of therapeutic play applied using toy nebulizer and toy mask on the child's fear and anxiety level. (Master's thesis). Izmir, Ege University.
23. Knell, S.M. (1993). Cognitive-behavioral play therapy. Northvale, NJ: Jason Aronson.
24. Li, W.H.C., Chung, J.O.K., Ho, K.Y.& Kwok, B.M.C. (2016). Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatrics, 16:36, DOI 10.1186/s12887-016-0570-
25. Lin, Y. & Bratton, S.C. (2015). A meta-analytic review of child- centered play therapy approaches. Journal of Counseling and Development, 93(1), 45-58. doi: 10.1002/j.1556-6676.2015.00180.x
26. Metlek, S. (2021). The effect of therapeutic play on children's pain and anxiety levels and parents' anxiety levels before and after circumcision. (Master's thesis). Haliç University.
27. Moher, D. Liberati, A., Tetzlaff, J. & Altman, D.G. (2009). PRISMA Group, 2009. Reprint—preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA statement. PhysicalTherapy, 89, 873-880.
28. Orhan, E. (2014). The effect of the training given with therapeutic play on the level of anxiety while opening peripheral vascular access to pediatric oncology patients. (Master's Thesis). Istanbul, Istanbul University.
29. Sefer, S.R. & Akfırat, O.N. (2009). The use of creative drama method in the acquisition of life skills. Journal of Creative Drama, 4(8).
30. Semerci, D. (2022). Investigation of the effect of child-centered play therapy on behavioral problems and social skill levels of 48-72 month old children. (Doctoral dissertation). Istanbul, Marmara University.
31. Silva, S.G.T., Santos, M.A., Floriano, C.M.F., Damião, E.B.C., Campos, F.V. & Rossato, L.M. (2017). Influence of Therapeutic Play on the Anxiety of Hospitalized School-Age Children: Clinical Trial. Rev Bras Enferm,70(6):1244-9. DOI: http://dx.doi.org/10.1590/0034-7167-2016-0353.
32. Slade, M.K. & Warne, R.T. (2016). A Meta-Analysis of The Effectiveness of TraumaFocused Cognitive-Behavioral Therapy And Play Therapy For Child Victims of Abuse. Journal of Young Investigators, 30(6), 36-43.
33. Soniya, S. & Solomon, R. (2019). Effectiveness of play therapy on anxiety among hospitalized preschool children. Asian Journal of Nursing Education and Research, 9(2):193-196, doi:10.5958/2349-2996.2019.00040.5
34. Şimşek, N. (2021). The effect of therapeutic play on the child's compliance with the treatment and the anxiety of the parent in 1-3 year old children undergoing inhalation therapy. (Master's thesis). Ankara, Gazi University.
35. Taşkın, B.D. (2018). The effect of therapeutic play method on anxiety and fear in children hospitalized in pediatric service before peripheral vascular access procedure. (Master's thesis). Edirne, Trakya University.
36. Teber, M. (2015).The effect of child-centered play therapy on the solution of behavioral problems in children. (Master's thesis). Istanbul, Hasan Kalyoncu University.
37. The Joanna Briggs Institute Critical Appraisal Tools Foruse in IBI Systematic Reviews. http://joannabriggs.org/research/critical-appraisal-tools.html(25.11.2024).
38. Tufanaru, C., Munn, Z., Aromataris, E., Campbell, J. & Hopp, L. (2017). Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual. The Joanna Briggs Institute.
39. Tuncay, S. (2021). The effect of therapeutic play and animation intervention on the fear, anxiety and pain of circumcised children and the anxiety of parents. (Doctoral dissertation). Erzurum, Atatürk University.
40. Tural, E. (2012). Examination of the effect of education and therapeutic play methods given to children in the preoperative period on the anxiety, fear and pain levels of the child. (Doctoral dissertation). Izmir, Ege University.
41. Tutar, N. (2022). Investigation of life skills of 48-60 month old children attending Waldorf, montessori and Meb preschool education programs. (Master's thesis). Ankara, Gazi University.
42. Türe, E. & Barut, Y. (2020). Examination of play therapy studies conducted in Turkey. Journal of Life Skills Psychology. 4(8)127-138. DOI: 10.31461/ybpd.837024.
43. Ucun, Y. & Küçük, L. (2020). The effect of therapeutic clown intervention on children's mental health: A systematic review. Jaren, 6(3):598-609.
44. Uzunpınar, S. (2023). Development of life skills of adolescents through creative drama: example of communication skills. (Master's thesis). Ankara, Başkent University.
45. Vural, S.T. & Sağlam, M. (2022). Game therapy studies: A review and meta-analysis sample. Participatory Educational Research (PER), 9(4), pp. 19-32, July2022.
46. Yıldız, F.Ü. (2018). Examination of the effects of Montessori mother support education program on mathematics and daily life skills of 4-5 year old children receiving Montessori education. (Doctoral dissertation). Konya, Selcuk University.
47. Yılmaz, Ö. (2018). Evaluation of the effect of play therapy on separation anxiety in preschool children. (Master's thesis). Zonguldak, Bülent Ecevit University.
48. Yılmaz, T. (2021). Examination of daily life skills and prosocial tendencies of secondary school students. (Master's thesis). Ankara, Ankara Yıldırım Beyazıt University.
49. Zengin, M., Yayan, E.H., Düken, M.E. (2021). The Effects of a therapeutic play/play therapy program on the fear and anxiety levels of hospitalized children after liver transplantation. Journal Of Perianesthesia Nursing, 36(1),81-85.