اثربخشی آموزش بازی درمانی مبتنی بر رابطه درمانی بر مشکلات رفتاری کودکان کم شنوا و تاب آوری مادران آنها (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
هدف از پژوهش حاضر، بررسی اثربخشی آموزش بازی درمانی مبتنی بر رابطه درمانی بر مشکلات رفتاری کودکان کم شنوا و تاب آوری مادران آنها بود. این پژوهش ازنظر هدفْ کاربردی و ازنظر روشْ شبه آزمایشی با طرح پیش آزمون و پس آزمون با گروه کنترل بود. 30 نفر از مادران به روش نمونه گیری دردسترس از مدارس ناشنوای شهر اصفهان انتخاب و به طور تصادفی در یک گروه کنترل و یک گروه آزمایش 15نفری جایگزین شدند. آموزش بازی درمانی مبتنی بر رابطه درمانی در 10 جلسه 90دقیقه ای به گروه آزمایش ارائه شد؛ درحالی که گروه کنترل تا پایان مرحله پس آزمون هیچ آموزشی دریافت نکردند. آزمودنی ها با استفاده از پرسشنامه نقاط قوت و ضعف گودمن (1997) و مقیاس تاب آوری کانر دیویدسون (2003) ارزیابی شدند. داده های به دست آمده با استفاده از روش تحلیل کوواریانس تک متغیری و چندمتغیری با استفاده از نرم افزار SPSS 26 تجزیه وتحلیل شد. یافته ها حاکی از آن بود که آموزش بازی درمانی مبتنی بر رابطه درمانی بر مشکلات رفتاری و برخی از مؤلفه های آن ازجمله علائم عاطفی و رفتارهای مطلوب اجتماعی در کودکان کم شنوا و تاب آوری مادران آنها تأثیر مثبت و معناداری داشت (01/0 > p )؛ بنابراین، می توان نتیجه گرفت که برنامه آموزش بازی درمانی مبتنی بر رابطه درمانی باعث بهبود مشکلات رفتاری کودکان کم شنوا و تاب آوری مادران آنها می شود و می توان از این برنامه در مدارس ویژه کودکان کم شنوا استفاده کرد.Effectiveness of Relationship-based Play-therapy on Behavioral Problems of Children with Hearing Impairment and Their mothers’ Resilience
The purpose of the present study was to investigate the effectiveness of play-therapy which is based on relationship therapy on the behavioral problems of children who suffer from hearing loss and the resilience of their mothers. This research was applied in terms of purpose and quasi-experimental in terms of method. It had a quasi-experimental design with a pre-test, post-test and a control group. Thirty mothers were selected by convenience sampling method from the students with hearing loss in Isfahan. They were randomly assigned to experimental ( n = 15) and control groups ( n = 15). Play-therapy training was provided to the experimental group in 10 sessions of 90 minutes, while the control group did not receive any training until the end of the post-test phase. Participants were assessed using the Goodman Strengths and Difficulties Questionnaire (1997) and the Connor-Davidson Resilience Scale (2003). The obtained data were analyzed by univariate and multivariate analysis of covariance using SPSS 26 software. The findings indicated that play-therapy training had a positive and significant effect on behavioral problems. Some of its components, include emotional symptoms and desirable social behaviors in children who suffer from hearing loss ( p < 0.01). Therefore, it can be concluded that the a play-therapy training program which is based on relationship therapy improves the behavioral problems of children who are suffering from hearing loss and this program can be used in special schools for students with hearing loss.
Introduction
Intra-family relationships affect children's social and emotional development and play an important role in preventing their behavioral problems (Ildiz & Ayhan, 2020). Behavioral problems in children who are suffering from hearing loss are often attributed to poor communication skills, low quality of parent-child relationships, parental behaviors, and lack of family dynamics (Fiorillo et al., 2017). On the other hand, the performance and behavior of parents with their children who are suffering from hearing loss affect children in different ways (Ashori, 2022). As a result, for such parents to obtain sufficient information and skills, they need a special training program (Porter & Edirippulige, 2007). For this reason, play-therapy trainings which are based on relationship therapy can be effective for such parents (Rodríguez et al., 2021).
Play-therapy training which is based on relationship therapy is a type of intervention that is designed based on child-centered game-therapy and through knowledge of the principles of child development (Kim, 2021). This type of play-therapy is comparable to some psychological interventions such as parent-child interaction therapy (Ashori, 2018). In this program, parents gradually learn and use child-centered game-therapy skills (Bratton & Landreth, 2019). The goal of play-therapy based on relationship therapy is for parents to become an available, responsive, and cooperative personalities (Topham & VanFleet, 2011). Therefore, the present paper aimed to investigate the effectiveness of play therapy on the behavioral problems of children who are suffering from hearing loss and the resilience of their mothers.
Method
The present study used quasi-experimental design with pre-test, post-test and control group. The statistical population of the present study included all mothers of children who are suffering from hearing loss aging 7 to 11 in Isfahan. Participants were selected by convenience sampling method from the Shafagh and Alinaghian Deaf Schools in Isfahan. They were randomly assigned to experimental ( n = 15) and control groups ( n = 15). Both groups were assessed using the Goodman Strengths and Difficulties Questionnaire (1997) and the Connor-Davidson Resilience Scale (2003) in the pre-test phase.
Play-therapy based on relationship therapy was provided to the experimental group in ten sessions (each session 90 minutes, and one session per week), while the control group did not receive any training until the end of the post-test phase. After the last session, the experimental and control groups responded to the same questionnaires as the post-test. Data analysis was done using SPSS 26. In fact, univariate and multivariate analyses of covariance were used to explore the change in behavioral problems of children who are suffering from hearing loss and the resilience of their mothers at pre and post-test stages.
Results
Univariate covariance analysis was used to investigate the effect of play-therapy training which is based on relationship therapy on the behavioral problems of children who are suffering from hearing loss, the results are reported in Table 1.
Table 1.
Univariate analysis of covariance of the total score of behavioral problems
Source
SS
df
MS
F
Sig.
Eta 2
Test power
Pre-test
480.38
1
480.38
93.22
0.01
0.77
1.00
Group
71.92
1
71.92
16.41
0.01
0.37
0.97
Error
118.28
27
4.38
Total
11235.00
30
Based on the results of Table 1, play-therapy which is based on relationship therapy had a positive and significant effect on the post-test scores of behavioral problems of children who were suffering from hearing loss. According to the eta coefficient, it is stated that 37% of changes in behavioral problems come from play-therapy training based on relationship therapy. The results of multivariate covariance analysis showed that the intervention had a positive and significant effect on the post-test scores of the subscales of emotional symptoms and desirable social behaviors in children who were suffering from hearing loss ( p < 0.01). Univariate covariance analysis was used to investigate the effect of play-therapy training based on relationship therapy on the resilience of the mothers of children who were suffering from hearing loss, the results of which are reported in Table 2.
Table 2.
Univariate analysis of covariance of resilience scores
Source
SS
df
MS
F
Sig.
Eta 2
Test power
Pre-test
1210.15
1
1210.15
35.68
0.01
0.56
1.00
Group
285.14
1
285.14
8.40
0.01
0.23
0.79
Error
915.71
27
33/91
Total
33000.00
30
Based on the results of Table 2, the intervention had a positive and significant effect on post-test scores of the resilience of mothers ( p < 0.01). According to the eta coefficient, it is stated that 23% of changes in resilience come from play-therapy training which is based on relationship therapy.
Discussion
The results showed that play-therapy training which is based on relationship therapy had a significant effect on improving the behavioral problems in children who are suffering from hearing loss and the resilience of their mothers. In training through play-therapy which was based on relationship therapy, parents are helped to reorganize their beliefs and focus only on the child's competence (Bratton & Landreth, 2019). On the other hand, considering that the family and school environment affect the type of access of children who are suffering from hearing loss (Tapia-Fuselier & Ray, 2019). Therefore, it seems natural that play-therapy method which is based on relationship therapy can affect the behavioral problems of children who are suffering from hearing loss and increase the resilience of their mothers.
Among the limitations of the current study, we can mention the implementation of the study for mothers of children who are suffering from hearing loss and the lack of opportunity for a follow-up test. Therefore, it is better to be cautious in generalizing the results. It is suggested to investigate the effectiveness of play-therapy training which is based on relationship therapy for parents of children who are suffering from hearing loss at different ages and with different hearing levels. It is better to consider the follow-up stage in addition to the pre-test and post-test stages. In addition, it is suggested to investigate the effectiveness of play-therapy training which is based on relationship therapy on the behavioral problems of other children with special needs and the resilience of their parents.
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