Sandplay therapy in the treatment of children with Oppositional Defiant Disorder and Conduct Disorder

CHALFON, Mariana Simão Taliba; RAMOS, Denise Gimenez

doi:10.1590/1982-0275202239e200223

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CLINICAL PSYCHOLOGY AND PSYCHOTHERAPIES • Estud. psicol. 39 • 2022 • https://doi.org/10.1590/1982-0275202239e200223 copy

Sandplay therapy in the treatment of children with Oppositional Defiant Disorder and Conduct Disorder

A terapia de sandplay no tratamento de crianças com Transtorno Opositivo-Desafiador e Transtorno de Conduta

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The study aimed at assessing the effectiveness of sandplay therapy in the treatment of children with symptoms of oppositional defiant disorder and/or conduct disorder. The intervention consisted of twelve weekly sessions of sandplay therapy. The Child Behavior Checklist 6-18 was used to assess symptoms before and after the intervention. Participants were 41 children of both sexes, randomly divided into two groups. The control group remained on hold while experimental group 1 underwent the intervention. After three months, control group participants who still met the inclusion criteria were placed in experimental group 2. Results were analyzed statistically, in order to compare the control group and experimental group 1, as well as to assess the evolution of the total experimental group, which included experimental groups 1 and 2. Results pointed to the effectiveness of sandplay therapy in reducing symptoms of oppositional defiant disorder and conduct disorder.

Keywords
Child psychotherapy; Conduct disorder; Oppositional defiant disorder; Sandplay

CBCL/6-18	T0					T1
	EG (n = 21)		CG (n = 20)		p	EG (n = 21)		CG (n = 20)		p	r
	M	(SD)	M	(SD)	p	M	(SD)	M	(SD)	p	r
IP	19.38	(8.23)	21.20	(7.54)	0.620^* * Mann-Whitney test;	9.94	(5.21)	18.89	(7.38)	< 0.001^* * Mann-Whitney test;	0.54
EP	26.43	(4.60)	24.60	(6.34)	0.295^ t test.	12.28	(7.87)	23.84	(4.78)	< 0.001^* * Mann-Whitney test;	0.70
TP	77.14	(20.36)	75.15	(23.06)	0.771^ t test.	41.22	(15.04)	65.42	(20.89)	< 0.001^* * Mann-Whitney test;	0.56
A/D (SSS)	11.81	(5.01)	12.55	(4.41)	0.539^* * Mann-Whitney test;	5.83	(2.97)	11.84	(4.50)	< 0.001^* * Mann-Whitney test;	0.60
D/W (SSS)	3.62	(2.22)	3.60	(2.74)	0.981^ t test.	2.39	(2.09)	3.37	(2.65)	0.219^ t test.
SC (SSS)	3.95	(3.01)	5.05	(4.36)	0.352^ t test.	1.72	(1.99)	3.68	(3.50)	0.044^ t test.	0.37
SP(SSS)	7.43	(3.89)	7.15	(4.26)	0.664^* * Mann-Whitney test;	3.33	(1.78)	5.95	(3.63)	0.009^ t test.	0.42
TP (SSS)	6.19	(4.14)	5.95	(4.42)	0.858^ t test.	3.28	(2.56)	4.11	(3.68)	0.707^* * Mann-Whitney test;
AP (SSS)	9.90	(4.36)	8.10	(5.07)	0.272^* * Mann-Whitney test;	6.72	(2.54)	6.11	(4.05)	0.707^* * Mann-Whitney test;
RBB (SSS)	5.14	(2.29)	4.55	(2.84)	0.467^ t test.	2.56	(2.43)	4.89	(2.00)	0.001^* * Mann-Whitney test;	0.51
AB (SSS)	21.29	(3.33)	20.05	(4.11)	0.299^ t test.	9.72	(5.87)	18.95	(3.55)	< 0.001^* * Mann-Whitney test;	0.69
DP DSM)	5.67	(3.29)	6.80	(4.05)	0.373^* * Mann-Whitney test;	3.61	(2.43)	5.53	(3.57)	0.064^ t test.
AO (DSM)	8.29	(2.85)	8.25	(3.31)	0.948^* * Mann-Whitney test;	4.17	(2.75)	7.89	(3.40)	0.001^* * Mann-Whitney test;	0.51
SO (DSM)	2.67	(2.31)	2.75	(2.90)	0.920^ t test.	1.22	(1.80)	2.05	(2.09)	0.199^* * Mann-Whitney test;
AD (DSM)	8.90	(3.63)	7.65	(3.84)	0.244^* * Mann-Whitney test;	5.72	(3.48)	6.00	(3.20)	0.822^* * Mann-Whitney test;
ODP (DSM)	8.14	(1.62)	8.40	(0.94)	0.541^ t test.	3.83	(1.82)	8.26	(1.40)	< 0.001^* * Mann-Whitney test;	0.75
CP (DSM)	8.29	(3.62)	6.90	(3.82)	0.195^* * Mann-Whitney test;	4.00	(4.97)	7.00	(3.42)	0.042^ t test.	0.36

CBCL/6-18	T0’		T1’		T2’
CBCL/6-18	M	(SD)	M	(SD)	M	(SD)
IP	20.06	(7.14)	10.06	(5.00)	12.00	(5.43)
EP	25.03	(4.17)	9.16	(4.35)	11.25	(5.08)
TP	72.25	(20.08)	35.00	(12.95)	39.34	(14.96)
A/D (SSS)	12.22	(4.35)	6.22	(3.10)	6.75	(3.22)
D/W (SSS)	3.69	(2.15)	2.28	(2.27)	2.69	(2.27)
SC (SSS)	4.16	(3.36)	1.56	(1.95)	2.56	(2.45)
SP (SSS)	6.81	(3.86)	3.03	(1.77)	3.22	(2.10)
TP (SSS)	4.84	(3.91)	2.87	(2.73)	2.65	(2.56)
AP (SSS)	8.31	(4.71)	5.06	(3.25)	5.13	(3.62)
RBB (SSS)	4.91	(2.01)	1.81	(1.5)	2.22	(1.74)
AB (SSS)	20.13	(2.89)	7.34	(3.55)	9.03	(4.17)
DP (DSM)	5.41	(3.20)	2.97	(2.50)	3.09	(2.41)
AO (DSM)	8.37	(3.02)	4.84	(2.46)	5.19	(2.50)
SO (DSM)	2.53	(2.32)	0.97	(1.56)	1.50	(1.65)
AD (DSM)	7.34	(3.83)	4.69	(3.17)	4.72	(3.52)
ODP (DSM)	8.22	(1.44)	3.16	(1.59)	3.97	(1.81)
CP (DSM)	7.47	(3.51)	2.19	(2.06)	2.69	(2.51)

CBCL/6-18	T0’ - T1’		T1’ - T2’		T0’ - T2’
CBCL/6-18	p	r	p	ES	p	r
IP	< 0.001^* * paired Wilcoxon test;	0.86	0.016^* * paired Wilcoxon test;	0.43	< 0.001^* * paired Wilcoxon test;	0.43
EP	< 0.001^* * paired Wilcoxon test;	0.87	0.012^* * paired Wilcoxon test;	0.45	< 0.001^ paired t-test;	0.95
TP	< 0.001^* * paired Wilcoxon test;	0.87	0.006^* * paired Wilcoxon test;	0.48	< 0.001^ paired t-test;	0.89
A/D (SSS)	< 0.001^* * paired Wilcoxon test;	0.85	0.489^* * paired Wilcoxon test;	-	< 0.00^* * paired Wilcoxon test;	0.77
D/W (SSS)	< 0.001^ paired t-test;	0.64	0.102^ paired t-test;	-	0.001^ paired t-test;	0.57
SC (SSS)	< 0.001^ paired t-test;	0.65	0.016^ paired t-test;	0.41	0.022^ paired t-test;	0.40
SP(SSS)	< 0.001^* * paired Wilcoxon test;	0.79	0.667^* * paired Wilcoxon test;	-	< 0.001^* * paired Wilcoxon test;	0.76
TP (SSS)	0.004^* * paired Wilcoxon test;	0.49	0.410^ paired t-test;	-	0.001^ paired t-test;	0.56
AP (SSS)	< 0.001^* * paired Wilcoxon test;	0.68	0.885^* * paired Wilcoxon test;	-	< 0.001^* * paired Wilcoxon test;	0.72
RBB (SSS)	< 0.001^ paired t-test;	0.85	0.227^ paired t-test;	-	< 0.001^ paired t-test;	0.74
AB (SSS)	< 0.001^ paired t-test;	0.87	0.012^* * paired Wilcoxon test;	0.44	< 0.001^ paired t-test;	0.96
DP DSM)	< 0.001^* * paired Wilcoxon test;	0.66	0.721^ paired t-test;	-	< 0.001^ paired t-test;	0.64
AO (DSM)	< 0.001^* * paired Wilcoxon test;	0.73	0.634^* * paired Wilcoxon test;	-	< 0.001^* * paired Wilcoxon test;	0.68
SO (DSM)	0.001^ paired t-test;	0.56	0.143^ paired t-test;	-	0.070^ paired t-test;	-
AD (DSM)	< 0.001^* * paired Wilcoxon test;	0.63	0.969^* * paired Wilcoxon test;	-	< 0.001^* * paired Wilcoxon test;	0.76
ODP (DSM)	< 0.001^* * paired Wilcoxon test;	0.88	0.014^* * paired Wilcoxon test;	0.43	< 0.001^* * paired Wilcoxon test;	0.87
CP (DSM)	< 0.001^* * paired Wilcoxon test;	0.86	0.730^* * paired Wilcoxon test;	-	< 0.001^* * paired Wilcoxon test;	0.85

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E-mail: psychologicalstudies@puc-campinas.edu.br

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[1] Correspondence to: D. RAMOS. E-mail: denisegr@pucsp.br.