Middle Eastern Journal of Disability Studies

Background and Objective: Oppositional defiant disorder (ODD) is one of the common behavioral disorders in children that can lead to serious problems. In this context, cognitive-behavioral play therapy has increasingly attracted attention as an effective treatment approach. The aim of this study was to investigate the effectiveness of cognitive-behavioral play therapy in reducing oppositional defiant behavior in children through a meta-analysis of studies conducted in Iran, with an emphasis on the moderating role of gender.

Methods: This study was a meta-analysis and included 7 quasi-experimental studies conducted between 2011 and 2024, which were extracted from reputable domestic databases such as Normags, MagIran, Comprehensive Humanities Portal, Alamnet, Civica, and Jihad Daneshgaghi. They were selected based on criteria such as using valid instruments, experimental or quasi-experimental design, and providing sufficient data to calculate the effect size. In all articles, cognitive behavioral play therapy was implemented on children and the oppositional defiant score was measured. CMA2 software and Hedges' g index were used to estimate the effect size of the studies.

Findings: The results showed that the combined effect size was -1.742, and the observed effect sizes ranged from -0.999 to -2.629. The Q statistic was 12.718 with 6 degrees of freedom, which was statistically significant and indicated heterogeneity among the primary studies. The I² index was 52.823%, suggesting that more than half of the variance in effect sizes was due to heterogeneity; therefore, the random-effects model was chosen as the appropriate model. Analysis of gender as a moderator revealed that the effect sizes for boys (0.417) and girls (0.660) were not statistically significant, as their p-values were 0.291 and 0.758, respectively, and their 95% confidence intervals included zero. These findings indicate that gender did not have a significant impact on the effectiveness of the intervention.

Conclusion: The findings of this meta-analysis are consistent with previous studies and demonstrate that cognitive-behavioral play therapy is an effective method for reducing oppositional defiant behavior in children. Therefore, this approach can be widely used in therapeutic programs to improve children's behavioral problems.