Comparing the Effectiveness of Play Therapy Training Based on Parent-Child Relationship and Parent Management Program Training in Reducing the Symptoms of Oppositional Defiant Disorder and Improving the Resilience of These Children in Elementary School

Tatlari, Fatemeh; Hakimirad, Elham; Kashani Vahid, Leila; Ebrahimpoor, Majid; Nosrati, Fatemeh; Mojaver, Shirin

Volume 13 - Articles-1402 MEJDS (2023) 13: 79 | Back to browse issues page

Mendeley

Zotero

RefWorks

Tatlari F, Hakimirad E, Kashani Vahid L, Ebrahimpoor M, Nosrati F, Mojaver S. Comparing the Effectiveness of Play Therapy Training Based on Parent-Child Relationship and Parent Management Program Training in Reducing the Symptoms of Oppositional Defiant Disorder and Improving the Resilience of These Children in Elementary School. MEJDS 2023; 13 :79-79
URL: http://jdisabilstud.org/article-1-3148-en.html

Comparing the Effectiveness of Play Therapy Training Based on Parent-Child Relationship and Parent Management Program Training in Reducing the Symptoms of Oppositional Defiant Disorder and Improving the Resilience of These Children in Elementary School

Fatemeh Tatlari¹

, Elham Hakimirad ^*²

, Leila Kashani Vahid³

, Majid Ebrahimpoor³

, Fatemeh Nosrati⁴

, Shirin Mojaver⁵

1- Master in Psychology and Education of Exceptional Children, School of Literature, Social Science and Humanities, Science & Research Branch, Islamic Azad University, Tehran, Iran
2- Assistant Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran
3- Assistant Professor, Department of Psychology and Education of Exceptional Children, School of Literature, Social Science and Humanities, Science & Research Branch, Islamic Azad University, Tehran, Iran
4- Associate Professor, Department of Psychology and Education of Exceptional Children, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
5- PhD Student in Psychology and Exceptional Child Education, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran

Abstract: (1043 Views)

Abstract
Background & Objectives: Some children may show internalizing and externalizing behavior problems in the family or school environment. Among the externalizing behavioral problems of children, oppositional defiant disorder is one of the most common psychological problems. Some researchers emphasize the role of environmental factors in children's psychopathology, including the occurrence of symptoms of oppositional defiant disorder. In other words, the family provides structural and internal dynamics that may result in behavioral problems in children and the behavioral functioning of families. In this research, we explored which family–oriented interventions are more effective in improving the symptoms of stubborn disobedience disorder and increasing resilience. As a result, the present study aimed to compare the effectiveness of play therapy training based on parent–child relationship and parent management program training on reducing the symptoms of oppositional defiant disorder and improving the resilience of these children in elementary school.
Methods: The current research method was quasi–experimental with a pretest–posttest design with a control group. The study's statistical population included all the mothers of first– to third–grade children with oppositional defiant disorder studying in the boys' primary school in the 18^th district of Tehran City, Iran, in the academic year of 2021–2022. The research sample consisted of 36 mothers. They were selected by available sampling and assigned to three groups: play therapy based on the parent–child relationship, parent management program, and control (12 mothers in each group). The inclusion criteria were as follows: diagnosing symptoms of the oppositional defiant disorder in their children, lacking other severe psychiatric disorders such as schizophrenia and obsession or psychological disorders, not receiving medicine in students, lacking a history of physical diseases in students, providing consent of mothers to participate in the research, and participating in all sessions. The exclusion criteria were non–cooperation and the absence of more than two group training sessions. The study data in the pretest and posttest were gathered via Child Symptom Inventory–4 (Gadow & Sprafkin, 1994) and Social–Emotional Assets and Resilience Scales (SEARS) (Merrell et al., 2011). The subjects of the experimental groups (mothers) received play therapy sessions based on the parent–child relationship and parent management program, and no action was taken in the control group. The analysis of research data was done through descriptive (mean and standard deviation) and inferential statistics (multivariate and univariate analysis of covariance tests and Tukey's post hoc test) in SPSS version 24 software. P values less than 0.05 were considered statistically significant.
Results: Findings showed that play therapy based on parent–child relationship and parent management program were effective in reducing symptoms of oppositional defiant disorder (p<0.001) and in increasing resilience components, including self–regulation (p<0.001), social competence (p<0.001), empathy (p<0.001), responsibility (p<0.001), and total resilience (p<0.001). A pairwise comparison showed no significant difference between the two intervention groups in reducing the variables of oppositional defiant disorder syndrome (p=0.510) and improving resilience components, including self–regulation (p=0.741), social competence (p=0.981), empathy (p=0.427), responsibility (p=0.974), and total resilience (p=0.887).
Conclusion: Play therapy based on parent–child relationships and parent management program effectively improves the children's oppositional defiant disorder symptoms and resilience. Furthermore, there were no significant differences between the effectiveness of the two interventions. Therefore, it is recommended that both interventions be conducted in schools and health centers by psychologists and counselors.

Keywords: Play therapy based on parent–child relationship, Parent management program, Oppositional defiant disorder syndrome, Resilience

Full-Text [PDF 747 kb] (351 Downloads)

Type of Study: Original Research Article | Subject: Psychology

References

1. Achenbach TM, Ivanova MY, Rescorla LA, Turner LV, Althoff RR. Internalizing/externalizing problems: review and recommendations for clinical and research applications. J Am Acad Child Adolesc Psychiatry. 2016;55(8):647–56. [DOI]

2. León–Del–Barco B, Mendo–Lázaro S, Polo–Del–Río MI, López–Ramos VM. Parental psychological control and emotional and behavioral disorders among Spanish adolescents. Int J Environ Res Public Health. 2019;16(3):507. [DOI]

3. Burke JD, Evans SC, Carlson GA. Debate: oppositional defiant disorder is a real disorder. Child Adolesc Ment Health. 2022;27(3):297–9. [DOI]

4. Tung I, Lee SS. Negative parenting behavior and childhood oppositional defiant disorder: differential moderation by positive and negative peer regard. Aggress Behav. 2014;40(1):79–90. [DOI]

5. Booker JA, Capriola-Hall NN, Greene RW, Ollendick TH. The parent–child relationship and posttreatment child outcomes across two treatments for oppositional defiant disorder. J Clin Child Adolesc Psychol. 2020;49(3):405–19. [DOI]

6. Mawson AR. On the association between low resting heart rate and chronic aggression: retinoid toxicity hypothesis. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(2):205–13. [DOI]

7. Lavigne JV, Gouze KR, Hopkins J, Bryant FB, LeBailly SA. A multi–domain model of risk factors for ODD symptoms in a community sample of 4–year-olds. J Abnorm Child Psychol. 2012;40(5):741–57. [DOI]

8. Liu X, Lin X, Zhou Q, Zhou N, Li Y, Lin D. Family and individual risk and protective factors of depression among chinese migrant children with oppositional defiant disorder symptoms. Front Psychol. 2017;8:508. [DOI]

9. Tang Y, Lin X, Chi P, Zhou Q, Hou X. Multi–level family factors and affective and behavioral symptoms of oppositional defiant disorder in Chinese children. Front Psychol. 2017;8:1123. [DOI]

10. Taghizade S, Mahmoodi Z, Zandifar A, Qorbani M, Mohamadi F, Mehrafzoun N. The relationship model among parent–child relationship, coping responses and behavioral problems in children with attention deficit hyperactivity disorder. BMC Psychiatry. 2022;22(1):596. [DOI]

11. Lin X, Li L, Heath MA, Chi P, Xu S, Fang X. multiple levels of family factors and oppositional defiant disorder symptoms among Chinese children. Fam Process. 2018;57(1):195–210. [DOI]

12. Southwick SM, Bonanno GA, Masten AS, Panter–Brick C, Yehuda R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014;5:25338. [DOI]

13. Masten AS. Global perspectives on resilience in children and youth. Child Dev. 2014;85(1):6–20. [DOI]

14. Wright MO, Masten AS, Narayan AJ. Resilience processes in development: four waves of research on positive adaptation in the context of adversity. In: Goldstein S, Brooks RB, editors. Handbook of resilience in children. Boston, MA: Springer US; 2013. pp: 15–37. [DOI]

15. Ungar M, Theron L. Resilience and mental health: how multisystemic processes contribute to positive outcomes. Lancet Psychiatry. 2020;7(5):441–8. [DOI]

16. Masten AS. Resilience in developmental systems: principles, pathways, and protective processes in research and practice. In: Multisystemic resilience: adaptation and transformation in contexts of change. New York, NY, US: Oxford University Press; 2021. pp: 113–34. [DOI]

17. Kalisch R, Baker DG, Basten U, Boks MP, Bonanno GA, Brummelman E, et al. The resilience framework as a strategy to combat stress–related disorders. Nat Hum Behav. 2017;1(11):784–90. [DOI]

18. Akbari A, Monirpour N, Mirzahosseini H. The effectiveness of parent–based play–therapy on aggression and and symptoms of oppositional defiant disorder. Quarterly Journal of Child Mental Health. 2021;8(1):126–40. [Persian] [DOI]

19. Bratton SC, Landreth GL, Kellam T, Blackard SR. Child parent relationship therapy (CPRT) treatment manual: A 10–session filial therapy model for training parents. New York, NY, US: Routledge/Taylor & Francis Group; 2006.

20. Mostafavi S, Shaeeri MR, Asghari Moghaddam MA, Mahmoudi Gharaie J. Effectiveness of educating play therapy based on child parent relationship Therapy (CPRT) according Landreth model to mothers on reducing child behavioral problems. Clinical Psychology and Personality. 2013;10(2):33–42. [Persian] [Article]

21. Jafari N, Mohammadi MR, Khanbani M, Farid S, Chiti P. Effect of play therapy on behavioral problems of maladjusted preschool children. Iran J Psychiatry. 2011;6(1):37–42.

22. Garrett M. Play–based interventions and resilience in children. International Journal of Pshychology and Counselling. 2014;6(10):133–7.

23. Barkley RA. Taking charge of ADHD: the complete, authoritative guide for parents. 3rd ed. The Guilford Press; 2013.

24. Scott S, Sylva K, Doolan M, Price J, Jacobs B, Crook C, et al. Randomised controlled trial of parent groups for child antisocial behaviour targeting multiple risk factors: the SPOKES project. J Child Psychol Psychiatry. 2010;51(1):48–57. [DOI]

25. Dopheide JA, Pliszka SR. Attention–deficit–hyperactivity disorder: an update. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2009;29(6):656–79. [DOI]

26. Kazdin AE, Glick A, Pope J, Kaptchuk TJ, Lecza B, Carrubba E, et al. Parent management training for conduct problems in children: Enhancing treatment to improve therapeutic change. Int J Clin Health Psychol. 2018;18(2):91–101. [DOI]

27. Fongaro E, Picot MC, Stringaris A, Belloc C, Verissimo AS, Franc N, et al. Parent training for the treatment of irritability in children and adolescents: a multisite randomized controlled, 3–parallel–group, evaluator–blinded, superiority trial. BMC Psychol. 2022;10(1):273. [DOI]

28. Murrihy RC, Drysdale SAO, Dedousis-Wallace A, Rémond L, McAloon J, Ellis DM, et al. Community–delivered collaborative and proactive solutions and parent management training for oppositional youth: a randomized trial. Behav Ther. 2023;54(2):400–17. [DOI]

29. Borden LA, Schultz TR, Herman KC, Brooks CM. The incredible years parent training program: promoting resilience through evidence–based prevention groups. Group Dynamics: Theory, Research, and Practice. 2010;14(3):230–41. [DOI]

30. Lin X, He T, Heath M, Chi P, Hinshaw S. A systematic review of multiple family factors associated with oppositional defiant disorder. Int J Environ Res Public Health. 2022;19(17):10866. [DOI]

31. Mesman E, Vreeker A, Hillegers M. Resilience and mental health in children and adolescents: an update of the recent literature and future directions. Curr Opin Psychiatry. 2021;34(6):586–92. [DOI]

32. Ding W, Meza J, Lin X, He T, Chen H, Wang Y, et al. Oppositional defiant disorder symptoms and children's feelings of happiness and depression: mediating roles of interpersonal relationships. Child Ind Res. 2020;13(1):215–35. [DOI]

33. Li L, Lin X, Chi P, Heath MA, Fang X, Du H, et al. Maltreatment and emotional and behavioral problems in chinese children with and without oppositional defiant disorder: the mediating role of the parent–child relationship. J Interpers Violence. 2016;31(18):2915–39. [DOI]

34. Gadow KD, Sprafkin J. Child Symptom Inventories manual. Stony Brook, NY: Checkmate Plus; 1994.

35. Merrell KW, Cohn BP, Tom KM. Social–Emotional Assets and Resilience Scales (SEARS). Lutz, FL: Psychological Assessment Resources; 2011.

36. Mohamadesmaiel E, Alipour A. A preliminary study on the reliability, validity and cut off points of the Disorders of Children Symptom Inventory–4 (CSI–4). Journal of Exceptional Children. 2002;2(3):239–54. [Persian] http://joec.ir/article-1-484-en.pdf

37. Mashhadi A, Hosieni Yazdi SA, Asemi Z, Kimyaie SA. The effectiveness of CODIP on improvement of self–concept and enhancement of resilience in children of divorce. Journal of Educational Psychology. 2015;6(2):48–58. [Persian] [Article]

38. Barkley RA, editor. Attention–deficit hyperactivity disorder: a handbook for diagnosis and treatment. 3rd ed. New York & London: Guilford Press; 2006.