Investigating the effect of cognitive-behavioral game therapy on the communication skills of high-functioning 7-10-year-old children

Dissertation for obtaining a master's degree in the field of psychology for exceptional children

Abstract

The field of self-reliance is an important topic of study and research in the field of mental health and education at the world level. Cognitive-behavioral play therapy methods are offered to deal with concerns such as anger, anxiety, perfectionism, aggression, separation, social skills, abuse and self-confidence. The purpose of this research is to investigate the effect of cognitive-behavioral play therapy on the communication skills of high-functioning independent children. The statistical population includes 7 to 10-year-old children with high performance who visited Behjatabad and Amirabad cultural centers in Tehran in 2013. The measurement tool in this research is the data recording sheet, which was done through a precise and scientific observation by the researcher. In this research, the experimenter defines the two dimensions of communication skills in which the children who are left alone have defects, and which were discussed in the researches of Charlop, Walsh in 1986 and Connor in 1943 (Charlop, 1986; translated by Nainian, 2018) in the form of observable and measurable behaviors and records each of them through careful and scientific observation.

The studies in This research shows that the frequency of target behaviors has increased after the completion of this intervention program, which indicates the effectiveness of this intervention program. Based on this research, we can reach the general conclusion that cognitive-behavioral play therapy can be effective in increasing the communication skills of high-functioning withdrawn children.

Keywords: play therapy, communication skills, withdrawn children. 

Introduction and statement of the problem

Communication skills are specific abilities that a person needs to be able to function adequately when conveying messages symbolically to another person. These skills often include the skills of listening, speaking, self-expression, emotion management (Bertstein[1], 1982; quoted by Zadeh Haft Tanian, 2016). However, some people are not effective in communicating. Therefore, in the last few decades, attention to communication skills and their training has been proposed as one of the ways to reduce communication problems and improve the quality of life (Malaki, 2016). According to the studies, one of the groups that do not function effectively in communication skills, and are included in the classification of pervasive developmental disorders, is self-restraint disorder. Autism is the main group of pervasive developmental disorders that puts autistic children and their families in special conditions. Children with autism often show a strong interest in a limited range of activities, show resistance to change, and do not respond appropriately to the social environment. These disorders affect different areas of development, appear in early childhood and cause continuous disturbances in normal functions. Autism disorder is characterized by severe and extensive damage in various developmental fields such as impairment in social skills, communication skills, interest and stereotyped activities (Mearschat[2], 2010). This term is used for children who have autism, but their intellectual and learning skills are at a normal level. At least a quarter to a third of children who have autistic disorder are in this category (Uzenov[3], 1996; translation by Sharifi Awadi, 2015).

According to the matters mentioned about the importance of communication skills of people in the society, as well as the lack of this skill in children with high-functioning autistic disorder, various programs and interventions have been proposed and implemented for these children. Most of these programs require systematic and formal interventions that are usually provided in the context of educational programs in schools and medical clinics (Asghari Nikah, 2019).It is worth noting that various tools and devices have been used in these interventions, and each of them in some way tries to provide a background to motivate, change behavior and facilitate interpersonal communication and interaction, which are tools such as common toys, books and pictures, computers, audio-visual equipment, musical instruments, and the use of robots adapted to play or communicate with orphaned children, among the tools and devices used in these educational and rehabilitation interventions. Also, the review of rehabilitation and treatment interventions for orphaned children shows that play therapy, as a safe and compatible treatment with the developmental characteristics and conditions of orphaned children, has always been a part of educational, psychological and rehabilitation interventions for these children (Asghari Nikah, 2013).

One of the effective play therapies is play therapy with a cognitive-behavioral approach. Cognitive behavioral play therapy is able to coordinate behavioral and cognitive interventions in play therapy. This model is based on the interaction of cognition, emotions and behavior. In cognitive behavioral play therapy, there is a lot of emphasis on the child's involvement in the treatment process compared to other treatments for young children. Cognitive-behavioral play therapy engages the child with therapy through play. This type of play therapy is a combination of traditional play therapy techniques with behavioral-cognitive techniques. Cognitive-behavioral game therapy, by combining cognitive and behavioral measures in a game therapy model, was introduced to psychotherapy literature by Nell [4] (1995) (Markai [5], 1998). Cognitive behavioral play therapy has been developed as an intrusive treatment that relies on the flexibility of younger children, reduces expectations for verbal expressions with children, and increases confidence in the experiential approach. Cognitive-behavioral game therapy is a relatively unique adaptation of cognitive-behavioral therapy for adults, which was developed for preschool children and the first years of elementary school. Prior to its inception, most game techniques were either therapeutic or based on psychodynamic or client-centered theories. With both previous theoretical perspectives, play therapy was unstructured and child-directed. Cognitive-behavioral play therapy provides a new theoretical perspective in child psychotherapy, in which the most important differences between this type of play therapy and other play therapies include its structure, psycho-educational implementation, and goal-oriented and collaborative perspectives, that is, it is guided by both the child and the therapist (Nell, 2006). The theoretical framework of this cognitive therapy is based on the cognitive model of emotional disorders. This model is based on the interaction of cognition, emotions and behavior. Disordered behavior represents irrational thinking, and treatment is based on cognitive change. When working with children using this model, the interventions are focused on helping the child to formulate thoughts that should be adapted to their situation, not forcing the child to think like an adult. Cognitive-behavioral play therapy is typically a hybrid modeling of adaptive coping skills. During game use, cognitive change is indirectly communicated and most adaptive behaviors are introduced to children. This plan is designed for use with many specific cognitive and behavioral interventions. In the combinations of this type of game, the overall result and prevention of recurrence are important features. With minor modifications and modifications, many of the principles of cognitive therapy designed for use with adults can also be used for younger children (Nell, 1998). Such approaches are useful and effective in developing problem-solving skills and social skills. Cognitive-behavioral play therapy enables the child to interact with his peers, requires his active participation in his treatment, and as a result, the advantages of this approach overcome the shortcomings of other approaches to a large extent. In addition, one of the advantages of the cognitive-behavioral game is that it has specific goals and treatment methods. In terms of the success of cognitive-behavioral play therapy, most play therapists believe that in eighty percent of cases, their treatments have been successful. The impact mechanisms of this approach are carried out through the modification of incompatible ideas and changing the opinions and attitudes related to the symptoms of the disease, and it takes into account the two-way and complex interaction between cognitions, emotions, behavior and the environment (Gerald[6], 1999). On their own, those who have a higher level of performance can benefit from play therapy methods. Although these people are suffering from autonomic disorder, their intelligence performance is higher than other people who have classic autonomic disorder (Samadi, 2019).