In collaboration with Payame Noor University and Iranian Health Psychology

Document Type : research

Authors

1 Master of Clinical Psychology for Children and Adolescent-shahid beheshti university

2 associate professor in psychology at Shahid Beheshti University, Tehran, Iran

3 Assistant Professor of Counseling, Shahid Beheshti University of Tehran, Iran

4 PhD student in Psychology, Shahid Beheshti University of Tehran, Iran

Abstract

Objective: This study aimed to determine the effectiveness of painting therapy in reducing emotional- behavioral problems of children with cancer (internalized problems: anxious-depressed, withdrawn-depressed, somatic complaints; externalized problems: aggressive behavior and rule-breaking behavior).
Method: The research method was quasi-experimental with a pretest-posttest design and control group with follow-up. Using targeted sampling, 40 children (6-12 years old) with cancer, whose score on the Child Behavior Check List (CBCL) was one standard deviation above the mean, was selected and randomly divided into two experiment (n = 20) and control (n = 20) groups, but due to drop in the number of participants, it decreased to 31 (16 experimental group and 15 control group). The painting program was performed on the experimental group in the form of 8 two-hour sessions. To analyze the data, the mixed variance analysis method was used.
Results: The results showed that although the overall score of the internalized and externalized problems was significantly reduced, painting therapy did not affect the somatic complaints (of internalized problems) and the rule-breaking behavior (of externalized problems).
Conclusions: The results showed that painting therapy can be an effective way to reduce the emotional-behavioral problems of children with cancer. Therefore the findings of this study can have preventive clinical applications.

Keywords

Article Title [Persian]

بررسی اثربخشی نقاشی درمانی بر مشکلات هیجانی-رفتاری کودکان دارای سرطان

Authors [Persian]

  • سیده شهرزاد هجری 1
  • شهلا پاکدامن 2
  • سعید قنبری 3
  • صدیقه السادات میرزایی 4

1 کارشناس ارشد روانشناسی بالینی کودک و نوجوان- دانشگاه شهید بهشتی

2 دانشیار روانشناسی دانشگاه شهید بهشتی، تهران، ایران

3 استادیار مشاوره دانشگاه شهید بهشتی تهران، ایران

4 دانشجوی دکتری روانشناسی، دانشگاه شهید بهشتی تهران، ایران

Abstract [Persian]

هدف: پژوهش حاضر به منظور تعیین اثربخشی نقاشی درمانی بر کاهش مشکلات هیجانی رفتاری (مشکلات درونی سازی شده : اضطراب – افسردگی، گوشه گیری – افسردگی، شکایات جسمانی، و مشکلات برونی سازی شده: رفتارپرخاشگرانه و رفتارقانون شکنانه) کودکان دارای سرطان انجام شد.
روش: طرح پژوهش شبه آزمایشی با پیش آزمون – پس آزمون و گروه گواه همراه با پیگیری بود. با استفاده از روش نمونه گیری هدفمند، تعداد 40 نفر از کودکان 6 تا 12 ساله مبتلا به سرطان بخش آنکولوژی بیمارستان افضلی پور شهر کرمان که در پرسشنامه‌ فهرست‌ رفتاری‌ کودک (CBCL) نمره آنها یک انحراف معیار بالاتر از میانگین بود به عنوان نمونه اصلی پژوهش انتخاب شدند و به طور تصادفی در دو گروه آزمایش (n=20)و گواه (n=20) قرار گرفتند؛اما بر اثر افت آزمودنی تعداد به 31 نفر (16نفر گروه آزمایش و 15 نفر گروه گواه) کاهش یافت و برنامه نقاشی درمانی در قالب 8 جلسه 2 ساعته بر روی آنها اجرا شد. به منظور تجزیه و تحلیل داده ها از روش تحلیل واریانس آمیخته استفاده شد.
یافته‌ها: نتایج نشان داد اگرچه نمره کلی مقیاس مشکلات درونی سازی شده و مشکلات برونی سازی شده به طور معناداری کاهش یافت اما نقاشی درمانی بر زیر مقیاس های شکایات جسمانی (از مشکلات درونی سازی شده) و رفتارقانون شکنانه (از مشکلات برونی سازی شده) اثر معناداری نداشت.
نتیجه گیری: نتایج نشان داد که نقاشی درمانی می تواند روشی کارآمد برای کاهش مشکلات هیجانی – رفتاری کودکان مبتلا به سرطان باشد. یافته های این پژوهش می تواند کاربردهای پیشگیرانه بالینی داشته باشد.

Keywords [Persian]

  • نقاشی درمانی
  • مشکلات هیجانی - رفتاری
  • مشکلات درونی سازی شد
  • مشکلات برونی سازی شده
  • سرطان
 Achenbach, T. M., & Rescorla, L. (2001). Manual for the ASEBA school-age forms & profiles: An integrated system of multi-informant assessment. Burlington, VT:: Aseba.
Bazargan Y, Pakdaman S. (2016). The effectiveness of art therapy on reducing internalizing and externalizing problems of female adolescents. Arch Iran Med, 19(1), 51 – 56.
 Bazmi, N., &  Nersi, M. (2013). The Effect of Play Therapy' Techniques on Reduction of Anxiety and Increasing of Positive Feeling as Well as General Adjustment Level in Children Suffering Blood Cancer in Tehran City.  Psychological Studies, 4(7), 107-130.
Beh‐Pajooh, A., Abdollahi, A., & Hosseinian, S. (2018). The effectiveness of painting therapy program for the treatment of externalizing behaviors in children with intellectual disability. Vulnerable children and youth studies13(3), 221-227.
Demehri, F., Saeidmanesh, M., & Razban, S. (2019). Art therapy based on painting approach on eating behavior and maladaptive problems in children of Malayer city. Middle Eastern Journal of Disability Studies9, 16-16.
Granek, L., Ben-David, M., Bar-Sela, G., Shapira, S., & Ariad, S. (2019). “Please do not act violently towards the staff”: Expressions and causes of anger, violence, and aggression in Israeli cancer patients and their families from the perspective of oncologists. Transcultural psychiatry56(5), 1011-1035.
Greenzang, K. A., Fasciano, K. M., Block, S. D., & Mack, J. W. (2020). Early information needs of adolescents and young adults about late effects of cancer treatment. Cancer, 126(14), 3281-3288.
Hogan, S. (2001). Healing arts: The history of art therapy. Jessica Kingsley Publishers.
Ibrahim, H. A., & Amal, A. A. (2020). The Effectiveness of Play Therapy in Hospitalized Children with Cancer: Systematic Review. Journal Of Nursing Practice3(2), 233-243.
Katz, C., & Hamama, L. (2013). “Draw me everything that happened to you”: Exploring children's drawings of sexual abuse. Children and Youth Services Review35(5), 877-882.
Khodabakhshi Koolaee, A., Vazifehdar, R., & Bahari, F. (2016). Impact of painting therapy on aggression and anxiety of children with cancer. Caspian Journal of Pediatrics2(2), 135-141.
Leibring, I., & Anderzén-Carlsson, A. (2019). Fear and coping in children 5–9 years old treated for acute lymphoblastic leukemia-A longitudinal interview study. Journal of pediatric nursing46, e29-e36.
Loeffen, E. A., Knops, R. R., Boerhof, J., Feijen, E. L., Merks, J. H., Reedijk, A. M., ... & Tissing, W. J. (2019). Treatment-related mortality in children with cancer: Prevalence and risk factors. European Journal of Cancer121, 113-122.
Logan, S., Perz, J., Ussher, J. M., Peate, M., & Anazodo, A. (2019). Systematic review of fertility‐related psychological distress in cancer patients: informing on an improved model of care. Psycho‐oncology28(1), 22-30. Malchiodi, C. A. (2003). Expressive arts therapy and multimodal approaches. Handbook of art therapy, 106-117.
Mehdipour. F., Rafiepoor. A., & Haji Alizadeh. K. (2019).  The effectiveness of mindfulness-based group cognitive therapy on improving the quality of life in patients with cancer. Biquarterly iranian journal of health psychology, 2(1), 125-134.
Minaei, A. (2006). Adaptation and standardization of the Akhenbach's Child Behavior Checklist, self-assessment questionnaire and teacher report form. Research on exceptional children, 19(1), 529-558
Nash, S. H., Day, G., Hiratsuka, V. Y., Zimpelman, G. L., & Koller, K. R. (2019). Agreement between self-reported and central cancer registry-recorded prevalence of cancer in the Alaska EARTH study. International journal of circumpolar health78(1), 1571383.
Oun, R., Moussa, Y. E., & Wheate, N. J. (2018). The side effects of platinum-based chemotherapy drugs: a review for chemists. Dalton transactions47(19), 6645-6653.
Puhr, A., Ruud, E., Anderson, V., Due-Tønnesen, B. J., Skarbø, A. B., Finset, A., & Andersson, S. (2019). Self-reported executive dysfunction, fatigue, and psychological and emotional symptoms in physically well-functioning long-term survivors of pediatric brain tumor. Developmental neuropsychology44(1), 88-103.
Ross, L., Boesen, E. H., Dalton, S. O., & Johansen, C. (2002). Mind and cancer: does psychosocial intervention improve survival and psychological well-being?. European Journal of Cancer38(11), 1447-1457.
Ruttle, P. L., Shirtcliff, E. A., Serbin, L. A., Fisher, D. B. D., Stack, D. M., & Schwartzman, A. E. (2011). Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: Longitudinal and concurrent associations with cortisol. Hormones and behavior59(1), 123-132.
Shafiee, F., Shariatmadar, A., & Farahbakhsh, K. (2019). Investigating lived experiences of psychological stresses of cancerous children and their families at different stages of the disease. Quarterly Journal of Health Psychology, 8(3), 119-138. ]Persian[.
Soundy, A., & Reid, K. (2019). The Psychosocial Impact and Value of Participating in a Storytelling Intervention for Patients Diagnosed with Cancer: An Integrative Review. Open Journal of therapy and Rehabilitation7(02), 35.
Zarani, F., Panaghi, L., Mirzaei, S., & Helmi, S. (2019). Identification of Psycho-Social Needs and Coping Strategies in Iranian Children with Cancer. Basic & Clinical Cancer Research11(3). Retrieved from http://bccr.tums.ac.ir/index.php/bccrj/article/view/315
Zimmermann, F. F., Burrell, B., & Jordan, J. (2018). The acceptability and potential benefits of mindfulness-based interventions in improving psychological well-being for adults with advanced cancer: A systematic review. Complementary therapies in clinical practice30, 68-78.