Comparing the Effectiveness of Emotional Disclosure Through Drawing and Family-Based Floortime Play Therapy on Emotion Regulation Difficulties and Internalizing and Externalizing Symptoms in Children with Anxiety Symptoms
Keywords:
Emotional disclosure, Drawing therapy, Floortime play therapy, Emotion regulation, Internalizing symptoms, Externalizing symptoms, Child anxietyAbstract
This study aimed to compare the effectiveness of emotional disclosure through drawing and family-based Floortime play therapy in improving emotion regulation and reducing internalizing and externalizing symptoms in children with anxiety symptoms. This quasi-experimental study used a pretest–posttest design with a control group and follow-up. The statistical population comprised children aged 8–10 years in Qaen, South Khorasan Province, in 2024–2025. Forty-five children with anxiety symptoms, identified by scoring at least one standard deviation above the mean on the Spence Children’s Anxiety Scale–Parent version (SCAS-P), were selected through purposive sampling and randomly assigned to three groups: emotional disclosure through drawing, family-based Floortime play therapy, and control (15 participants each). Both interventions were delivered in eight 45-minute sessions held twice weekly. Data were collected using the Difficulties in Emotion Regulation Scale for Children (DERS-C) and the Child Behavior Checklist (CBCL) and analyzed with analysis of covariance (ANCOVA) and Bonferroni post hoc tests using SPSS 26. ANCOVA results indicated a significant main effect of group on emotion regulation difficulties (F = 14.926, p = .001, η² = .421), internalizing symptoms (F = 30.363, p < .001, η² = .603), and externalizing symptoms (F = 36.531, p < .001, η² = .646). Bonferroni comparisons showed both interventions were significantly more effective than the control group at posttest and follow-up (p < .001). No significant difference was observed between emotional disclosure and Floortime groups (p > .05). Both emotional disclosure through drawing and family-based Floortime play therapy effectively improved emotion regulation and reduced anxiety-related internalizing and externalizing symptoms in children, with sustained effects at follow-up, suggesting these methods as accessible and family-friendly therapeutic options.
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Copyright (c) 2025 Amir Dariush Tavasoli (Author); Samaneh Sadat Jafar Tabatabaei; Fatemeh Shahabizadeh , Maryam Nasri (Author)
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