目的 研究家庭沙盘游戏治疗对学龄前儿童分离性焦虑障碍(SAD)的干预效果,为构建有效干预模式提供依据。方法 2019年1月1日—2020年12月30日在大连市妇女儿童医疗中心,从确诊SAD患儿中随机抽取60例患儿分为对照组(n=30)和治疗组(n=30),对照组进行家长SAD知识的教育,治疗组进行沙盘游戏治疗和SAD知识教育,每周1～2次,每次40 min。采用Spence学前儿童焦虑量表(中文版)于干预前、干预7次、14次、21次后进行测评,并记录治疗师个案治疗报告、家庭成员治疗感受。 结果 家庭沙盘游戏治疗干预后,治疗组儿童广泛性焦虑、社交恐惧、强迫-冲动障碍、躯体伤害恐惧、分离焦虑及焦虑总分均降低(t=2.002、7.300、8.160、12.138、11.676、9.370,P<0.001)。干预前后,治疗组儿童广泛性焦虑、社交恐惧、强迫-冲动障碍、躯体伤害恐惧、分离焦虑得分及焦虑总分的差值显著高于对照组(t=6.758、3.953、3.478、5.471、7.027、6.012,P<0.001)。家庭沙盘游戏治疗14次、21次后,治疗组焦虑总分低于对照组,差异有统计学意义(t=3.934、7.889,P<0.001)。结论 家庭沙盘游戏治疗可降低学龄前SAD儿童焦虑水平,需达到有效疗程才能显现效果。
Abstract
Objective To study the effect of family sandplay therapy on preschool children with separation anxiety disorder(SAD),in order to provide basis for developing an effective intervention model. Methods Sixty children with SAD were randomly selected from Dalian Women and Children's Medical Center Group from January 1st,2019 to December 30th 2020,and were divided into control group(n=30) and treatment group(n=30). The control group was given health education on SAD,while sandplay therapy and health education on SAD were implemented in treatment group with the frequency of 1 to 2 times/week,40 minutes/time. The Spence Children's Anxiety Inventory(Chinese version) was administered before,after 7,14 and 21 interventions. The treatment reports of the therapists and the treatment feelings of family members were recorded. Results After 21 times of family sandplay intervention,the scores of generalized anxiety,social fear,obsessive-impulsive disorder,physical injury fear,separation anxiety and total anxiety of children in the treatment group were significantly lower than those of the control group(t=2.002,7.300,8.160,12.138,11.676,9.370, P<0.001). Before and after intervention,the differences in scores of generalized anxiety,social fear,obsessive-impulsive disorder,physical injury fear,separation anxiety,and total anxiety in the treatment group were significantly higher than those in the control group(t=6.758,3.953,3.478,5.471,7.027,6.012,P<0.001). After 14 and 21 interventions,the total anxiety score of the treatment group was lower than that of the control group(t=3.934,7.889,P<0.001). Conclusion Family sandplay therapy can reduce the anxiety level of preschool children with SAD after a certain course of treatment.
关键词
沙盘游戏治疗 /
分离性焦虑障碍 /
家庭养育环境 /
学龄前儿童
Key words
sandplay therapy /
separation anxiety disorder /
family nurturing environment /
preschool children
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基金
大连市医学科学研究计划项目(1911072)
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