The Effectiveness of Play Therapy Based on Cognitive-Behavioral Approach on Reducing Depression and Isolation in Homeless and Poorly Cared for Girls

It is difficult to diagnose depression in children in some cases, because sometimes its symptoms are similar to some other disorders such as autism. For this reason, parents' attention and awareness of the child's behavior and timely psychological diagnosis is very important. For this reason, parents' attention and awareness of the child's behavior and timely psychological diagnosis is very important.Shyness or isolationism is another problem that has affected different people in many different ways from the past to the present. This problem has not been addressed for a variety of reasons, and the public is less likely to refer to it as a problem. Unaware that isolationism and shyness in the heart of society, the person faces many problems, includingthe inability to relate to others and, consequently, the inability to learn and acquire abilities of various skills (6).Therefore, the results show that the two indicators of isolation and depression can affect the mental health of the child and can affect her future life. On the other hand, research results have shown that depression can lead to isolationism, and on the other hand, isolationism stress, anxiety and depression, according to the above, seems to be one of the most important and effective treatments for mental disorders. Or communication problems among children such as depression and isolation. In this regard, the present study seeks to answer the question whether play therapy based on cognitive-behavioral approach can be effective in reducing depression and isolation of orphaned and poorly cared for girls in Tehran?

For the present quasi-experimental study, which was conducted with a pre-test and post-test design with a control group, among orphaned and abused female children in Shahid Zarghami and Khayyam child care centers in Tehran in 1997-98, which had a high score of completing questionnaires on depression and isolation. A total of 24 people were randomly selected as a sample and randomly divided into experimental and control groups. Then, before the intervention, all the subjects received the Children and Adolescents Depression Inventory called CDS-A, which has 25 questions, a single-factor score based on a Likert scale of 5 points, and all elements of depression based on cognitive theory. Covers and has Cronbach's alpha validity and reliability of 0.86. And Shahim Children Behavioral Problems Questionnaire (1996) which has 28 questions and is scored based on a 5-point Likert scale and has 3 subscales of aggression, inattention and childish behaviors, isolationism and anxiety (9). Completed. In the next step, the research protocol was performed under 10 sessions of 90 minutes (two sessions per week) according to Table 1 for the experimental group.Finally, Smirnov-Kolmograph test was used to determine the normality of the data, Levin test to determine the homogeneity or equality of variances, as well as homogeneity of regression slope and covariance test were used for analysis. It should be noted that all statistical calculations were performed with SPSS software version 24.

Studies have shown that most people in the statistical population were between 11 and 8 years old and were studying in the first to fourth grades of elementary school. Based on the results obtained from Table 2, the weight of depression in the experimental period was 410/109 and in the control period was 169/109, and in the weight of depression in the experimental period was 74.250 and in the control period was 111.250, the weight of depression was reduced.Figure 1 In Table 3, The weight of isolation in the experimental period is 917/34 and in the control zone is 333/34, and in the weight of isolation in the experimental period is 199/9 and in the control zone is 834.34%. Isolation in the free spheres.The results showed that play therapy based on cognitive-behavioral approach is effective in reducing the isolation of orphaned and poorly cared for girls in Tehran. So that the group factor with a significant level of less than 0.05 (p = 0.0001) has an effect on the change of isolationism. While the significance level of the pre-test is more than 0.05 (p = 0.304).Another finding showed that play therapy based on cognitive-behavioral approach is effective in reducing depression in orphaned and neglected girls in Tehran. So that the group factor with a significant level of less than 0.05 (p = 0.0001) has an effect on depression. This is while the significance level of the pre-test is more than 0.05 (p = 0.341).

The results showed that play therapy based on cognitive-behavioral approach led to a decrease in students' isolation. The results of the present study with the results of Tavakoli and Kalantari (2017) that examined the effect of play therapy with cognitive-behavioral approach on the regulation of emotion, anxiety and depression in children with type 1 diabetes and concluded that play therapy in the post-test phase has an effect on reducing aggression It did not but had an effect on other research variablessuch as isolationism. Also, the results in the follow-up phase showed that the mean scores of aggression, isolationism decreased significantly, which indicates the effectiveness of play therapy is consistent (11).Another finding showed that play therapy based on cognitive-behavioral approach reduces students' depression. Boyd Webb (2018) addresses play therapy for bereaved children: adapting strategies for use in the community, schools, and family environment. In this article, it is stated that play therapy is one of the most flexible treatment methods that can be changed according to the age of children, conditions, and the environment in which counseling is performed. Play therapy can be used to help children who have lost loved ones in schools, social settings, and at home. After examining the basic developmental factors that affect children's ability to understand the meaning of death, this article discusses the specific characteristics of grief in different situations. These include social counseling after Hurricane Katrina, school-based group play therapy after the teacher's death, and parent-child play therapy after a father dies in a terrorist attack. To increase the acceptability and effectiveness of play therapy, professional psychologists must consider the beliefs and practices of teachers and parents. In addition, psychologists are expected to use play-based activities to help children express their grief more easily (14).