Therapeutic Play and Its Effect on Children's Psychosocial Well-Being

November 18, 2025 updated by: Sinem Yalnızoglu Caka, Kocaeli University

The Effect of Therapeutic Play-Based Intervention Programme (TOTEM) Applied to 4-6 Age Group Earthquake Victims Living in Kahramanmaraş on Children's Psychosocial Well-Being

The aim of this study was to evaluate the effectiveness of the Therapeutic Play-Based Intervention Programme (TOTEM), which was developed to reduce the negative psychosocial effects of the earthquake in children aged 4-6 years, and its effect on children's psychosocial well-being.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Earthquakes are among the most impressive geological processes and are defined as an unpredictable natural disaster due to their destructive effects on people and structures. In Turkey, a 7.7-magnitude earthquake occurred on 6 February 2023 at 04.17 local time, centred in Kahramanmaraş, and another 7.6-magnitude earthquake occurred about nine hours later. In addition, more than 1000 aftershocks were recorded in the region and these events further increased the scale of the disaster. Earthquakes have the potential to have profound and traumatic effects on people's psychological functioning. Children are particularly affected by these effects due to their vulnerability during natural disasters. Children who experience disasters may face various problems in physical, cognitive and socio-emotional development.

Therapeutic play intervention is based on the belief that play is a universal language that allows children to easily express their feelings and thoughts. This approach is an effective strategy that helps the child to explore their problems, seek solutions, express their feelings and emotional regulation. It also promotes cognitive development, reduces anxiety and stress, and increases confidence.

Providing appropriate support to children after a traumatic event such as an earthquake is critical for preventing future psychological problems. In this context, providing children with supportive approaches such as play therapy and conducting these methods by expert teams can contribute to children's well-being. Therapeutic games play an important role by providing a universal language for children to express their emotions and cope with stress.

Study Type

Interventional

Enrollment (Actual)

53

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Izmit
      • Kocaeli, Izmit, Turkey (Türkiye), 41001
        • Kocaeli University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being between the ages of 4-6
  • Having literate parents
  • Having adequate Turkish receptive-expressive language skills
  • Not having a previously diagnosed psychiatric problem declared by the parents
  • Not having participated in a training programme on psychosocial well-being before
  • Not attending any pre-school education institution at the time of the training
  • Volunteering to participate in the study by themselves and their parents

Exclusion Criteria:

  • The participant wants to leave the study
  • The participant has not participated in one or more of the trainings to be given within the scope of the programme
  • The participant shows any diagnosed atypical development
  • Children who show a level of resistance that disrupts their adaptation to normal life in pre-tests, during the study or in post-tests, children with anxiety disorder or other psychiatric problems

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control Group
Control group (routine education programme): The children in the control group were administered a pre-test in the kindergartens they were currently attending (which were included in daily routine life, games, etc. by preschool teachers living in the city), a post-test after five weeks in parallel with the study group, and then a retention test at the end of the first month. Considering ethical principles, the TOTEM programme was also applied to the children in this group after the study was completed.
Experimental: Experimental: Group receiving Therapeutic Play
The Therapeutic Play-Based Intervention Programme (TOTEM) designed for the research was carried out with the children in the intervention group on the determined days and hours. The children were administered the post-test immediately after the end of the programme and then the retention test at the end of the first month.
Other: Therapeutic play
In this context, the pre-school teachers in the container area were contacted and the sessions were held every Wednesday-Thursday (8 sessions in total) for 5 weeks, taking into account their availability hours. Children were included in the programme in groups of 12. Before data collection, the necessary materials were provided and stored in an empty container. It was found appropriate to complete the trainings in kindergartens located in the container city (4). A total of 3 evaluations were carried out: a post-test immediately after the end of the programme and a retention test at the end of the first month.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anxiety Scale in Preschool Children
Time Frame: A total of 3 evaluations will be made: before the programme starts, the post-test immediately after the end of the programme and the retention test at the end of the first month.
The Anxiety Scale in Preschool Children (Spence et al., 2001) developed by Spence, Rapee, McDonald, Ingram (2001) was adapted into Turkish by Şahin (2020). While the original scale had 28 items measuring social anxiety, separation anxiety, fear of physical injury, general anxiety and obsessive-compulsive disorder, Şahin added 5 items related to post-traumatic stress disorder while adapting it to Turkish and validity and reliability studies were conducted with these items. The scale is a 5-point scale and each item is scored between 0 and 4. A total score can be obtained from the scale. A high score on the scale indicates that anxiety in preschool children is high, while a low score indicates that anxiety in preschool children is low. Within the scope of the reliability of the scale, Cronbach's Alpha coefficient was calculated as 0.93 (Şahin, 2020). For this study, Cronbach's Alpha coefficient was calculated as 0.91.
A total of 3 evaluations will be made: before the programme starts, the post-test immediately after the end of the programme and the retention test at the end of the first month.
Psychosocial Status Assessment Scale for 3-6 Year Old Children (Parent Form)
Time Frame: A total of 3 evaluations will be made: before the programme starts, the post-test immediately after the end of the programme and the retention test at the end of the first month.
Psychosocial Situation Rating Scale (PSRS) was developed by Güneş-Şan and Altay and is a measurement tool consisting of 31 items that measures Psychosocial Situation Rating based on parental report in children aged 3-6 years. For each item in the PSDD, there are 5-point Likert type options 0-'never', 1-'rarely', 2-'sometimes', 3-"often", 4-'always'. Based on the score given for each item, a minimum score of '0' and a maximum score of '124' can be obtained from the questionnaire. A low total score indicates that there is no risk for psychosocial problems in the child, while a high score indicates that there is a risk for psychosocial problems. Within the scope of the reliability of the scale, Cronbach's Alpha coefficient was calculated as 0.83 and test-retest reliability was calculated as 0.957 (Güneş-Şan & Altay, 2021). For this study, Cronbach's Alpha coefficient was calculated as 0.88.
A total of 3 evaluations will be made: before the programme starts, the post-test immediately after the end of the programme and the retention test at the end of the first month.
Sleep Disturbance Scale for Children
Time Frame: A total of 3 evaluations will be made: before the programme starts, the post-test immediately after the end of the programme and the retention test at the end of the first month.
The scale developed by Bruni et al. (1996) was adapted into Turkish and the validity and reliability study was conducted by Ağça-Bilmenoğlu (2019). The scale developed to investigate sleep disorders in children consists of 26 items and each question is scored between 1-5. The measurement tool includes questions measuring sleep initiation and maintenance problems, sleep breathing disorders, sleep-wake disorders, sleep-wake transition disorders, excessive sleepiness disorders and excessive sweating during sleep. The scores that can be obtained from the scale vary between 26 and 130, and high scores are interpreted as a high degree of sleep disorder. Within the scope of the reliability of the scale, Cronbach's Alpha coefficient was calculated as 0.84 and test-retest reliability as 0.79 (Ağça-Bilmenoğlu, 2019). For this study, Cronbach's Alpha coefficient was calculated as 0.85.
A total of 3 evaluations will be made: before the programme starts, the post-test immediately after the end of the programme and the retention test at the end of the first month.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kocaeli University

Collaborators

Kahramanmaraş İstiklal University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2024

Primary Completion (Actual)

September 1, 2024

Study Completion (Actual)

December 1, 2024

Study Registration Dates

First Submitted

February 20, 2025

First Submitted That Met QC Criteria

February 20, 2025

First Posted (Actual)

February 25, 2025

Study Record Updates

Last Update Posted (Actual)

November 21, 2025

Last Update Submitted That Met QC Criteria

November 18, 2025

Last Verified

May 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2023/15/15
  • 123S913 (Other Grant/Funding Number: TÜBİTAK)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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