Document Type : original article


1 MSc, Department of Clinical Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran.

2 Assistant Professor , Department of Psychology, Faculty member of Raghib Isfahani Institute of Higher Education,Isfahan,Iran.


Background: The individuals' physical, behavioral, and emotional growth is most significant during childhood and adolescence. The purpose of this study was to determine the effectiveness of play therapy with clay and cognitive-behavioral therapy on children's behavioral-emotional disorders.
Methods: The study was a quasi-experimental design with a pre-test and post-test. The participants were selected by simple random sampling and divided into an experimental (n= 15) and a control (n = 15) group. The statistical population consisted of all children aged 7 to 9 years, living in Mobarakeh, Iran, during 2017-18.  The intervention of play therapy with clay and cognitive-behavioral therapy was conducted in ten 45-minute sessions; the participants were assessed by the Child Behavior Checklist and finally both prior to and one month after the intervention. Data was analyzed by the use of SPSS software version 23.0.
Results: The results of data analysis, on the 30 male participants with a mean age of 8.1 years, showed that after the therapeutic intervention, there was a significant decrease in the scores of behavioral-emotional problems (p <0.05) of the participants in the experimental group compared to the control group.
Conclusion: According to the results, psychotherapeutic interventions of play therapy with clay and cognitive-behavioral therapy can help decrease the behavioral-emotional problems among 7-9-year-old children.


  1. Headley S. Young adolescents' well-being and health-risk behaviors: Gender and socioeconomic differences. (Mental health). Youth Studies Australia. 2002 Jun 1; 21(2):63-4.
  2. Bullis JR, Boettcher H, Sauer-Zavala S, Farchione TJ, Barlow DH. What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention. Clinical psychology: Science and practice. 2019 Jun; 26(2):e12278.
  3. Ogundele MO. Behavioral and emotional disorders in childhood: A brief overview for pediatricians. World journal of clinical pediatrics. 2018 Feb 8; 7(1):9.
  4. Kolubinski DC, Frings D, Nikčević AV, Lawrence JA, Spada MM. A systematic review and meta-analysis of CBT interventions based on the Fennell model of low self-esteem. Psychiatry research. 2018 Sep 1; 267:296-305.
  5. Timulak L, Keogh D, Chigwedere C, Wilson C, Ward F, Hevey D, Griffin P, Jacobs L, Irwin B. A comparison of emotion-focused therapy and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: study protocol for a randomized controlled trial. Trials. 2018 Dec; 19(1):1-1.
  6. Minde K, Roy J, Bezonsky R, Hashemi A. The effectiveness of CBT in 3–7 year old anxious children: Preliminary data. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2010 May; 19(2):109.
  7. Creswell C, Waite P. Recent developments in the treatment of anxiety disorders in children and adolescents. Evidence-based mental health. 2016 Aug 1; 19(3):65-8.
  8. Schwartz C, Barican JL, Yung D, Zheng Y, Waddell C. Six decades of preventing and treating childhood anxiety disorders: a systematic review and meta-analysis to inform policy and practice. Evidence-based mental health. 2019 Aug 1; 22(3):103-10.
  9. Oud M, De Winter L, Vermeulen-Smit E, Bodden D, Nauta M, Stone L, Van Den Heuvel M, Al Taher R, De Graaf I, Kendall T, Engels R. Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis. European psychiatry. 2019 Apr; 57:33-45.
  10. Ma ZR, Shi LJ, Deng MH. Efficacy of cognitive behavioral therapy in children and adolescents with insomnia: a systematic review and meta-analysis. Brazilian Journal of Medical and Biological Research. 2018; 51(6).
  11. Scott JG, Tunbridge M, Stathis S. The aggressive child. Journal of pediatrics and child health. 2018 Oct; 54(10):1165-9.
  12. Vacher C, Goujon A, Romo L, Purper-Ouakil D. Efficacy of psychosocial interventions for children with ADHD and emotion dysregulation: a systematic review. Psychiatry research. 2020 May 30:113151.
  13. Vigerland S, Ljótsson B, Thulin U, Öst LG, Andersson G, Serlachius E. Internet-delivered cognitive behavioral therapy for children with anxiety disorders: A randomized controlled trial. Behavior research and therapy. 2016 Jan 1; 76:47-56.
  14. Silk JS, Tan PZ, Ladouceur CD, Meller S, Siegle GJ, McMakin DL, Forbes EE, Dahl RE, Kendall PC, Mannarino A, Ryan ND. A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders. Journal of Clinical Child & Adolescent Psychology. 2018 Jul 4; 47(4):542-54.
  15. Ashori M, Dallalzadeh Bidgoli F. The Effectiveness of Play Therapy Based on Cognitive-Behavioral Model: Behavioral Problems and Social Skills of Pre-School Children with Attention Deficit Hyperactivity Disorder. jrehab. 2018; 19 (2): 102-115
  16. Dos Santos MM, Giglio JS. P-1158-Group play therapy for children promising findings of a systematic revision of literature. European Psychiatry. 2012; 27(S1):1.
  17. Shalani B, Azadimanesh P. The Comparison of Efficacy of Group Art Therapy and Puppet Play Therapy on the Social Skills of Children with Attention Deficit/ Hyperactivity Disorder. J Child Mental Health. 2016; 2 (4):103-112
  18. Wong CL, Ip WY, Kwok BM, Choi KC, Ng BK, Chan CW. Effects of therapeutic play on children undergoing cast-removal procedures: a randomized controlled trial. BMJ open. 2018 Jul 1; 8(7):e021071.
  19. Chilamakuri S, Nuvvula S, Sunkara N. Play therapy in pediatric dentistry. J Pediatr Dent. 2014 Jan 1; 2:28.
  20. Cheng YJ, Ray DC. Child-centered group play therapy: Impact on social-emotional assets of kindergarten children. The Journal for Specialists in Group Work. 2016 Jul 2; 41(3):209-37.
  21. Achenbach, T.M. Integrative guide for the 1991 CBCL/4-18, YSR, and TRF Profiles. Burlington, VT: University of Vermont, Department of Psychiatry. 1999.
  22. Achenbach TM, Rescorla L. Multicultural understanding of child and adolescent psychopathology: Implications for mental health assessment. Guilford Press; 2007.
  23. Minaei A. Adaptation and standardization of Akhenbach's child's behavioral checklist. Self-assessment questionnaire and teacher report form, research in the field of exceptional children. 2006; 19 (1): 529-58.
  24. Akbari B, Rahmati F. The Efficacy of Cognitive Behavioral Play Therapy on the Reduction of Aggression in Preschool Children with Attention-Deficit/Hyperactivity Disorder. J Child Mental Health. 2015; 2 (2):93-100
  25. Soleimani S, Fardoost Z. The Effectiveness of a Child-centered play therapy on Internalized Children's Problems. JPEN. 2020; 7 (1):23-30
  26. Nikpour G, Zare poor M, Nikpour F. The Effect of Play Therapy with Cognitive Behavioral Approach on Reducing Oppositional Defiant Disorder Symptoms in Children Aged 8 to 11 Years. TB. 2018; 17 (1):62-72