EXPLORING THE EFFICACY OF PLAY THERAPY AMONG PEDIATRIC

PATIENTS WITH SPECIAL NEEDS

Thesis

Presented to the Faculty of College of Nursing

Lyceum-Northwestern University

Dagupan City

In Partial Fulfillment of the Requirements for the Degree

Bachelor of Science in Nursing

Reasearchers:

Carbonell, Lauren C.

Dapiaoen, Jolreia Luisa M.

De Guzman, Marc Triesha A.

Crepa, Jasper Carlos D.

May 2024

Research Adviser:

Maricel S. Nasog, RN, MAN, Ed. D, DNM

 Abstract

Exploring the Efficacy of Play Therapy among pediatric Patients with Special
Needs

L. Carbonell, J.L. Dapiaoen, M.T. De Guzman and J.C. Crepa. College of

Nursing, Lyceum-Northwestern University, Tapuac Distrtict, Dagupan City

This qualitative research explores the impact of play therapy on

pediatric patients with special needs at the Stimulation and Therapeutic
Activity Center in Dagupan City. Using the Colaizzi method for
phenomenological analysis, the study delves into the experiences and
perspectives of 12 health workers who facilitate and observe play therapy
sessions.

The participants offered detailed observations on how play therapy

affects the developmental and emotional well—being of children with special
needs, emphasizing its therapeutic advantages. According to the health
workers, structured play activities significantly enhanced the patients' social
skills, emotional regulation, and cognitive functions. These activities,
customized to each child's specific needs, created a nurturing and stimulating
environment that encouraged their growth and development.

The phenomenological analysis provided a comprehensive

understanding of the therapeutic process, capturing the subtle ways in which
play therapy benefits both the children and the practitioners. The study's
findings highlight the effectiveness of play therapy in improving the quality of
life for pediatric patients with special needs. The interventions not only led to
positive behavioral changes but also equipped the children with essential
coping strategies. This research supports the inclusion of play therapy as a
crucial element in the holistic treatment of children with special needs,
advocating for its wider adoption in therapeutic practices.
 TABLE OF CONTENTS

Page

List of Tables
List of Figures
Chapter I. INTRODUCTION

Rationale and Background of the Study

Theoretical Framework
Conceptual Framework

Statement of the Problem

Scope and Delimitation
Significance of the Study
Definition of Terms

Chapter II. REVIEW OF RELATED LITERATURE

Chapter III. RESEARCH METHODOLOGY
Research Design
Sources of Data
Instrumentation and Data Collection
Tools for Data Analysis

Chapter IV. RESULTS AND DISCUSSION

Chapter V. SUMMARY, CONCLUSION, AND RECOMMENDATIONS
Summary
Findings
Conclusion
Recommendations
 CHAPTER 1

INTRODUCTION

Rationale and Background of the Study

Play therapy has emerged as a potential healing method for people

with special needs, giving a unique outlet for emotional release and growth.
The effectiveness of play therapy in improving healing results for this group is
a topic of growing interest and importance within the field of psychology.
Special needs cover a wide range of conditions, including but not limited to
developmental challenges, autism spectrum disorder, attention deficit
hyperactivity disorder (ADHD), and physical disabilities. These people often
face difficulties in speech, social engagement, emotional control, and
cognitive performance, which can greatly impact their quality of life and
general well-being.

Traditional therapy methods may not always be acceptable or

successful for people with special needs due to the unique nature of their
situations. Play therapy, however, offers a socially appropriate and enjoyable
way for meeting their psychological needs. Rooted in psychodynamic
principles and influenced by theories of child development, play therapy uses
play as a means for communication and self-expression, allowing people to
explore and process their thoughts, feelings, and experiences in a safe and
helpful setting. By participating in play activities led by a trained therapist,
people with special needs can develop important skills such as emotional
control, socialization, problem-solving, and self-awareness.

Individuals with special needs form a diverse community with a wide

range of cognitive, developmental, physical, and social difficulties. These
challenges can greatly impact their daily functioning, social relations, school
successes, and general quality of life. While standard therapeutic methods,
such as talk therapy or cognitive-behavioral treatments, have been utilized to
address the needs of people with special needs, they may not always be
acceptable or successful due to the unique nature of their conditions.
 While the use of play therapy with people with special needs has
gained ground in clinical practice, actual study on its effectiveness is still
relatively limited. Existing studies have proven hopeful results, showing
changes in various areas such as mental control, social skills, adaptive
functioning, and disease relief. For example, research has shown that play
therapy interventions can lead to reductions in problem behaviors among
children with autism spectrum disorder (ASD), improvements in attention and
impulse control in children with attention deficit hyperactivity disorder
(ADHD), and enhanced communication skills in children with developmental
delays.

Research on the efficacy of play therapy for individuals with special

needs is still relatively limited but growing. Existing studies have shown
promising results, Elbeltagi et al., (2023) shows that play therapy helps
children with autism to participate in play activities of their interest and choice
to express themselves in the most comfortable ways. It changes their play
therapy in children with autism self-expression from unwanted behaviors to
more non-injurious expressive behavior using toys or hobbies of their choice
as their words. Play therapy also helps those children to experience finding
out various relationship styles. Every child with autism is unique and reacts
differently. Therefore, different types of assistance, like play therapy, could fit
the differences in children with autism. Proper evaluation of the child is
necessary to evaluate which type fits the kid more than the others. The study
updated the different types of play therapy that could fit children with autism
in an evidence-based way. Despite weak proof, play therapy still has possible
benefits for patients and their families.

Play-based treatments are used ubiquitously with children with social,

speech, and language needs but the effects of these interventions on the
mental health of this group of children is unknown. Francis et al., (2022)
despite their pre-existing hurdles, the mental health of children with
developmental language disorder (DLD) and autism spectrum disorder (ASD)
should be given equal attention to the other more noticeable features of their
condition. A key finding is the variety of study features related to study
sample size, length of treatments, study sites, background of interventionists,
and unpredictability of specific mental health outcomes. Play-based
treatments appear to have a helpful effect on positive, but not negative,
mental health in children with ASD. There are no high--quality studies
examining the effectiveness of such treatments in children with DLD.

However, many of these studies suffer from methodological flaws,

including small sample numbers, lack of control groups, and reliance on
subjective outcome measures. Additionally, the processes underlying the
healing benefits of play therapy for people with special needs remain badly
known. Further study is needed to thoroughly examine the effectiveness of
play therapy methods, find the specific healing processes at play, and
determine the best treatment strategies for different groups and presenting
issues.

The purpose of this study is to determine the impact that play therapy
can have on assisting children with special needs as they develop emotionally,
socially, and cognitively. The goal of the study is to identify the precise
therapeutic outcomes and benefits play therapy may provide for pediatric
patients with special needs. To improve play therapy’s effects on these
individuals, it also seeks to establish best practices for applying it in
therapeutic environments.

Theoretical Framework

Psychodynamic Theory

Psychodynamic theory, which originated with Freud, is a psychological

approach that focuses on the intricate connections inside the human mind
that lead to psychiatric diseases. It proposes that previous events, especially
painful ones, have a major impact on current behavior (Main, 2023). The
hypothesis is used in a variety of areas, including developmental psychology,
social psychology, and mental disease research. It focuses on the
unconscious mind's impact, biological urges, and dynamic interactions
between the conscious and unconscious, such as sexual sensations and
protective reactions. Unhealthy habits are often the result of unresolved
problems from earlier psychosexual phases of development. Psychodynamic
treatment, which is closely related to psychoanalytic therapy, seeks to bring
the unconscious mind into awareness, allowing people to comprehend and
address their genuine emotions.

Psychodynamic theory serves as a theoretical framework for

understanding the therapeutic processes that underpin play therapy
treatments for people with special needs in this research. In the perspective
of psychodynamic theory, play is a symbolic medium through which people
may express and process unconscious conflicts, emotions, and fantasies.
Individuals with special needs who may struggle with verbal communication
or have little understanding of their own experiences might benefit from play
therapy, which provides a non-threatening way to explore and work with
underlying psychological concerns. Participants in play activities led by a
competent therapist may externalize their inner world, gain insight into their
thoughts and emotions, and build better coping mechanisms. Thus,
psychodynamic theory emphasizes the importance of play as a therapeutic
technique for increasing emotional expression, self-awareness, and
psychological development in people with special needs, which closely aligns
with the present study's aims and objectives.

Psychodynamic theory was utilized in our research due to its ability to

offer insights into processes, emotional development, and interpersonal
dynamics (Smith, 2019). These aspects are crucial in comprehending the
underlying issues and therapeutic progress in pediatric populations,
particularly those with special needs. Moreover, play therapy frequently
incorporates psychodynamic principles to enhance communication and
emotional expression in children.

Statement of the Problem

This study sought to determine the Efficacy of Play Therapy among

Pediatric Patients with Special Needs in Dagupan City. Specifically, it
answered the question:

1. What are the experiences of the pediatric patients with special needs in
relation to play therapy as perceived by health workers?
Scope and Delimitation

This study investigated the efficacy of play therapy among pediatric

patients with special needs. The study involved conducting interviews as the
primary data-gathering method. It solely concentrated on investigating the
efficacy of play therapy for pediatric patients with special needs, without
examining the effectiveness of alternative therapeutic methods or
interventions. The participants were the 12 health workers employed at the
Stimulation and Therapeutic Activity Center who provided therapeutic
management to pediatric patients with special needs. This study covered the
period from May 2024.

Significance of the Study

This study will benefit the following:

Nursing education: The study provides information on effective

interventions for supporting children with special needs. By understanding its
benefits nursing students can learn how to better support children with
special needs.

Nursing practice: The findings can be used to develop better care

plans that include play therapy, addressing both the emotional and
psychological needs of patriotic patients with special needs. This can lead to
overall outcomes for these children.

Nursing research: The study will contribute to the existing literature

on play therapy and interventions for children with special needs, providing a
basis for more research on play therapy, encouraging further studies to
explore its long-term effects and different methods. This can help improve
nursing practices and policies for caring for children with special needs.

Definition of Terms
 This section includes key terms essential for comprehending the study,
aiming to maintain clarity and prevent ambiguity, which might otherwise
result in differing interpretations of the terms.

Efficacy: refers to the measure of effectiveness or success of play

therapy in achieving desired outcomes for pediatric patients with special
needs.

Pediatric patients: are the children and adolescents who are

receiving medical or therapeutic care, particularly those with special needs.

Play therapy: is a therapeutic approach tailored specifically to

children, utilizing play activities as a means of communication and expression.

Special needs: a variety of conditions or circumstances that require

specific attention, support, or accommodations to address.
 CHAPTER II

REVIEW OF RELATED LITERATURE

This chapter presents the literature and studies which are relevant and
significant to research studies. They have given the thoughts and ideas that
formed the basis for this study’s conceptualization of the framework.

Effectiveness of Play Therapy

Internalizing disorders, including major depressive disorder, dysthymia, and somatic disorders, are li
 Thomas et al., (2022) argued that the types, qualities, and results of
Play Therapy (PT) treatments for kids with chronic health conditions (CHC)
and to find out how these outcomes were measured on a psychological level.
The study found 6742 papers and six studies, with a group size of 4 to 58 and
two randomized control trials. Children had mental and behavioral problems,
like worry, sadness, and low self-esteem. Two studies showed that PT helped
people who were depressed, and one study found that it helped people feel
better about their own selves. Three tests with less than 30 people as
participants found no effect.

The current data on whether PT can improve the psychological results

for children with chronic illnesses is not clear-cut because the studies used
different methods and had small sample sizes. A recent review found that
physical therapy (PT) can help kids deal with and get used to major medical
treatments and stays in the hospital. The study shows that people are
interested in using PT to help kids with CHC learn how to change and deal
with problems. There needs to be more data from more well-powered
studies, but this review gives some tentative support to the idea that PT may
have some good effects on the psychological results of children with CHC.

Therapeutic Mechanism of Play Therapy

Play is a universal action and natural way of self-expression for

children, enabling them to express their feelings and ideas. By the age of six,
children had likely played for more than 15,000 hours. Play is essential for
children's physical, psychological, and psychosocial development because it
helps them comprehend others, teaches principles such as justice, sharing,
and social reciprocity, and builds confidence and self-efficacy. Play therapy is
an interpersonal process in which trained professionals use the healing
properties of play to assist clients in resolving psychological issues and
preventing future ones. It is a systematic, theoretical-based method that
fosters strong relationships between therapists and children by using play as
the primary mode of communication. Play therapy, like adult counseling or
psychotherapy, allows children to express their inner world in a secure and
comfortable setting. Shrinivasa (2018) study gives a short introduction of play
therapy as a therapeutic agent for change, the many processes exhibited in
play, the therapeutic properties of play, and the primary approaches to play
therapy. It also provides research articles demonstrating the usefulness of
play therapy in various diseases and recommends future directions for its
application in children.

The Integrating Theory, Evidence, and Action (ITEA) systematic

review process examined the therapeutic powers of play (TPoP) framework in
child-parent relationship therapy (CPRT). Griffin & Parson (2023) found that
filial therapy, which involves complete parental engagement, had a larger
impact size than partial or no parental involvement. This understanding of the
therapeutic change process in filial therapy can help therapists improve the
intervention's strengths and tailor treatments to specific situations or groups.
The research demonstrates that filial therapy is a developmentally sensitive
intervention that promotes therapeutic change across the life span and family
system. The parent-child relationship subsystem had the largest number of
TPoP, and filial therapy promotes social ties by stimulating attachment, social
competence, empathy, and therapeutic partnerships. Explicit incorporation of
TPoP, such as creating a goal-setting tool or providing feedback on TPoP
activation, could enhance the therapeutic efficacy of filial therapy. Further
observation is needed to determine the prevalence of implicitly activated
TPoP.

Play Therapy Interventions

 Children are more exposed to difficulties and life-threatening
situations such as chronic illnesses, disabilities, and overall hardship. These
challenges may disrupt children's core protection mechanisms, resulting in
maladjustment and poor mental health outcomes. There is an increasing
interest in preparing youngsters to tackle these problems better. Play
behavior is particularly interesting since it is the preferred mode of
engagement with their surroundings. Play therapy provides a secure setting
for children to overcome negative experiences and learn how to effectively
adjust to future stressful occurrences. However, research on play therapy
remains limited, with substantial gaps in the release of study publications.
Most of the previous studies is focused on kid case studies, making it difficult
to generalize. The research on play therapy methods that promote resilience
is likewise limited since it is a complex and dynamic construct. Weis (2020)
literature looked at current play therapy strategies that help children develop
innate resilience. The findings suggested that children with impairments need
a more structured kind of play therapy. The area of play therapy treatments
that promote the innate features of resilience is a multifaceted, dynamic, and
complex construct that is still in the early stages of study. Limitations of the
study and further research are mentioned.

Autism spectrum disorder (ASD) and developmental language disorder

(DLD) are two prevalent neurodevelopmental disorders, with incidence rates
of about 1% and 7%, respectively. These illnesses are distinguished by social,
communication, and language problems, and young individuals with ASD and
DLD often have lower mental health than their neurotypical peers. Play-based
therapies have been demonstrated to improve positive mental health
outcomes in children with ASD but not in those with DLD. However, there
have been no high-quality research on the effectiveness of such therapies in
children with DLD. Francis et al., (2022) examine the evidence from
experimental trials on the efficacy of play-based therapies for mental health in
children and adolescents with ASD and DLD. The research used a
comprehensive systematic review strategy, which included a thorough
systematic search of seven academic databases, double abstract screening,
and full-text screening, to find papers using randomized controlled trial (RCT)
and quasi-experimental (QE) methods. The findings revealed that play-based
therapies tend to benefit positive mental health in children with ASD, but not
poor mental health in children with DLD. More study is required to determine
how frequently used play-based therapies aimed to enhance young people's
social, communication, and language needs affect the mental health of
children with ASD or DLD.

Outcomes of Play Therapy

Individuals must pursue higher education in order to build the skills

and knowledge required for future occupational success. Traditional teaching
techniques often use lecture-based training, which promotes passive learning.
However, student participation is critical to learning. In counselor education
programs, hands-on teaching approaches are favored over lecture-based
ones. According to Taylor et al., (2017) study, counselors-in-training (CITs)
go through developmental phases, moving from black-and-white to
relationship and process thinking. This transition corresponds to the
educational movement from modernist to constructivist thinking in counseling
school classes. Counselor educators want to help students evolve from "black
and white" thinkers to thoughtful practitioners. They also support knowledge
topic areas and abilities necessary for counselor training. Research on
learning and pedagogical techniques in counselor education is scarce,
particularly in play therapy settings. A qualitative study looking at the impact
of a constructivist-developmental structure on student knowledge acquisition
in a play therapy counseling course found that it was helpful in encouraging
professional growth.

Play is essential to children's development because it provides

enjoyable, instructive, creative, and stress-relieving chances for
communication and relationship-building. It helps youngsters develop self-
awareness, self-esteem, and self-respect while also increasing confidence via
the acquisition of new abilities. The therapeutic power of play may be divided
into eight categories: communication skills, emotional regulation, relationship
consolidation, ethical judgment, stress management, ego-boosting, life
preparation, and self-actualization. According to Sorunlari (2018), play
therapy has been documented in many cultures throughout history, and its
efficacy in assisting children with emotional and behavioral disorders is
proved by 25 therapeutic variables. These include self-expression, access to
the unconscious, direct and indirect instruction, abreaction, and stress
inoculation. Self-expression enables children and teenagers to express their
emotions and start the healing process. Direct and indirect teaching enhances
learning and motivation, while abreaction helps youngsters to vent their
traumatic experiences and establish a feeling of control. Stress inoculation
assists youngsters in overcoming anticipated life situations by using model
coping techniques. Play therapy is an effective psychotherapy strategy for
treating children and adolescents since it is an important part of childhood
and has become a standard intervention in counseling settings. It is carried
out in a supportive setting, enabling children to express their feelings and
perspectives on themselves and others via play. This article will define play
therapy, establish its efficacy, and discuss current difficulties related to its
usage.

Factors Influencing Play Therapy Efficacy

Play therapy is commonly used for young individuals aged 10 to 18

who struggle to regulate their anger, emotions, ideas, and actions. Client
Centered Play Therapy (CCPT) is an effective strategy for dealing with
aggressive behavior because it seeks to find the underlying reasons of violent
conduct via observable behavioral changes. CCTP varies from cognitive
behavior therapy in that it emphasizes self-regulation, behavioral control, and
executive functioning. Bent et al., (2022) focuses on young individuals with
minor intellectual impairments and examines the literature for common and
distinctive features in play therapy treatments. The study's goal is to
determine the efficacy of play therapy for these people, with an emphasis on
the nonverbal component. Play therapy is a kind of psychotherapy designed
for children that is also utilized for persons with intellectual impairments. The
most often stated aspect is the therapeutic partnership, which includes both
therapeutic skills and attitude. Despite its widespread usage among young
individuals with minor intellectual impairments, there is little proof of its
benefit and efficacy.

Externalizing behavior issues in children may have a severe influence

on their academic, social, and mental health. These concerns might vary from
disobeying the rules to engaging in violent conduct, which often leads to
problems with social behavior and emotional control. Socioemotional abilities,
such as empathy and emotion management, protect against behavioral
issues. Vazifehghelichi (2023) study investigates the efficacy of child-centered
play therapy (CCPT) in decreasing externalizing difficulties and improving
socioemotional competences in children aged 3–12. CCPT employs play as a
natural language to foster a therapeutic interaction between play therapists
and children, offering a secure space for children to express themselves and
build self-regulation skills. However, the effect of CCPT in improving
socioemotional abilities is unclear. The study's weaknesses include a lack of
research in this area and limited sample numbers, which prevent
extrapolation to all groups. Future study should give a more complete picture
of how CCPT minimizes externalizing difficulties and the skills it teaches
children to deal with them.

The effectiveness of play therapy underscores its holistic approach to

addressing behavioral and psychological challenges in children and
adolescents, spanning from developmental conditions like ASD and DLD to
internalizing issues such as depression and anxiety. Play therapy's therapeutic
mechanism focuses on fostering self-expression, social cognition, and
empathy, with customized interventions addressing specific needs like
resilience-building or chronic health issues. Various factors, including client-
centered approaches and the importance of socioemotional skills, influence
the effectiveness of play therapy, highlighting the intricacies of its
implementation and advocating for further research to develop personalized
therapies for diverse patient populations.
 CHAPTER III

RESEARCH METHODOLOGY

This chapter presented the research design which was considered

appropriate for the study. It includes the sample, the data gathering
procedure and analysis, the ethical considerations and the instrument used
for obtaining the necessary data to answer the stated problem of the study.

Research Design

This study utilized a phenomenological research design, an approach

that focuses on exploring individuals' lived experiences and subjective
interpretations of a specific phenomenon (Smith,2018) to pursue the research
question, perspective, and experiences of health workers at Stimulation and
Therapeutic Activity Center in play therapy among pediatric patients with
special needs. Using qualitative research design to determine the
understanding ideas, views, and experiences of 12 health workers that
providing play therapy in pediatric patients with special needs at Stimulation
Therapeutic Center (STAC) at AB Fernandez West, Babaliwan, Barangay
Poblacion Oeste, Dagupan City.

Sources of Data

The participants in this research study include 12 health workers

currently employed in the STAC who are willing to participate in this study.
Utilizing the purposive sampling technique, the study encompassed health
workers specializing in pediatric care, particularly with special needs
populations, at the Stimulation and Therapeutic Activity Center in Dagupan
City. Eligible therapists must possess qualifications in therapy, demonstrate
specialized experience in pediatric care, and express a willingness to
contribute to research endeavors.
Instrumentation and Data Collection

The researchers used a semi-structured interview guide to collect the

data. The interviews were conducted face-to-face after obtaining consent
from the participants. A total of 10 questions were included in the semi-
structured interviews, focusing on the participants' perceptions, experiences,
thoughts, and outcomes related to play therapy. With the participants'
permission, the structured interviews were recorded on audio and then
transcribed verbatim for data analysis.

Prior to collecting the data, the researchers sought approval from the
registered social worker. Ethical review and clearance were also requested
from the LNU university research ethics board. Furthermore, consent was
obtained from the participants after discussing the research objectives and
information.

Tools for Data Collection

The interview transcripts were utilized for the Colaizzi method to

provide a comprehensive understanding of health workers' perspectives and
experiences in using play therapy to assist pediatric patients with special
needs. This method entailed a thorough and structured examination of
individual experiences to uncover key themes and patterns within the data.
Through in-depth interviews, researchers engaged with participants to
capture their viewpoints, emotions, and outcomes following play therapy
sessions.

The goal of employing the Colaizzi method was to reveal the core
essence of participants' experiences, shedding light on the behavioral,
emotional, and developmental transformations resulting from play therapy. By
adopting the Colaizzi method in data collection, the study aimed to conduct a
comprehensive and detailed analysis of how play therapy addresses the
unique needs of pediatric patients with special needs.

Colaizzi's method, a qualitative research approach involving seven

steps, was followed. The researchers began by familiarizing themselves with
the phenomenon, identifying significant statements, formulating meanings,
clustering themes, developing an exhaustive description, seeking validation,
and maintaining the results. They then identified core themes and sub-
themes, integrated these into a comprehensive narrative, and sought
validation from participants or experts.

1. Familiarization with the The researcher immerses

Phenomenon themselves in the data
collected from interviews,
observations, or other
sources to gain a deep
understanding of the
phenomenon being studied.

2. Identifying Significant The researcher identifies

Statements significant statements or
quotes from the data that
capture the essence of the
participants' experiences
related to the phenomenon.

3. Formulating Meanings The researcher extracts

explicit and implicit meanings
from the significant
statements to uncover the
underlying themes, patterns,
and insights within the data.

4. Clustering Themes The researcher organizes the

extracted meanings and
themes into clusters or
groups based on similarities
and relationships to identify
core themes and sub-themes
that represent the essence of
the phenomenon.
5. Developing an Exhaustive The researcher develops an
Description exhaustive description of the
phenomenon by integrating
the clustered themes,
meanings, and significant
statements into a
comprehensive narrative that
captures the richness and
complexity of the
participants' experiences.

6. Seeking Validation The researcher validates the

findings and interpretations
with participants or experts
familiar with the
phenomenon to ensure the
accuracy, credibility, and
authenticity of the results.

7. Maintaining the Results The researcher maintains and

documents the results of the
analysis, including the
identified themes, meanings,
and descriptions, to provide a
detailed account of the
phenomenon and the insights
gained through the research
process.
 CHAPTER IV

RESULTS AND DISCUSSION

This chapter comprised the findings of the study, data presentation,

with careful and expanded analysis and interpretation of data extracted from
the participants. All of which were gathered at the Stimulation and
Therapeutic Activity Center, Dagupan City following the research title
“Exploring the Efficacy of Play Therapy among Pediatric Patients with Special
Needs”.

There were 2 main themes, and several subthemes were formulated

from the data gathered, these are:

SOP 1: What are the experiences of the pediatric patients with

special needs in relation to play therapy as perceived by health
workers?

a. The impact of play therapy to pediatric patients

Theme 1: Emotional Healing

Respondent 1: “Naobserve namin na mas naging masaya ang mga bata

after ng play therapy.”

(We observed that the children became happier after play therapy.)

Respondent 4. “Sa tulong ng play therapy, mas mahusay na magpahayag

ang mga nagiging kalmado na ang bata.”

(With the help of play therapy, children can express their emotions better.)

Respondent 9 “After ng play therapy, mapapansin na mas nagiging

kalmado na ang bata.”
(After play therapy, it will be noticed that the child is becoming calmer.)

Understanding and addressing the emotional needs of pediatric

patients with special needs is paramount in ensuring their holistic well-being.
These children often face unique challenges that can impact their emotional
health, such as communication difficulties, sensory sensitivities, and social
barriers. Research by Smith et al. (2020) highlights the importance of
recognizing and addressing these emotional needs early on, as they can
significantly influence the child’s development and ability to cope with their
condition.

Moreover, emotional regulation plays a vital role in the daily lives of

pediatric patients with special needs. Difficulties in managing emotions can
lead to behavioral issues, academic struggles, and strained interpersonal
relationships. Therefore, interventions aimed at promoting emotional
awareness and regulation skills are essential components of comprehensive
care plans for these individuals. By equipping them with effective coping
strategies and providing a supportive environment, healthcare workers can
help mitigate the negative impact of emotional challenges on the child’s
overall well-being.

Furthermore, it is crucial for healthcare providers to adopt a patient-

centered approach that acknowledges the individuality of each pediatric
patient with special needs. This involves actively listening to their concerns,
validating their emotions, and involving them in decision-making processes
regarding their care. Through such personalized care practices, healthcare
professionals can foster a sense of empowerment and self-efficacy in these
children, ultimately contributing to their emotional resilience and overall
quality of life (Smith et al., 2020)

Theme 2: Social Skills Development

Respondent 3: “Naging mas open sila at nag-eenjoy sa activities. Yung iba,

medyo shy at first, pero later on, nagiging mas engaged sila.”

(They become more open and enjoy the activities. Some are a bit shy at first,
but later on, they become more engaged.)
Respondents 8: “Yung bata ay nagiging relaxed at cooperative habang
tumatagal sa sessions. Sa una, may mga bata na hesitant pa, pero habang
tumatagal they get more comfortable, nagiging mas engaged sila at nag-
eenjoy.”

(The child becomes more relaxed and cooperative as the sessions go on. At
first, there are children who are still hesitant, but as time goes on, they get
more comfortable, they become more engaged and enjoy themselves.)

Respondent 10: “Kadalasan, ang feedback ng mga magulang ay positive.

Sinasabi nilang nag-iimprove ang social interactions ng kanilang anak.”

(Most of the time, feedback from parents is positive. They say their child's
social interactions are improving.)

Social skills are integral to children’s development, shaping their

interactions and relationships with peers and adults alike. However, pediatric
patients with special needs often face unique challenges in acquiring and
applying these skills. According to a study by Bellini and Akullian (2007),
children with autism spectrum disorder (ASD) commonly exhibit deficits in
social communication and interaction, making it difficult for them to engage
with others in meaningful ways. These challenges can extend to other
pediatric patients with various developmental disorders, such as attention
deficit hyperactivity disorder (ADHD) or intellectual disabilities, impacting their
ability to navigate social situations effectively.

The importance of addressing social skill development in pediatric

patients with special needs cannot be overstated, as these skills are crucial
for their overall well-being and integration into society. Interventions tailored
to the specific needs of each child, such as social skills training programs and
behavioral therapies, have shown promise in improving social functioning and
enhancing quality of life (White et al., 2011). By providing early and targeted
interventions, healthcare professionals can support pediatric patients with
special needs in developing the social skills necessary for successful social
interactions and relationships, ultimately fostering their growth and
development.

Theme 3: Behavioral Improvements:

Respondent 6: “Isa sa mga napansin kong improvement ay ang pag-lessen
ng tantrums ng mga bata.”

(One of the improvements I noticed was the lessening of children's tantrums.)

Respondent 9: “Most parents report na nag-improve ang behavior ng

kanilang anak at mas naging cooperative na sila sa bahay.”

(Most parents report that their child's behavior has improved, and they have
become more cooperative at home.)

Respondent 12: “Nagiging focus ang bata tapos nag-improve rin ang kilos
at asal nila.”

(The child becomes focused, and their actions and behavior also improve.)

There was a growing acknowledgment and comprehension of the

distinct behavioral obstacles confronted by pediatric patients with special
needs. Studies conducted during this era illuminated various factors
influencing behavior, encompassing sensory sensitivities, communication
hurdles, and concurrent medical conditions. For instance, a study conducted
by Mayes et al. (2013) underscored the prevalence of coexisting psychiatric
disorders among children diagnosed with autism spectrum disorder (ASD),
highlighting the intricate interplay between behavioral manifestations and
underlying neurodevelopmental conditions.

Additionally, interventions customized to cater to the specific

requirements of pediatric patients with special needs garnered attention
throughout this decade. Approaches such as applied behavior analysis (ABA),
sensory integration therapy, and social skills training emerged as promising
methodologies for addressing behavioral challenges and enhancing the quality
of life for these individuals (Brookman-Frazee et al., 2012). By acknowledging
and tackling the unique behavioral profiles of pediatric patients with special
needs, healthcare professionals and caregivers became better equipped to
offer effective support and personalized interventions.

b. The barriers in providing play therapy

Theme 1: Trauma and Anxiety

Respondent 2: “Nagiging mahirap para sa mga patient na may trauma ang
magtiwala at makipag-ugnayan sa aming mga workers.”

(It becomes difficult for trauma patients to trust and interact with our
workers.)

Respondent 5: “Ang mga patient na may anxiety ay hindi makapag-focus sa

activity na part ng therapy.”

(Patients with anxiety cannot focus on the activity part of therapy.)

Respondent 8: “Kapag may anxiety ay madalas nahihirapan silang

maprocess ang activity na part ng therapy.”

(When there is anxiety, they often have difficulty processing the activity part
of the therapy.)

Trauma and anxiety pose significant challenges for pediatric patients

with special needs, impacting their overall well-being and complicating their
medical care. Children with special needs often encounter various stressors,
including medical procedures, social interactions, and sensory sensitivities,
which can contribute to the development or exacerbation of trauma and
anxiety symptoms. Additionally, communication barriers and limited coping
mechanisms may further intensify their experiences, highlighting the
importance for caregivers and healthcare providers to promptly recognize and
address these issues (Lavigne et al., 2012).

Understanding the prevalence and manifestations of trauma and

anxiety in this population is crucial for providing effective support and
interventions. Research indicates that pediatric patients with special needs
are at a heightened risk for experiencing traumatic events and developing
anxiety disorders compared to their typically developing peers (Katz et al.,
2011). Furthermore, the impact of trauma and anxiety can extend beyond
psychological distress, affecting their physical health, academic performance,
and social functioning. By acknowledging the unique needs of these
individuals, healthcare professionals can implement targeted interventions
that promote resilience and enhance their quality of life.

Theme 2: Cognitive Limitations

Respondent 3: “May mga patient na hirap maintindihan ang layunin ng mga
activity sa play therapy, then nagdulot ‘yon ng frustration at pagkalito nila.”

(When there is anxiety, they often have difficulty processing the activity part
of the therapy.)

Respondent 7: “Isa sa mga challenges ay ‘pag ang bata ay nahihirapan sa

verbal expression o sa pag-unawa ng kanilang sariling emosyon, kasi
pwedeng makapigil ‘yon sa ability nilang makipag-communicate sa amin.”

(One of the challenges is when the child has difficulty with verbal expression
or understanding their own emotions, because that can hinder their ability to
communicate with us.)

Respondent 11: “Isa sa mga challenges ay ang cognitive limitations ng mga

bata, tulad ng mahirap silang makapag-focus sa mga activities o hindi nila
agad naiintindihan ang instructions.”

(One of the challenges is the cognitive limitations of the children, such as

difficulty focusing on activities or not immediately understanding the
instructions.)

Cognitive limitations among pediatric patients with special needs

present unique challenges in healthcare settings, often requiring tailored
approaches to diagnosis, treatment, and care. These limitations encompass a
spectrum of conditions including developmental disabilities, intellectual
disabilities, and neurodevelopmental disorders, such as autism spectrum
disorder (ASD). Understanding the cognitive profiles of these individuals is
crucial for healthcare providers to effectively communicate, engage, and
deliver appropriate interventions. According to a study by Miodrag et al.
(2020), cognitive limitations in pediatric patients with special needs
significantly impact their ability to comprehend and express themselves,
potentially hindering accurate assessment and exacerbating healthcare
disparities. Consequently, healthcare professionals must adopt patient-
centered strategies that accommodate these cognitive differences to ensure
equitable access to quality care for this vulnerable population (Miodrag et al.,
2020)

Theme 3: Short Attention Spans

Respondent 1: “Meron kaming patient na madaling mawalan ng interes sa
mga activity na part ng play therapy.”

(We have a patient who easily loses interest in activities that are part of play
therapy.)

Respondent 7: “Ang ibang patient ay biglang tumitigil sa activity na

ginagawa kasi nadidistract sila sa tunog sa paligid.”

(Other patients suddenly stop the activity they are doing because they are
distracted by the sound around them.)

Respondent 12: “Ang pinaka challenging is yung ikeep ang interest ng child
at attention.”

(The most challenging part is keeping the child's interest and attention.)

The challenges faced by pediatric patients with special needs in

healthcare settings, particularly regarding attention and focus during medical
appointments, have been highlighted in a recent study by LeBourgeois et al.
(2020). This research emphasizes that children with conditions like autism
spectrum disorder or ADHD may have shorter attention spans compared to
their neurotypical peers, necessitating a nuanced approach to care. Strategies
such as sensory accommodations and visual aids are crucial in managing
attentional issues during appointments, as highlighted by the study's findings.

Moreover, LeBourgeois et al. (2020) underscore the broader impact of

short attention spans on the engagement of pediatric patients in therapeutic
and educational activities. Tailored interventions that address the attentional
needs of these children are essential for fostering learning and skill
development. By acknowledging and addressing these attentional challenges,
healthcare providers, educators, and caregivers can collectively contribute to
the holistic well-being and development of pediatric patients with special
needs.

Play therapy has shown significant effectiveness in fostering emotional

healing, social skills development, and behavioral improvement among
pediatric patients with special needs. Through the utilization of play, this
therapeutic method creates a safe space for children to express and process
their emotions. With the guidance of trained health workers, children can
 navigate their feelings, reduce anxiety, and cultivate resilience, resulting in
tailored emotional healing. Furthermore, play therapy facilitates social skills
development through interactive sessions where children learn cooperation,
communication, and empathy. Under the direction of skilled health workers,
children gain the necessary tools and confidence to engage with their peers
effectively, promoting positive relationships and social integration. In essence,
play therapy offers a comprehensive intervention that addresses the diverse
needs of pediatric patients with special needs, providing opportunities for
emotional expression, social advancement, and behavioral progress.

Conceptual Framework

PLAY
THERAPY

DEVELOPMENTAL
BEHAVIORAL
OUTCOMES OUTCOMES

EMOTIONAL
OUTCOMES
 CHAPTER V

SUMMARY OF FINDINGS, CONCLUSION, RECOMMENDATION

This chapter presents the summary of the study, the formulated

conclusions, and recommendation that were derived from the analysis and
interpretation of the findings from the data gathered.

Summary of Findings

Health workers' insights into the play therapy experiences of

pediatric patients with special needs.

According to the data study, the research underscores the significant

impact of play therapy on the emotional, social, and behavioral well-being of
young patients. Engaging in play fosters increased joy, better emotional
expression, and reduced agitation, leading to stronger social competencies
and positive parental feedback on social interactions. Through meaningful
connections, play therapy equips pediatric patients with valuable skills for
navigating social dynamics and feeling more confident within their
communities.

In addition to emotional and social benefits, play therapy also yields

tangible behavioral improvements, such as decreased tantrums, enhanced
cooperation, and improved focus at home. These outcomes illustrate how
play therapy not only addresses emotional and social needs but also
encourages positive behavior. Through tailored interventions, play therapy
becomes an essential component of pediatric care, providing comprehensive
support to address diverse needs and promote overall well-being.

However, play therapy for pediatric patients with special needs

encounters significant challenges, including trauma, anxiety, cognitive
limitations, and short attention spans. Overcoming these obstacles
necessitates a comprehensive approach that includes building trust,
accommodating cognitive differences, managing attentional challenges, and
fostering collaboration among caregivers, educators, and health workers. By
addressing these complex barriers, play therapy can offer equitable access to
quality care and enhance holistic well-being for all pediatric patients.

Recommendations

Based on the findings and conclusions of the study the researchers

wants to recommend that:

To improve the efficacy of play therapy for pediatric patients with

special needs, health workers should implement a tailored and individualized
approach. Play therapy interventions should be customized to address the
unique needs of each child, taking into account their specific conditions and
developmental stages. Continuous training for health workers in the latest
play therapy techniques and evidence-based practices is essential to ensure
effective delivery. Collaboration among therapists, pediatricians, educators,
and caregivers is crucial to establish a cohesive and supportive environment
for the child. Furthermore, incorporating feedback from children and their
families provides valuable insights that help refine therapeutic strategies.
Regular assessment and documentation of the child's progress are necessary
to adapt therapy and maximize its benefits. By adhering to these
recommendations, health workers can significantly enhance the outcomes of
play therapy for pediatric patients with special needs, supporting their overall
development and well-being.

For parents considering play therapy for their children with special
needs, understanding its potential benefits in fostering emotional, social, and
cognitive development is crucial. Play therapy provides a secure and
structured environment where children can express their emotions, process
their experiences, and develop essential coping mechanisms. Parental
involvement is key to the success of this therapy. Parents are encouraged to
collaborate closely with the health workers, support therapeutic play activities
at home, and observe therapy sessions when appropriate. This participation
helps reinforce therapeutic progress, enhances parents' insight into their
child's emotional world, and contributes to a nurturing home atmosphere.
Maintaining open lines of communication with the health workers is vital to
ensure that the therapy is tailored to the child's unique needs and that their
progress is continuously assessed. By working together, parents and health
workers can significantly enhance the effectiveness of play therapy, resulting
in improved outcomes for children with special needs.

Future researchers delving into the efficacy of play therapy among

pediatric patients with special needs should prioritize longitudinal studies to
gauge both short-term and long-term outcomes. Diverse samples and
rigorous control groups are crucial to fortify the validity of findings. Employing
standardized measures to evaluate various domains of functioning, like
emotional regulation, social skills, and adaptive behavior, would offer
comprehensive insights into the intervention's effectiveness. Additionally,
integrating qualitative methodologies to capture the subjective experiences of
both children and caregivers can deepen the understanding of the therapeutic
process. Exploring potential moderators and mediators of treatment
outcomes, such as the type and severity of the special need, family dynamics,
and health workers characteristics, could inform tailored intervention
approaches.
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