A efetividade da Terapia do Sandplay em crianças vítimas de maus tratos com problemas de comportamento internalizantes e externalizantes
Palavras-chave:
Psicoterapia breve, Abuso da criança, Transtorno de comportamento infantil, Psicoterapia da criança, Crianças abrigadasResumo
O presente estudo tem como objetivo investigar o efeito da Terapia do Sandplay no tratamento de crianças vítimas de maus tratos e com problemas de comportamento internalizantes e/ou externalizantes. Participantes: 60 crianças vítimas de maus tratos e institucionalizadas. O instrumento Child Behavior Checklist foi aplicado nas crianças avaliadas, todas com idades entre 6 anos e 6 meses e 10 anos e 11 meses, de 24 instituições. Todas apresentaram níveis clínicos e/ou limítrofes. Por sorteio, foi determinado em qual instituição as crianças seriam grupo controle e em quais receberiam tratamento com terapia de Sandplay (grupo experimental) ou tratamento placebo. O mesmo instrumento foi aplicado após tratamentos ou 20 semanas; no grupo experimental houve testagem após seis meses. Os resultados demonstram que as crianças do grupo experimental apresentaram melhoras significativas. Essas mudanças ainda eram perceptíveis seis meses após o término da terapia e foram verificadas pela análise dos cenários de Sandplay
Downloads
Referências
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-age forms & profiles. Burlington: University of Vermont.
Adams, K. (2007). Reconnecting to the source: recovering from sexual molestation. Journal of Sandplay Therapy, 16(2), 55-73.
Augusti, E. M., Baugerud, G. A., Sulutvedt, U., & Melinder, A. (2018). Maltreatment and trauma symptoms: does type of maltreatment matter? Psychological Trauma: Theory, Research, Practice, and Policy, 10(4), 396-401. http://dx.doi. org/10.1037/tra0000315
Balfour, R. N. (2008). Evolution of sandplay images in healing: a case of childhood sexual abuse of a 36-year-old woman. Journal of Sandplay Therapy, 17(2), 33-49.
Callegaro B. J., & Tiellet N. M. L. (2011) Prevalência de problemas de comportamento em uma amostra de crianças em idade escolar da cidade de Porto Alegre. Aletheia, 34, 32-46
Cecil, A. M., Essi, V., Pasco, F., Glaser, D., & McCrory, J. (2017). Disentangling the mental health impact of childhood abuse and neglect. Child Abuse and Neglect, 63(1), 106-119. http://dx.doi.org/10.1016/j.chiabu.2016.11.024
Centro de Combate à Violência Infantil. (2009). Dados científicos. Violência física – Estatísticas: dados estatísticos, principais características, perfil da vítima, perfil do agressor, etc. Curitiba: CECOVI.
Cowel, R., Cicchetti, D., Rogosch, F., & Toth, S. (2015). Childhood maltreatment and its effect on neurocognitive functioning: timing and chronicity matter. Development and Psychopathology, 27(2), 521-533. http://dx.doi. org/10.1017/S0954579415000139
D’Andrea, W. D., Ford, J., Stolbach, B., Spinazzola, J., & van Der Kolk, B. A. (2012). Understanding interpersonal trauma in children: why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82(2), 187-200. htttp://dx.doi.org/10.1111/j.1939-0025.2012.01154.x
Doyle, K., & Magor-Blatch, L. E. (2017). “Even adults need to play”: sandplay therapy with an adult survivor of childhood abuse. International Journal of Play Therapy, 26(1), 12-22. http://dx.doi.org/10.1037/pla0000042
Friedman, H., & Mitchell, R. (1994). Sandplay: past, present, and future. New York: Routledge.
Hecker, T., Boettcher, V. S., Landolt, M. A., & Hermenau, K. (2019). Child neglect and its relation to emotional and behavioral problems: a cross-sectional study of primary school-aged children in Tanzania. Development and Psychopathology, 31, 325-339. http://dx.doi.org/10.1017/S0954579417001882
Helton, J. J., Gochez-Kerr, T., & Gruber, E. (2017). Sexual abuse of children with learning disabilities. Child Maltreatment, 23(2), 157-165. http://dx.doi.org/10.1177/1077559517733814
Hermann, S. B. (2008). Treatment of an abandonment trauma. Journal of Sandplay Therapy, 17(2), 51-73.
Hermann, S. B. (2011). Transformation of violence: the case of Jacob. Journal of Sandplay Therapy, 20(1), 117-132.
Hildyard, K. L., & Wolfe, D. A. (2002). Child neglect: developmental issues and outcomes. Child Abuse and Neglect, 26, 679-695. https://doi.org/10.1016/S0145-2134(02)00341-1
Hodges, M., Godbout, N., Briere, J., Lanktree, C., Gilbert, A., & Kletzka, N. T. (2013). Cumulative trauma and symptom complexity in children: a path analysis. Child Abuse and Neglect, 37(11),891-898. http://dx.doi.org/10.1016/j. chiabu.2013.04.001
Hong, G. (2011). Sandplay Therapy: research and practice. New York: Routledge.
Hovens, J. G. F. M., Giltay, E. J., van Hemert, A. M., & Penninx, B. J. H. (2015). Childhood maltreatment and the course of depressive and anxiety disorders: the contribution of personality characteristics. Depression and Anxiety, 33(1), 27-34. http://dx.doi.org/10.1002/da.22429
Howe, D. (2005). Child abuse and neglect: attachment, development and intervention. London: Palgrave MacMillan.
Infurna, M. R., Reich, C., Schimmenti, A., Bifulco, A., & Kaess, M. (2016). Associations between depression and specific childhood experiences of abuse and neglect: a meta-analysis. Journal of Affective Disorders, 190(15), 47-55. http:// dx.doi.org/10.1016/j.jad
Kalff, D. M. (2003). Sandplay: a psychotherapeutic approach to the psyche? Santa Monica: Sigo Press.
Kirke-Smith, M., Henry, L. A., & Messer, D. (2015). The effect of maltreatment type on adolescent executive functioning and inner speech. Infant and Child Development, 25(6), 516-532. http://dx.doi.org/10.1002/icd
Knox, J. (2011). Self-agency in psychotherapy (attachment, autonomy and intimacy). London: Routledge.
Lewis, T., McElroy, E., Harlaar, N., & Runyan, D. (2016). Does the impact of child sexual abuse differ from maltreated but non-sexually abused children? A prospective examination of the impact of child sexual abuse on internalizing and externalizing behavior problems. Child Abuse and Neglect, 1, 31-40. http://dx.doi.org/10.1016/j.chiabu016
McLaughlin, K. A., & Sheridan, M. A. (2016). Beyond cumulative risk: a dimensional approach to childhood adversity. Current Directions in Psychological Science, 25(4), 239-245. http://dx.doi.org/10.1177/0963721416655883
Mello, M. F., Faria, A. A., Mello, A. F., Carpenter, L. L., Tyrka, A., & Price, L. H. (2009) Maus-tratos na infância e psicopatologia no adulto: caminhos para a disfunção do eixo hipotálamo-pituitária-adrenal. Revista Brasileira de Psiquiatria, 31(2), 41-48. http://dx.doi.org/10.1590/S1516-44462009000600002
Muniz, C. N., Fox, B., Miley, L. N., Delisi, M., Cigarran, G. P., & Birnbaum, A. (2019). The effects of adverse childhood experiences on internalizing versus externalizing outcomes. Criminal Justice and Behavior, 46(4), 568-589. http:// dx.doi.org/10.1177/0093854819826213
Oswald, S. H., Heil, K., & Goldbeck, L. (2010). History of maltreatment and mental health problems in foster children: a review of literature. Journal of Pediatric Psychology, 35(5), 462-472. https://doi.org/10.1093/jpepsy/jsp114
Parlar, M., Frewen, P., Nazarov, A., Oremus, C., MacQueen, G., Lanius, R., & McKinnon, M. C. (2014). Alterations in empathic responding among women with posttraumatic stress disorder associated with childhood. Brain and Behavior, 4(3), 381-389. http://dx.doi.org/10.1002/brb3.215
Ramos, D. G., & Matta, R. M. (2008). Sandplay: a method for data analysis. Journal of Sandplay Therapy, 17(2), 93-115.
Read, J., Harper, D., Tucker, I., & Kennedy, A. (2018). Do adult mental health services identify child abuse and neglect? A systematic review. International Journal of Mental Health Nursing, 27, 7-19. http://dx.doi.org/10.1111/inm.12369
Rocha, M. M., Pereira, R. F., Arantes, M. C., & Silvares, E. F. M. (2010). Guia para profissionais da saúde mental sobre o Sistema Achenbach de Avaliação Empiricamente Baseada (ASEBA). São Paulo: Universidade de São Paulo.
Roesler, C. (2019). Sandplay therapy: an overview of theory, applications and evidence base. The arts in Psychotherapy, 64, 84-94. http://dx.doi.org/10.1016/j.aip.2019.04.001
Rosen, A. L., Handley, E. D., Cicchetti, D., & Rogosch, F. A. (2018). The impact of patterns of trauma exposure among low-income children with and without histories of child maltreatment. Child Abuse and Neglect, 80, 301-311. http:// dx.doi.org/10.1016/j.chiabu.2018.04.005
Schore, A. N. (2003). Affect regulation and the repair of the self. New York: W.W. Norton & Company.
Schore, A. N. (2007) Psychoanalytic research, progress, and process: developmental affective neuroscience and clinical practice. Psychologist-Psychoanalyst, 27(3), 6-15.
Silva, R. W. S., Azambuja, C. V., & Santana, A. (2015) Perfil de crianças e adolescentes vítimas de maus-tratos atendidos em ambulatório de psicologia da região sul do Brasil. Aletheia, 47, 136-141.
Sowell, M., Leon G., & van Liew, C. (2019). The effects of stage of onset and type of abuse on cooperation and aggression in children. Journal of Articles in Support of the Null Hypothesis,16(1), 1-10.
Toth, S. L., & Manly, J. T. (2019) Developmental consequences of child abuse and neglect: implications for intervention. Child Development Perspectives, 13(1), 59-64. http://dx.doi.org/10.1111/cdep.12317
Vahl, P., van Damme, L., Doreleijers, T., Vermeiren, R., & Colins, O. (2016). The unique relation of childhood emotional maltreatment with mental health problems among detained male and female adolescents. Child Abuse and Neglect, 62, 142-150. http://dx.doi.org/10.1016/j.chiabu.2016.10.008
van Der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: the empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18, 389-399. http://dx.doi.org/10.1002/ jts.20047
van Westrhenen, N., Fritz, E., Vermeer, A., Boelen, P., & Kleber, R. (2019). Creative arts in psychotherapy for traumatized children in South Africa: an evaluation study. Plos One, 14(2), e0210857. http://dx.doi.org/10.1371/journal. pone.0210857
Vasileva, M., & Petermann, F. (2018). Attachment, development, and mental health in abused and neglected preschool children in foster care: a meta-analysis. Trauma, Violence and Abuse, 19(4), 443-458. http://dx.doi. org/10.1177/1524838016669503
Viodres-Inque, S. R., & Ristum, M. (2008). Violência sexual: caracterização e análise de casos revelados na escola. Estudos de Psicologia (Campinas), 25(1), 11-21. http://dx.doi.org/10.1590/S0103-166X2008000100002
Warmingham, J. M., Handley, E. D., Rogosch, F. A., Manly, J. T., & Cicchetti, D. (2019). Identifying maltreatment subgroups with patterns of maltreatment subtype and chronicity: a latent class analysis approach. Child Abuse and Neglect, 87(1), 28-39. http://dx.doi.org/10.1016/j.chiabu.2018.08.013
Youjin, H., Yuseon, L., & Joo, H. S. (2017). Effects of a sandplay therapy program at a childcare center on children with externalizing behavioral problems. Arts in Psychotherapy, 52, 24-31. https://doi.org/10.1016/j.aip.2016.09.008
Zeanah, C. H., & Humphreys, K. L. (2018). Child abuse and neglect. Journal of the American Academy of Child and Adolescent Psychiatry, 57(9), 637-644. http://dx.doi.org/10.1016/j.jaac.2018.06.007
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Reinalda Melo da MATTA, Denise Gimenez RAMOS
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.