Effect of Play Therapy and Mindfulness for Reducing Anxiety on Children's Concentration after COVID-19 Lockdowns

This study compares the effect of play therapy and mindfulness-based stress reduction (MBSR) on students’ concentration after the COVID-19 lockdowns in 2022. The research design was semi-experimental with two experimental groups and one control group, along with pre-test and post-test. Students in the fourth grade of Alishahr All-Girls Primary School comprised the statistical population of the research, 45 of whom were selected by random two-stage cluster sampling, with 15 randomly placed in each of the play therapy, mindfulness and control groups. The control group did not receive any training. The D2 test of attention (Brickenkamp, 2002) was used. Each experimental group received special training during 8 weekly one-hour sessions. ANCOVA showed that MBSR explains 0.28 of the variance in attention, and unlike play therapy for anxiety reduction (r = 0.90), has a significant positive effect on attention. This study has important theoretical and practical implications for mindfulness in relation to concentration.
Introduction
This study was conducted to compare the effect of play therapy and mindfulness-based stress reduction (MBSR) on the concentration of female students in the fourth year of school at Alishahr Primary School in 2022 at the end of COVID-19 lockdowns with the re-opening of schools.
Prevention, diagnosis and timely treatment of common children's mental health problems by psychologists is crucial (Ogundele, 2018, p. 9). Developments in cognitive and emotional theory show that anxiety plays a relatively central role in negative emotions (Chorpita & Barlow, 2018, p. 227). One of the common psychological consequences of the COVID-19 pandemic, with little information available on its effective treatment, was anxiety (Zadafshar et al., 2022, p. 575). Anxiety impacts concentration (Moradi et al., 2020), and in educational settings, it is associated with confusion and scattered thoughts, thus damaging the students’ concentration and continuous attention and disrupting their mental integrity (Yarimoghadam et al., 2020, p. 203).
Play therapy is an efficient method to reduce anxiety and social problems and incompatibility (Butcher & Nice, 2005).
Goldin (2008, pp. 144-146) considered MBSR effective in managing and modulating anxiety and preventing its harmful consequences among children. Dunning et al. (2019) stated that "mindfulness-based interventions are a growing method to improve the behavioral, cognitive and mental health outcomes of children and adolescents" and found significant benefits concerning depression, anxiety and stress. Morais et al. (2021) showed that regular practice of mindfulness reduces stress and anxiety. In most studies, however, mindfulness intervention has been used for adults, though its use during childhood could be even more appropriate, since children experience many things for the first time, which is exactly what mindfulness tries to establish as the "initiator mind" (Hooker & Fodor, 2008, p. 82).
The three main hypotheses in this research are: 1. MBSR impacts concentration. 2- Play therapy for anxiety reduction impacts concentration. 3- MBSR and play therapy differ in terms of impact on concentration.
Methodology
This semi-experimental has multiple experimental groups and a control group. The female students in the fourth year of school at Alishahr Primary School in Bushehr in academic year 2022 formed the statistical population. A total of 45 students were assigned to three groups of 15 (two experimental groups and one control group) and received psychological interventions from the researcher. Mindfulness and play were used as therapy. The samples were selected by two-stage, cluster, random sampling. Alishahr city was first chosen to hold the training sessions, and one of its primary schools was then randomly chosen, and the fourth grade was selected. The three groups matched in terms of gender (girls). Their mean age was 9.58±0.29 years.
The D2 test of attention was used to measure concentration. This test was developed in 1962 after WWII by Brickenkamp in Essen, Germany (Brickenkamp, ​​2002). In 1970, the second edition of the test was adapted and standardized for the age range of 9-60 years. In Iran, Fariborz Bagheri standardized this test. The D2 test is used to measure selective attention, concentration and effort (Bagheri, 2012). The construct validity of the test has been reported as 0.99 abroad (Bagheri, 2012). Psychologically, the face validity of the D2 test of attention can be justified by observing the respondent’s behavior and his report of the test after administration. The respondents’ report clearly shows that performing the D2 test requires high selective attention (concentration) (Bagheri, 2017). Despite the differences in statistical population and internal consistency calculation methods, all the coefficients obtained in previous studies exceeded 0.9, showing very high reliability.
Results
One-way ANCOVA was used to investigate the hypothesis "MBSR impacts concentration".
A significant difference existed between the control and mindfulness groups in terms of concentration (P<0.05). The mean changes in concentration were higher in the mindfulness than control group. Examining the discriminant eta squared (effect size) showed that MBSR explains 0.28 of the variance in concentration, confirming the first hypothesis.
One-way ANCOVA was used to investigate the hypothesis "Play therapy for anxiety reduction impacts concentration".
The difference in concentration changes between the play therapy and control groups was not significant (P>0.05), thus rejecting the second hypothesis.
ANCOVA findings confirmed the third hypothesis, “MBSR and play therapy differ in terms of impact on concentration”.
Discussion and conclusion
This study compared the effect of play therapy and mindfulness on concentration in primary school students at the end of COVID-19 lockdowns. Play therapy unveils children's feelings, and mindfulness focuses on the current situation to free the mind from judgment and anxiety-provoking futurism, thus forming two powerful arms of this research that can help manage anxiety and stress. The conscious person tries to bring certain stimuli to his attention and leave others out –a work that is consistent with the nature of attention; as a result, the nature of MBSR to increase attention made the result significant. Play therapy for reducing anxiety did not significantly improve concentration. This disparity can be explained by comparing the nature of play therapy for anxiety reduction and MBSR technique. The timed administration of the D2 test might have made the children anxious, while the students in the mindfulness group had learnt relaxation techniques to use under difficult circumstances. Anxiety can disrupt the response process and impact concentration (Moradi et al., 2020). The limitations of this study included the small sample size and not controlling variables such as children from the different groups playing together outside the school time, which reduces the generalization of the findings to other ages and places (Delavarpour et al., 2024, p. 17). It is suggested to include play therapy and mindfulness in educational programs to enhance children’s happiness and relaxation. Teachers and educators, who have a lot of contact with children, are expected to include mindfulness in their teachings.
I express my gratitude to the study participants and their parents as well as the Professors of Psychology at Persian Gulf University in Bushehr, Iran.