The Role of Play Therapy and Art Therapy in Reducing Post-Traumatic Stress in School-Aged Children: Systematic Review

Introduction: Post traumatic stress disorder (PTSD) in school aged children can result from exposure to traumatic events such as accidents, abuse, natural disasters, or witnessing violence. PTSD in this age group is associated with emotional dysregulation, academic decline, social withdrawal, and long term mental health risks. Play therapy and art therapy, as developmentally appropriate and expressive interventions, enable children to process trauma through symbolic and creative activities, thereby reducing symptom severity and improving emotional resilience. This systematic review aimed to evaluate the effectiveness of play therapy and art therapy in reducing PTSD symptoms among children aged ۶-۱۲ years. Methods: Following PRISMA guidelines, a comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library, covering January ۲۰۱۰ to April ۲۰۲۵. Keywords included "play therapy," "art therapy," "post traumatic stress disorder," "children," and "school aged." Randomized controlled trials, quasi experimental studies, and pre post designs evaluating these therapies were included. Studies without validated PTSD outcome measures or non school aged populations were excluded. Methodological quality was appraised using the Joanna Briggs Institute (JBI) checklist. Due to heterogeneity in intervention designs and assessment tools, a narrative synthesis was undertaken. Results: Seventeen studies, involving ۱,۰۳۲ participants, met the inclusion criteria. Intervention durations ranged from ۶ to ۱۲ weeks, with sessions delivered in school, community, or clinical settings. Twelve studies reported significant reductions in total PTSD symptom scores (pooled standardized mean difference [SMD] = -۰.۵۸; ۹۵% CI: -۰.۷۴ to -۰.۴۲). Improvements were most notable in re experiencing and avoidance subscales. Programs combining both play and art therapy modalities yielded the greatest overall effect. Conclusion: Evidence suggests that play therapy and art therapy are effective, child friendly interventions for reducing PTSD symptoms in school aged children. Their integration into trauma focused pediatric mental health services may facilitate recovery and enhance psychosocial functioning. Further large scale RCTs are needed to determine optimal program length, setting, and therapeutic components.

کلیدواژه ها:

Play Therapy ، Art Therapy ، Post Traumatic Stress Disorder ، School Aged Children ، Pediatric Mental Health