Enhancing Assertiveness in Childhood Anxiety: A Randomized Controlled Comparison of Solution-Focused Skills Training,Acceptance and Commitment Therapy-Based Play Therapy

Background: Anxiety disorders represent one of the most prevalent mental health concerns in childhood and can substantially impair social and emotional functioning. The present study compared the effectiveness of two child-centered interventions—Solution-Focused Child Skills Training (SF-CST) and Acceptance and Commitment Therapy-based Play Therapy (ACT-based PT)—in promoting assertiveness among children with anxiety. Methods: This randomized controlled trial employed a pretest–posttest–follow-up design. Sixty female students aged ۹–۱۲ with a psychiatrist-confirmed diagnosis of social anxiety disorder or generalized anxiety disorder were recruited via convenience sampling from schools in District ۵, Tehran, during the ۲۰۲۴–۲۰۲۵ academic year. Participants were randomly assigned to three groups (n = ۲۰ per group): SF-CST, ACT-based PT, and a wait-list control group. Each intervention consisted of eight weekly ۶۰-minute sessions. Moreover, assertiveness was measured using the Gambrill and Richey Assertion Inventory at pretest, posttest, and three-month follow-up. Data were then analyzed using repeated-measures ANOVA followed by Bonferroni post-hoc tests in SPSS version ۲۶. Results: Both intervention groups exhibited significant improvements in assertiveness scores relative to the control group (p<۰.۰۰۱). The ACT-based PT group showed significantly greater gains in assertiveness than the SF-CST group at both posttest and follow-up (p<۰.۰۱). Treatment gains were sustained at the three-month follow-up in both intervention groups, with no significant deterioration observed. Conclusion: ACT-based PT proved more effective than SF-CST in enhancing assertiveness among children with anxiety. The greater efficacy of ACT-based PT may stem from its focus on psychological flexibility, emotional acceptance, and values-based action—core mechanisms that directly address experiential avoidance and fear-related responses characteristic of anxiety.

کلیدواژه ها:

Assertiveness ، Anxiety disorders ، Child ، Psychotherapy ، Acceptance and commitment therapy