International Journal of Science and Research (IJSR)

ISSN: 2319-7064
ResearchGate Impact Factor (2018): 0.28 | SJIF (2018): 7.426

Assess the Effectiveness, of Group Play Therapy for

Preschool Children on Reduction of Preschooler
Separation Anxiety Disorder
Seema Hiwale1, Vishakha D. Ganvir2
Godavari College of Nursing, Jalgaon, Maharashtra, India

Assistant Professor, Godavari College of Nursing, Jalgaon, Maharashtra, India

Abstract: Play therapy is a form of counseling or psychotherapy that uses play to communicate with and help people, especially
children, to prevent or resolve psychosocial challenges. This is thought to help them towards better social integration, growth and
development, emotional modulation, and trauma resolution. The various research studies are done to reduce the school phobia among
the children by providing different play therapies or strategy to reduce children separation anxiety disorder. This study was based on
Quantitative and evaluative approach. The method used for this study was Non equivalent control group pre test post test design i.e.,
quasi experimental research design. 60 samples were selected with non-probability purposive sampling technique which divided into two
control group (30) and experimental group (30). Sample selection was based on inclusive and exclusive criteria. The tools used for this
study was modified preschool separation anxiety scale with including selected Demographic variables, which was prepared on the basis
of review of literature, various information & informal discussion with the patients. While data collection process followed the ethical
consideration such as written permission was obtained from school authority and informed written consent obtained from mothers of
preschool children. Based on the objectives and the hypothesis the data were analyzed by using various statistical tests. Analysis of data
showed that there is significant difference between pre test and post test level preschooler separation anxiety disorder in experimental
group. The calculated „t‟ values are much higher than the tabulated values. Hence it is statistically interpreted that the group play
therapy for preschool children was effective to reduce the preschooler separation anxiety disorder.

Keywords: Group Play Therapy, Preschooler, Separation Anxiety Disorder, Phobia, School Environment

1. Introduction right place for the child‟s foundation for lifelong progress.
The skills and knowledge that the child develops in the Pre
“Play gives children a chance to practice what they are School have a great impact on the aptitude and attitude of
learning” the child later in life. Anxiety disorders are among the most
Mr. Roger frequently occurring childhood disorder with prevalence
estimates approaching 10% among preschool children.
Play is a child, natural medium to learn, communicate & Advances in early childhood assessment, albeit still largely
explore their world. Play therapy allows children to explore depends on parental reports, now make it easible to study
feeling & make sense of an recover from difficult life anxiety symptoms in young children.3
experiences in a safe & trusting environment. Play therapy
helps children understands Confused feeling & upsetting The pre-schoolers took part in a two-hour study using of
events. Play therapy helps the children work through various scenarios designed to detect if the child has an
emotional, social & behavioural disabilities& helps address anxious disposition or not. The researchers prompt the child
family problems. Use of medium of play, rather than talk, to to show a range of emotion and behaviours through these
help the child learn to express themselves, explore & make scenarios. The study included leaving the participants in a
sense of the world in which they live & resolve any difficult room with a stranger and playing with new, exciting toys.
or painful express.1 The episodes were each recorded through a one-way mirror
for later coding. Coding is the process of labelling the
A Preschool, also known as nursery school, pre primary observations made by the researchers so that the data can be
school, playschool or kinder garden, is an educational compared and analyzed. Over 90% of the parents and
establishment or learning space offering early childhood preschool participants returned for another lab session. This
education to children before they begin compulsory was to assess child and parent interaction. This included six
education at primary school. Going to Pre School is „A small tasks ranging from book reading to block building. Over 400
step for a giant exposure in a child‟s life‟. This is the first mothers and 400 fathers also completed a questionnaire
exercise in which children are separated from the comfort based on parenting style.4
and secure zone of their parents. Therefore, it has to be a
place which is a second home to the child; a place, which 2. Literature Survey
has enough material to attract and make the child feel
comfortable.2 A study was conducted to determine Maternal separation
anxiety is a construct that describes a mother's experience of
This is the first place where the child builds his/her self- worry, sadness, or guilt during short-term separations from
esteem. A child learns the importance of his own name, her child. This investigation examined potential differences
things and friends. Every child learns to communicate with in psychological correlates between mothers with high and
his teachers and fellow students in the Pre School. It is the low levels of anxiety when their children were 8 months, 3
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Paper ID: ART20198371 10.21275/ART20198371 157
 International Journal of Science and Research (IJSR)
ISSN: 2319-7064
ResearchGate Impact Factor (2018): 0.28 | SJIF (2018): 7.426
1/2 years, and 6 years of age. High levels of maternal Jamshid Jarareh et. al. (2016) conducted this study was to
separation anxiety had different psychological correlates investigate the effectiveness of group play therapy in
contingent upon the age of the child. Depressive preschooler children creativity and adhesion control. The
symptomatology and separation anxiety were unrelated at research method was experimental along with pre test post
times 1 and 2, but when the children were 6 years old, test design in control group. the major findings of the
mothers who had the highest levels of anxiety tended to have research indicate that group play therapy in preschool
more depressive symptomatology, fewer coping skills, a children creativity and aggression has a significant effect. 39
more negative representation of self, and embraced more
traditional sex-role values. Study findings are discussed with 3. Problem Definition
respect to their relevance to the mother's role as
developmental partner to the child and linked to major “Experimental study to assess the effectiveness of group
theoretical perspectives that address the mother-child play therapy for preschool children on reduction of
relationship.11 preschooler separation anxiety disorder among the mothers
of preschool children in selected urban area.”
This longitudinal study explored how adult mental
representations of attachment relationships and memories of 4. Objective
childhood experiences with parents contributed to a mother's
anxiety about separation from her own infant. The Maternal 1) To assess the effectiveness of group play therapy on
Separation Anxiety Scale, the Adult Attachment Interview, reduction of preschooler separation anxiety disorder
and the Mother–Father–Peer Scale were administered to a among the mothers of preschool children.
sample of 49 first-time mothers. The mothers with insecure 2) To assess the existing level of preschooler separation
attachment representations, when asked to remember details anxiety among the mothers of preschool children.
of their own childhood, reported more negative recollections 3) To associate the pre test level of preschooler separation
of early parental care giving, particularly rejection and anxiety score among the mothers of preschool children
discouragement of independence. When their own infants with their selected demographic variable.
were 2 months old, these mothers experienced heightened 4) To correlate the post test level of preschooler separation
levels of maternal separation anxiety. The findings provide anxiety score of experimental group with control group.
theoretical and empirical support for the view that very high
levels of maternal separation anxiety may indicate
dysfunction.12 5. Material and Methods

Soodabeh et. al. (2011) done the research is to investigate Non Equivalent Control Group Pre Test Post Test Design
the efficiency of family management training in reducing (Quasi Experimental Research Design) was chosen for this
anxiety difficulties in preschooler children (4 to 6 year) in study. In the present study sample were divided into two
Ahvaz. Total 50 mothers were randomly chosen and divided group control group and experimental group in which pre
into experimental and control groups. Result is multivariate test was administered by means of Modified preschool
analysis of covariance demonstrate that experimental separation anxiety scale for both the group depicted as P1
intervention is efficient in reduction of children and then Group Play Therapy was given only for
anxiety.(p=0.03) the result indicate that family anxiety experimental group depicted as X, a post test was conducted
management training has been effective in reduction of using the same Modified preschool separation anxiety scale
anxiety disorder in anxious children. Therefore, it can be again for both the group depicted P2.The study design is
useful strategy as an educational and preventive programe in depicted as –
preschool and school children.22
Group Pre Test Group Play Therapy Post Test
Control group P1 -- P2
Kimberly howard et. al. (2011) done research to examined
Experimental group P1 X P2
association between early mother child separation and
subsequent maternal parating behavior and children outcome
A quantitative Evaluative approach was found to be more
in a sample of 2080 families. Result is the effect of
appropriate to assess the effectiveness of group play therapy
separation on child aggression at age 5 was mediated by
for preschool children on reduction of preschooler
aggression at age 3, suggesting that the effect of separation
separation anxiety disorder. The proposed study was
on children‟s aggressive behavior are early and persistent.23
undertaken in at selected urban area. The population and
samples were preschooler mothers who were fulfilling the
Fatemeh Mollamohammadi et. al. (2017) done research to
inclusion and exclusion criteria and the sample consisted of
evaluate play therapy on social skill and social anxiety in
sixty preschooler mothers which is divided into two groups
preschool anxiety the methodology of this study was
control and experimental group equally. The sampling
experimental with a pretest post test in case and control
technique used in this study was non-probability purposive
groups the population consists of all preschool children
sampling. Tools used for data collection include two section
result the result indicated that play therapy could be
namely demographic variable and Modified preschool
effective in reduction of anxiety and the findings imply that
separation anxiety scale.
play therapy can be helpful in solving the problems related
to social anxiety and social skill disorder.38

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Licensed Under Creative Commons Attribution CC BY
Paper ID: ART20198371 10.21275/ART20198371 158
 International Journal of Science and Research (IJSR)
ISSN: 2319-7064
ResearchGate Impact Factor (2018): 0.28 | SJIF (2018): 7.426
6. Results post test anxiety. Hence it proves the effectiveness of group
play therapy.
Modified preschool separation anxiety scale is used for data
collection. The analysis was done with the help of Section IV
descriptive and inferential statistics. Deals with analysis of data related to the association of the
pre test level of preschooler separation anxiety score among
SN Data analysis Method Remark the mothers of preschool children with their selected
1. Descriptive Frequency and To describe distribution of demographic variable
statistics percentage. demographic variable
Mean, standard To determine the level of 7. Discussion
deviation preschooler separation
anxiety disorder.
The findings of the study have been discussed with reference
2. Inferential Paired “t” test To compare the level of
statistics preschooler separation
to the objective and hypothesis. As per the findings of the
anxiety disorder. study it provide the description related to demographic
Unpaired “t” test Associate demographic variable, which shows majority of mothers were between the
and one way variables with level of age below 25 years, 36.67%. With primary education
ANOVA and Chi preschooler separation qualification and housewife. As well as majority of the
square test anxiety disorder. mothers in this study belongs to nuclear family, and they are
having two children and majority of the mothers having poor
The data was analyzed and is presented in the following information regarding the separation anxiety disorder.
sections:-
In this study the investigator also assess the level of
Section I separation anxiety disorder of mothers of preschool children.
Deals with analysis of demographic data of the mothers of So findings shows that majority of the mothers pursue the
preschool children in selected urban area in terms of average information regarding the effectiveness of play
frequency and percentage. therapy on reduction of separation anxiety.

Section II The present study also Shows significant difference in the

Deals with analysis of data related to assessment of the pre and post test anxiety level.
existing preschooler separation anxiety disorder among the
mothers of preschool children in selected urban area in terms 8. Conclusion
of frequency and percentage.
Anxiety is normal, but highly subjective human emotion
Section III while normal anxiety serves a beneficial and adaptive
Deals with analysis of data related to assess the effectiveness purpose, anxiety can also become the cause of tremendous
of group play therapy for preschool children on reduction of suffering for millions of people. Separation anxiety is
preschooler separation anxiety disorder among the mothers common in children. It may be hard to see your child visibly
of preschool children in selected urban area upset by your departure. Separation anxiety is normal in
young children, until they age 3-4 years, when children are
Experimental Frequency Mean S.D. t value P value left in a daycare or preschool, away from their parent or
Pre 30 57.76 5.09 31.04 0.000 primary caregiver it is also important to note significant life
Post 30 34.76 2.64 changes experienced by the child either previous to or
present at the onset of the disorder.
The comparisons of the pre test and post test means of the
anxiety of experimental group were done by the paired t test. According to the investigator assess the level of separation
The pre test average score was 57.76 with standard deviation anxiety of mothers of preschool children regarding the
of 5.09. The post test average score was 34.76 with standard effectiveness of group play therapy findings and analysis of
deviation of 2.64. The test statistics value of the paired t test data shows that mothers of preschool children having the
was 31.04 with p value 0.00. Shows significant difference in poor information regarding separation anxiety disorder but
the pre and post test anxiety level. after provision of play therapy there is significant difference
in the pre and post test anxiety level. So as per findings, I
Anxiety POST Frequency Mean S.D. t value P value
accept the hypothesis H1 and H2.
Experimental 30 34.77 2.65 14.83 0.000
Control 30 51.27 5.49
9. Future Scope
The comparisons of the post test means of the anxiety of
experimental & control group were done by the unpaired t The future scope of this study has implications for nursing
test. The post test average score for experimental group was administration, nursing education, nursing research and
34.77 with standard deviation of 2.65. The post test average nursing practice.
score of control group was 51.27 with standard deviation of
5.49. The test statistics value of the unpaired t test was 14.83 Nursing Practice
with p value 0.000. Shows the significant difference in the School teachers are the appropriate persons for helping
mothers to increase their knowledge regarding effectiveness

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Paper ID: ART20198371 10.21275/ART20198371 159
 International Journal of Science and Research (IJSR)
ISSN: 2319-7064
ResearchGate Impact Factor (2018): 0.28 | SJIF (2018): 7.426
of group play therapy on reduction of preschooler separation 47:3/4 (2006), pp 313–337doi:10.1111/j.1469-
anxiety. Pediatric health nurse can conduct health education 7610.2006.01618.
to improve the knowledge of mothers regarding separation [5] Hock E, Schirtzinger MB. Maternal separation anxiety:
anxiety of preschool children. its developmental course and relation to maternal
mental health Child Dev. 1992 Feb;63(1):93-102.
Nursing Education [6] Wilma J. Lutz &Ellen Hock Maternal Separation
Nursing education is developing rapidly in India and nurse Anxiety: Relations to Adult Attachment Representations
from our country can be found all over the world providing in Mothers of Infants Pages 57-72 | Received 25 Aug
care and education. The nursing education curriculum must 1994, Published online: 06 Jul.
include imparting knowledge about the use of various audio [7] Soodabeh. Bassak, Fahimeh Poloi-Shaporabadi, Iran
visual aids and teaching strategies. Davoudi ( 2011), “Efficiency of family anxiety
management training with mothers of anxious preschool
Now a days much importance is given to awareness and children, Davoudil.Journal, ZJRMS 2014;vol-16 issue
promotion of health than the curative aspects. As the needs (5):Page no 45 to 49.
of society are continuously changing newer components [8] Kimberly, Howard, Anne Martin, Lisa J. Berlin, and
must be incorporated in the nursing curriculum. Nursing Jeanne Brooks-Gunn “Early mother child separation,
education must emphasize on preventive and rehabilitative parenting and child well being in early head start
aspects. families Journal of HHS Public asses: Humdev 2011
jan;vol-13 issue (1):Page no 5 to 26.
The nursing teachers can use the result of the study as an [9] Fatemeh Mollamohammadi & Fariba Yazdkh; “Effect
informative illustration for the students. Nursing students of play therapy of social anxiety and increasing social
must be able to recognize the importance of knowledge of skill in preschool children; Midiyeh international
mothers on child separation anxiety. Nursing students can journal of educational researches.Year:2017, Vol-
conduct educational programmes, role plays, workshop, and 3/Issue:2/Page:128-132.
campaign regarding play therapy for separation anxiety and [10] Jamshid Jarareh, Aref Mohammadi, Maghsoud Nader &
its prevention in the community to educate the community. Seyyed Akbar Moosavian Stefan Elmer. june(2016)
“The impact of group play therapy on creativity and
Nursing Administration control of aggression in preschool children, Journal.
As a part of administration, the nurse administrator plays a Cogent psychology/Vol-3; Issue-1.
vital role in educating clients and students nurse. Nursing
administration can depute nurse for various workshops, Author Profile
conference, and special courses; and also in-service
education programs can be arranged for nursing staff. Ms. Seema Hiwale is the Nursing student of master
degree in Child Health Nursing of Godavari college of
This study suggests that nurse administrations should Nursing, Jalgaon. Under Maharashtra University of
conduct in service education for the nursing staff about Health Sciences, Nasik, Maharashtra.
effectiveness of group play on separation anxiety and its
Miss. Vishakha Ganvir, Assistant Professor, Child
preventive measures. These findings will help the Health Nursing Department, Godavari College of
administrator to implement health education program on Nursing, Jalgaon
prevention of separation anxiety during school health camps.

Nursing Research
Nursing research is an essential aspect of nursing as it uplifts
the profession and develop new nursing norms and a body of
knowledge The study can be published in journal to
disseminated knowledge about child separation anxiety. The
nurse researcher should motivate the clinical nurse to apply
the research findings in practice.

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