Effects of Sandplay Therapy on Behavioral Problems and Cerebral Blood Oxygen Saturation in Adolescents

Effects of Sandplay Therapy on Behavioral Problems and Cerebral Blood Oxygen Saturation in Adolescents

This study aims to examine the effects of Sandplay therapy on behavioral problems and cerebral blood oxygen saturation in adolescents. Ten adolescents aged 13-15 participated in 8 individual Sandplay therapy sessions over the course of 8 weeks. Behavioral problems were assessed both before and after the therapy, while cerebral blood oxygen saturation was measured using functional near-infrared spectroscopy (fNIRS) during each session. These measurements were taken in two conditions: during the creation of sandpictures and during the conversation of the created sandpictures and their associations with the therapist. The therapy was administered individually by three experienced sandplay therapists, each with over 1,000 hours of experience. The Korean Youth Self Report (K-YSR) and fNIRS were used to evaluate the effects of Sandplay therapy. The findings revealed significant reductions in both externalized and internalized behavioral problems among the adolescents. In the sandpicture creation condition, cerebral blood oxygen saturation significantly increased in the right frontopolar prefrontal cortex (FPC) from before to after Sandplay therapy. In later sessions, there was a significant increase in cerebral blood oxygen saturation in several regions, excluding the right orbitofrontal cortex (OFC), left FPC, left dorsolateral prefrontal cortex (DLPFC), and left ventrolateral prefrontal cortex (VLPFC). During the conversation condition, there was a significant increase in cerebral blood oxygen saturation in both the right and left FPCs from pre-to post-therapy. Additional increases in cerebral blood oxygen saturation were observed in the second half of the sessions, except in the left DLPFC and left VLPFC. These results suggest that Sandplay therapy not only helps alleviate behavioral problems as self-reported by participants, but also enhances cerebral blood oxygen saturation in the frontal cortex, thereby activating its functions. While previous studies have primarily focused on self-reported behavioral changes, this study is notable for its measurement of increased cerebral blood oxygen saturation, which reflects the level of brain activity during Sandplay therapy.