The mental health of adolescents in Hong Kong and the effect and process of sandplay therapy

Abstract

Adolescence is a period of development when there are rapid bio-physiological changes, psychosocial development and brain development, which contributes to the rapid rise of the prevalence of mental health issues such as depressive episode in this population (Urdan & Klein, (1998). Non-directive, client-centered psychosocial interventions such as expressive art therapies have been shown to be welcomed by youths with mental health issues. Sandplay therapy is a type of expressive therapy which requires little or no artistic skills for participants to freely express themselves through the use of sand, water, and figurines in a sandtray under the witness and support of a trained therapist. Two related studies were conducted for a mental health project; the first study is a survey on the mental health of 2669 young adolescents and the related social and personal variables. It was found that the quality of marital relationship between parents had a significant effect on adolescents' emotion in both intact and non-intact families, after taking into account the effect of parent-child relationship. Personality and self-esteem were found to be strong predictors to the negative affects as well as to happiness. Family relationships affected adolescents' emotion more extensively than teacher-student relationship and peer relationship. Peer relationship was related to the positive emotional experience but was less related to negative emotions. Non-clinical adolescents with severe mood disturbances were identified in study I and entered study II. Study II is an evaluation of two modalities of group intervention, cognitive behavioural therapy and sandplay therapy. 110 students were selected from 1840 students of 7 schools to participate in this second phase. Four schools (n=60) were randomly assigned to run sandplay therapy, and 3 schools (n=50) to run CBT; the students in each school were further randomly assigned into treatment group or waitlist control group. In study II, trends of decrease were observed in the internalizing problems in adolescents after receiving SPT. Participants who received longer (16 sessions) group sandplay therapy showed continuous decrease in both internalizing problems and externalizing problems. With reference to the results of study I, preliminary analysis on the sandplay scenes were conducted. Participants who experienced more difficult family relationships may tend to express this in their first sandplay scene.