Effects of sandplay group therapy on children at risk of suicidal ideation

Abstract

Background: The recent surge in suicide rates of children and adolescents in Korea has become a social problem. Suicide and suicide attempts begin in children and adolescents and continue to progress, leading to serious suicide and suicide attempts, so early intervention is essential. This study investigated the effects of group sandplay therapy on depression, anxiety, and self-esteem in children at a risk of suicidal ideation.

Methods: This was a non-randomized, controlled trial. After recruiting 63 subjects at risk for suicidal ideation through convenience sampling based on a preliminary survey, the subjects were divided into a sandplay group therapy (SGT) group and a control group. The control group did not receive interventional therapy, whereas the SGT group received 10 sessions of sandplay therapy once a week, 40 min each. The clinical assessment instruments used were the Suicidal Ideation Questionnaire-Junior (SIQ-JR), Center for Epidemiologic Studies Depression Scale for Children (CES-DC), Revised Children's Manifest Anxiety Scale (RCMAS), and Rosenberg's Self-Esteem Scale (RSES). Statistical analysis was performed using IBM SPSS version 25.0, and multivariate analysis of variance (MANOVA) was used.

Results: Sandplay group therapy significantly reduced depression and anxiety in the SGT group at risk of suicidal thoughts compared to the control group, and also significantly improved self-esteem.

Conclusion: 10-week sandplay group therapy was effective in reducing depression and anxiety in children and improving self-esteem in children at risk of suicidal thoughts. The results of these interventions, first attempted in Korea, suggest that sandplay group therapy in schools can be an effective intervention for children and adolescents at risk of suicide. (Clinical Research Information Service (CRiS) of Republic of Korea, Registration Number: KCT0010738, Registration Date: 2025.07.09.).