The Role of Sandplay Therapy in the Treatment of Adolescents and Young Adults With Co-Occurring Substance Use Disorders and Trauma
Abstract
This study explored the effectiveness of the Bonding through Experiential Adventures in Recovery (BEAR) program and the role of sandplay therapy in addressing the complex needs of youth (ages 14-24) with co-occurring trauma and substance use disorders. BEAR incorporated sandplay therapy, adventure therapy, art therapy and recovery-oriented supports in addition to the evidence-based, 16-week Matrix Model intensive outpatient treatment program. A mixed methods quasi-experimental design was utilized to evaluate the program. Data was collected through questionnaires at approximately 2-month intervals—admission, midway through treatment, and at discharge. Separate focus groups were held with youth, parents, and staff with their responses evaluated using grounded theory. Results demonstrate that the youth who participated in BEAR significantly improved daily functioning at home, school, and in their community, and reduced the severity of their substance use problem and symptoms of distress associated with trauma exposure. Sandplay therapy positively impacted engagement in treatment with youth endorsing sandplay as the most helpful part of the program. The role of sandplay therapy in the treatment of trauma and addictions is discussed, along with implications for further research.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
BEAR participants and clinicians reported significant improvement in trauma-related distress.
“and trauma-related distress”
BEAR participants and clinicians reported significant improvement in severity of substance use problems, with the clinician-rated substance use subscale falling from 2.39 to 1.48.
“participants and clinicians reported significant improvements in severity of SU problems (clinician-rated SU subscale reduced from 2.39 to 1.48, p=0.001)”
The BEAR study was rated weak in quality because of a small sample and unclear selection bias, completion, and follow-up.
“Although study quality is weak, with a small sample, unclear selection bias, completion, and follow-up”
Creative and expressive therapies may help improve engagement in intensive substance use disorder programs among youth with a history of trauma.
“it suggests that creative/expressive therapies may help improve engagement in intensive SUD programs among youth with a history of trauma.”
In BEAR focus groups, youth spoke positively about the sandplay component.
“In focus groups youth spoke positively of the sandplay component.”
A couple of studies included creative and expressive components that were reportedly popular, suggesting that including such techniques may increase retention among at least a subset of youth.
“A couple studies included creative/expressive components, which were reportedly popular, suggesting inclusion of creative/expressive techniques may be a method of increasing retention among at least a subset of youth [61, 64].”
Cited by
Sorted by citations
Becker, T. D., Castañeda Ramirez, S., Bruges Boude, A., Leong, A., Ivanov, I., & Rice, T. R. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-023-02265-x · Cited by 18 · see citing works
- Authors
- Freedle, L. R., Altschul, D. B., & Freedle, A.
- Venue
- Journal of Sandplay Therapy
- Publisher
- Sandplay Therapists of America
- Published
- 2015
- Volume
- 24
- Issue
- 2
- Pages
- 127-145
- OpenAlex
- W4404737516
- Cited by
- 10
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2020: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Arts and Humanities › Conservation › Art Therapy and Mental Health
- Keywords
- sandplay therapy, adolescents and young adults, adventure therapy, art therapy, matrix models, intensive outpatient treatment, trauma exposure, treatment engagement, daily functioning
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
