The use of sandplay psychotherapy with an adolescent who has poor self-esteem

Abstract

The purpose of this study was to explore and describe the potential use of Sandplay psychotherapy with an adolescent who presented with poor self-esteem. In conducting my research I assessed one adolescent’s selfesteem by means of quantitative and qualitative measures and identified potential aspects that might require intervention, related to self-esteem. After the initial assessment, Sandplay psychotherapy was implemented as intervention, after which the participant’s self-esteem was re-assessed, comparing the results with those obtained during the initial assessment (baseline data). For the purpose of my study, I fulfilled the role of researcher, involving an intern educational psychologist in assessing the participant and conducting the intervention, thereby fulfilling the role of therapist. I followed a triangulation mixed methods intervention research approach, primarily relying on the interpretivist paradigm yet being informed and elaborated upon by a post-positivist component. I studied a single clinical case situated within the context of psychotherapy outcome research. This enabled me to draw conclusions on how suitable and helpful Sandplay psychotherapy might be (or not) for an adolescent who presented with poor self-esteem. In collecting quantitative data, I employed the Self-Esteem Index (Brown&Alexander, 1991) both prior to and after the intervention had been completed. In support, a qualitative post-modern assessment was included in the form of the Rosebush technique (Oaklander, 1988). Other qualitative data collection and documentation measures include observations, semi-structured interviews (with the participant and her parents), photographs of the sand trays and a semi-structured reflection journal (of the participant), as well as reflection journals of the researcher and therapist. Based on the pre- and post-assessments I was able to compare results of the participant’s self-esteem before and after the Sandplay psychotherapy intervention had been completed. Subsequent to thematic qualitative data analysis and my comparison of the quantitative results I obtained, three main themes emerged. Firstly, the self-esteem of the participant seemed to have improved following the intervention, since her limited self-knowledge, feelings of inferiority and her uncertainty in unknown situations seemingly changed into age-appropriate self-knowledge, feelings of self-worth and facing the unknown. Secondly, she displayed changes in the emotional domain of development post-intervention. She seemed more content with her situation, reportedly feeling more safe and secure as opposed to feeling academically pressured, as was the case at the onset of my study, and having a positive future perspective. Thirdly, changes in her social domain of development occurred as she displayed age-appropriate skills, acted more assertively and felt more accepted and ready to establish relationships. Based on the findings of my study, I can conclude that it seems possible to facilitate the improvement of adolescents’ self-esteem by conducting Sandplay psychotherapy. Besides an improvement in terms of overall self-esteem, the participant in my study seemingly displayed improvement in the areas of relationships and social skills, as well as conflict resolution skills.