Experiences of Emotional Healing After Figurines Intervention in Rural Thai Primary School Children: A Mixed-method Study

Authors

1 Department of Psychiatric and Mental Health Nursing, School of Nursing, Excellence Center of Community Health Promotion, Walailak University, Thailand

2 School of Nursing, University of Wisconsin-Madison, Madison, USA

Abstract

Background: Early emotional difficulties, even when not clinically diagnosed, may affect children’s social and academic development. Emotional healing can enhance children’s emotional awareness and coping skills, potentially preventing future mental health issues. This study aimed to explore the lived experiences of emotional healing after figurines intervention in rural Thai primary school children.
Methods: This study employed a mixed-method research design, including two parts: first, a pre- and post-test design, and second, a descriptive phenomenological approach. It was conducted from March to May 2025 at a rural primary school in Tha Sala District, Nakhon Si Thammarat Province, Thailand. 22 students who met the criteria for mild to moderate depressive symptoms based on the Patient Health Questionnaire for Adolescents (PHQ-A) 9 scores participated in a school-based healing program using miniature figurines; nine of them who completed the program were purposively selected with parental consent to share their experiences through semi-structured individual interviews. Data were thematically analyzed using Colaizzi’s phenomenological method, and saturation was reached when no new themes emerged.
Results: PHQ-A mean scores for the 22 participants decreased from pre-test (10.05±2.87) to post-test (4.09±1.41), (P=0.01). PHQ-A mean scores for the 9 students in the qualitative study decreased from pre-test (10.78±2.33) to post-test (3.33±0.87), (P=0.08). The qualitative findings were consistent with healing and showed a decrease in PHQ-A scores. The healing stories of 9 Thai school children showed awakening self-awareness, emotional healing, and developing personal growth.
Conclusion: The figurine intervention promotes emotional self-exploration, which can increase self-confidence in emotion management and build resilience in Thai school children.

Keywords

References

1.    Lu B, Lin L, Su X. Global burden of depression or depressive symptoms in children and adolescents: A systematic review and meta-analysis. Journal of Affective Disorders. 2024;354:553-62. 
2.    Xu DD, Rao WW, Cao XL, et al. Prevalence of depressive symptoms in primary school students in China: A systematic review and meta-analysis. Journal of Affective Disorders. 2020;268:20-7. 
3.    Department of Mental Health, Ministry of Public Health. In the COVID era, depression is closer than you think. Thailand: Department of Mental Health, Ministry of Public Health; 2022. [Cited 20 May 2025]. Available from: https://dmh.go.th/news-dmh/view.asp?id=31448 [In Thai]
4.    Aekwarangkoon S, Thanathammathee P. Associated patterns and predicting model of life trauma, depression, and suicide using Ensemble Machine Learning. Emerging Science Journal. 2022;6:679-93.
5.    Choi KW, Lee YH, Liu Z, et al. Social support and depression during a global crisis. Nature Mental Health. 2023;1:428-35.
6.    Pudpong N, Julchoo S, Sinam P, et al. Self-reported anxiety and depression among parents of primary school children during the COVID-19 pandemic in Thailand, 2022. International Journal of Environmental Research and Public Health. 2023;20:5622.
7.    Piao J, Huang Y, Han C, et al. Alarming changes in the global burden of mental disorders in children and adolescents from 1990 to 2019: A systematic analysis for the Global Burden of Disease study. European Child & Adolescent Psychiatry. 2022;31:1827-45.
8.    Yang W, Sun R., Wang C, et al. Epidemiology of depressive disorders among youth during Gaokao to college in China: Results from Hunan Normal University mental health survey. BMC Psychiatry. 2023;23:481.
9.    Ransri J. Mental health and well-being of Thai youth: Addressing the growing crisis. Journal of Modern Academic Social Science. 2024;1:14-25. [In Thai]
10.    Willmot RA, Sharp RA, Amir K, et al. A scoping review of community-based mental health intervention for children and adolescents in South Asia. Global Mental Health. 2022;10:e1.
11.    Paulus FW, Ohmann S, Mohler E, et al. Emotional dysregulation in children and adolescents with psychiatric disorders. A narrative review. Frontiers in Psychiatry. 2021;12:628252.
12.    Supreeyaporn N, Sakulsriprasert C. The effects of mental health literacy program (The CARE) for secondary school teachers. Journal of Education Studies. 2024;52:1-12. [In Thai]
13.    Ford T, Esposti MD, Crane C, et al. The role of schools in early adolescents’ mental health: Findings from the MYRIAD study. Journal of the American Academy of Child & Adolescent Psychiatry. 2021;60:1467-78.
14.    Taggart RR. Madeleine De Little, Where words can’t reach: Neuroscience and the Satir Model in the Sand Tray. Satir International Journal. 2016:4:114-6. 
15.    Rojjananukulpong R, Ahmad, MM, Saqib S. Disparities in physical accessibility among rural Thai under universal health coverage. American Journal of Tropical Medicine and Hygiene. 2021;105:837-45.
16.    Bosgraaf L, Spreen M, Pattiselanno K, et al. Art therapy for psychosocial problems in children and adolescents: A systematic narrative review on art therapeutic means and forms of expression, therapist behavior, and supposed mechanisms of change. Frontiers in Psychology. 2020;11:584685. 
17.    Wu JF, Chung CY. Art therapy as an intervention for children: A bibliometric analysis of publications from 1990 to 2020. SAGE Open. 2023;13:1-16.
18.    Panyawong W, Pavasuthipaisit C, Santitadakul R. Validation of the Thai version of the Patient Health Questionnaire for Adolescents (PHQ-A) in school setting. Journal of Mental Health of Thailand. 2022;30:38-48. [In Thai]
19.    Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M, editors. Existential Phenomenological Alternatives for Psychology. New York: Oxford University Press; 1978. p. 48-71. 
20.    Morrow R, Rodriguez A, King N. Colaizzi’s descriptive phenomenological method. The Psychologist. 2015;28:643-4.
21.    Thomas SP, Pollio HR. Listening to patients: A phenomenological approach to nursing research and practice. US: Springer Publishing Company; 2002. 
22.    Adler RH. Trustworthiness in qualitative research. Journal of Human Lactation. 2022;38:598-602.
23.    Anney VN. Ensuring the quality of the findings of qualitative research: Looking at trustworthiness criteria. Journal of Emerging Trends in Educational Research and Policy Studies. 2014;5:272-81.
24.    Mei F, Wang Z. Trends in mental health: A review of the most influential research on depression in children and adolescents. Annals of General Psychiatry. 2024;23:36.
25.    Jutaronsaga M., Amornrojanavaravutti W, Wattananon W, et al. Transformative education: The collaboration between educational institutes and healthcare service providers in communities. Nursing Journal of the Ministry of Public Health. 2019;29:1-17. [In Thai]
26.    Cozzolino M, Vivo DR, Celia G. School-based mind-body interventions: A research review. Human Arenas. 2022;5:262-78.
27.    Durlak JA, Mahoney JL, Domitrovich CE. How Roger Weissberg accomplished his vision to help millions of schoolchildren: Our personal perspectives. Social Emotion Learning: Research, Practice, and Policy. 2025;4:100123.
28.    Huang KY, Nakigudde J, Kisakye EN, et al. Advancing scalability and impacts of a teacher training program for promoting child mental health in Ugandan primary schools: Protocol for a hybrid-type II effectiveness-implementation cluster randomized trial. International Journal of Mental Health Systems. 2022;16:28.
29.    Jayuphan J, Sangthong R, Hayeevani N, et al. Mental health problems form direct vs indirect exposure to violent events among children born and growing up in a conflict zone of southern Thailand. Social Psychiatry and Psychiatric Epidemiology. 2020;55:57-62.
International Journal of Community Based Nursing & Midwifery
Volume 13, Issue 4 - Serial Number 52
October 2025
Pages 258-273

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