The Implementation of Sand Tray Therapy in Managing Mood Disorders among Adolescents in Primary Care: A Case Report

Vol. 21 No. 6 (suppl) : 2026 (7-12)

Irham Nordeena Muhammad Irham Nordeena Muhammad
Noor Azimah Muhammad Noor Azimah Muhammad
 Nurul Farehah Md Isa Nurul Farehah Md Isa
Ku Suhaila Ku Johari Ku Suhaila Ku Johari

Abstract
Depression and anxiety are common mental health disorders that can affect individuals across all age groups, including adolescents. These conditions can profoundly influence multiple dimensions of their lives. This case report aims to highlight the effectiveness of sand tray therapy (STT) as a counselling treatment modality for managing mood disorders among adolescents within primary care settings. This case report illustrated a 14-year-old girl who presented with a year-long history of depression and anxiety exacerbated by parental separation, school challenges, and psychosocial stressors. Diagnosed with generalised anxiety disorder and major depressive disorder, she received sertraline, psychoeducation and STT, alongside family psychotherapy sessions. Through her STT, she managed to share her innermost worries and find a way to overcome the emotions. Towards the end of the sessions, she showed significant improvement and she started reconnecting with her hobbies, enjoying school and building a stronger family relationship. The case highlights the value of a multimodal therapeutic approach in counselling, and particularly STT for adolescents with mood disorders. Early intervention can prevent severe long-term complications and support healthier adolescent developmental outcomes.  
Keywords : Anxiety; counselling; depression,
Abstrak
Kemurungan dan kebimbangan ialah gangguan kesihatan mental yang biasa berlaku dan boleh menjejaskan individu merentasi semua peringkat umur, termasuk remaja. Keadaan ini memberi kesan mendalam terhadap pelbagai aspek kehidupan mereka. Laporan kes ini menekankan keberkesanan terapi dulang pasir (sand tray therapy, STT) sebagai kaedah rawatan kaunseling dalam pengurusan gangguan emosi dalam kalangan remaja di penjagaan primer. Laporan ini memaparkan kes seorang remaja perempuan berusia 14 tahun yang mempunyai sejarah kemurungan dan kebimbangan selama setahun disebabkan oleh isu perpisahan ibu bapa, cabaran persekolahan dan tekanan psikososial. Beliau didiagnosis mengalami gangguan kebimbangan umum dan gangguan kemurungan utama dan diberikan ubatan sertraline, pendidikan psikologi dan STT, di samping sesi psikoterapi keluarga. Melalui STT, beliau dapat meluahkan kebimbangan paling dalam dan menemui cara untuk mengatasi emosi tersebut. Menjelang penghujung rawatan STT, beliau menunjukkan peningkatan yang ketara; mula melakukan semula hobinya, menikmati suasana sekolah serta lebih rapat dengan ahli keluarga. Kes ini menekankan kepentingan pendekatan terapeutik multimodal dalam kaunseling, khususnya STT bagi remaja yang mengalami gangguan emosi. Intervensi awal mampu mencegah komplikasi jangka panjang yang serius serta menyokong perkembangan remaja yang lebih sihat.
Kata Kunci : Kaunseling; kebimbangan; kemurungan,

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