The Effectiveness of Sandplay Therapy in Treating Generalized Anxiety Disorder Patients With Childhood Trauma Using Magnetic Resonance Spectroscopy to Examine Choline Level in the Dorsolateral Prefrontal Cortex and Centrum Semiovale

Generalized anxiety disorder (GAD) is a chronic psychological disorder that involves impairments in brain functioning. Sandplay therapy (SPT) has been shown to be successful in treating GAD symptoms, but few studies have been performed to investigate the efficacy of SPT in the treatment of GAD patients with childhood trauma (CT) using neuroimaging. This study investigated the efficacy of SPT in treating GAD symptoms using the Hamilton Anxiety Rating Scale (HAM-A) and the Generalized Anxiety Disorder Scale-7 (GAD-7) as clinical indicators of anxiety and also measured choline levels (a brain metabolite) in the dorsolateral prefrontal cortex (DLPFC) and centrum semiovale (CSO) using Magnetic Resonance Spectroscopy. Participants in this study were GAD patients with CT (n = 7) and healthy controls (n = 2) ages 21-40 years old. Treatment involved 30 sessions of SPT. Using a pre-post design, clinical assessments and neuroimaging measurements were conducted with a comparison of means statistical analysis. The findings showed significant improvement in symptoms of anxiety and choline levels moving into the healthy range or trending toward the healthy range in both the DLPFC and CSO. This research concludes that SPT is effective in treating symptoms of GAD with CT, and may also enhance brain metabolites. Limitations will be addressed, along with suggestions for further research.