A study on the effects of DIR/Floortime-based counseling program on emotional regulation in adolescents with ADHD symptoms
Main Article Content
Abstract
This study aimed to examine the effects of DIR/Floortime-based counseling on emotion regulation among adolescents with ADHD symptoms at the lower secondary school level. The study employed a Single Subject Experimental Design with repeated-measures. The participants were five lower secondary school students with ADHD symptoms from a secondary school in Chiang Mai Province. The research instruments included: 1) a DIR/Floortime-based counseling program, 2) a demographic questionnaire for adolescents with ADHD symptoms, and 3) The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA). Participants received the DIR/Floortime-based counseling intervention for 45 minutes per session, once a week, for a total of eight sessions. They were assessed before, during, and after the intervention, as well as at a one-month follow-up, resulting in a total of 6 assessments. Data were analyzed using scores obtained from the assessment instrument. The findings indicated that adolescents with ADHD symptoms demonstrated higher scores of emotion regulation after participating in the DIR/Floortime-based counseling program compared with before the intervention, and the positive effects were maintained at the one-month follow-up. Furthermore, the DIR/Floortime-based counseling approach encouraged adolescents with ADHD symptoms to use more appropriate emotion regulation strategies.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
หากผู้เสนอบทความมีความจำเป็นเร่งด่วนในการตีพิมพ์โปรดส่งลงตีพิมพ์ในวารสารฉบับอื่นแทน โดยกองบรรณาธิการจะไม่รับบทความหากผู้เสนอบทความไม่ปฏิบัติตามเงื่อนไขและขั้นตอนที่กำหนดอย่างเคร่งครัด ข้อมูลของเนื้อหาในบทความถือเป็นลิขสิทธิ์ของ Journal of Inclusive and Innovative Education คณะศึกษาศาสตร์ มหาวิทยาลัยเชียงใหม่
References
Ayano, G., Demelash, S., Gizachew, T., Tsegay, L., & Alati, R. (2023). Prevalence of attention-deficit/hyperactivity disorder in children and adolescents: A systematic review and meta- analysis. Child and Adolescent Psychiatry and Mental Health, 17(1), 8-19.
Astenvald, R., Andersson, G., & Johansson, R. (2025). Emotion regulation training for adolescents with ADHD: A multiple-baseline single-case experimental study. Cognitive Behaviour Therapy, 55(5), 728-744.
Barghi, F., Safarzadeh, S., Marashian, F. S., & Bakhtiarpour, S. (2024). Effectiveness of DIR/Floor Time Play Therapy in Social Skills and Emotion Regulation of Children with Autism Spectrum Disorder. Middle East Journal of Rehabilitation and Health Studies, 11(1), Article e168646.
Boshoff, K., Bowen, H., Paton, K., Cameron-Smith, S., Graetz, S., & Lane, K. (2020). Child development outcomes of DIR/Floortime™-based programs: A systematic review. Canadian Journal of Occupational Therapy, 87(2), 153–164.
Breaux, R., Langberg, J. M., Swanson, C. S., Eadeh, H. M., & Becker, S. P. (2020). Variability in Positive and Negative Affect Among Adolescents with and without ADHD: Differential Associations with Functional Outcomes. Journal of affective disorders, 274, 500–507.
Breaux, R., Waschbusch, D. A., Marshall, R., Rothe, E. M., Humphery, H., Pelham, W. E., & Waxmonsky, J. G. (2020). The role of parental knowledge and attitudes about ADHD and perceptions of treatment response in the treatment utilization of families of children with ADHD. Evidence-Based Practice in Child and Adolescent Mental Health, 5(1), 102-114.
Cavanage, M., Quinn, D., Duncan, D., Graham, T., & Balbuena, L. (2014). Oppositional Defiant Disorder Is Better Conceptualized as a Disorder of Emotional Regulation. Journal of Attention Disorders, 21(5), 381–389.
Chacko, A., Merrill, B. M., Kofler, M. J., & Fabiano, G. A. (2024). Improving the efficacy and effectiveness of evidence-based psychosocial interventions for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Translational Psychiatry, 14(1), Article 244.
Cierpka, M. (2016). Regulatory Disorders in Infants: Assessment, Diagnosis, and Treatment. Cham: Springer International Publishing.
Coxe, S., Sibley, M., & Becker, S. (2020). Presenting problem profiles for adolescents with ADHD: differences by sex, age, race, and family adversity. Child Adolesc Ment Health, 2021(3), 228-237.
Danielson, M. L., Claussen, A. H., Bitsko, R. H., Katz, S. M., Newsome, K., Blumberg, S. J., Kogan, M. D., & Ghandour, R. (2024). ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 53(3), 343–360.
Divya, K. Y., Begum, F., John, S. E., & Francis, F. (2023). DIR/Floor time in engaging autism: A systematic review. Iranian Journal of Nursing and Midwifery Research, 28(2), 132–138.
Eskander, N. (2020). The Psychosocial Outcome of Conduct and Oppositional Defiant Disorder in Children With Attention Deficit Hyperactivity Disorder.Cureus, 12(8), Article e9521.
Fombouchet, Y., Lannegrand, L., & Lucenet, J. (2024). Relationships between emotion regulation strategies and executive functions in adolescence: Exploring the effects of discrete emotions and age. Journal of Adolescence, 96(6), 1239–1248.
Greenspan, SI., & Wieder, S. (1998). The developmental individual-difference, relationship-based (DIR/Floortime). Cambridge: MA.: DeCapo Press
Greenspan, SI., & Wieder, S. (2008). Engaging autism : Using the floortime approach to help children relate, communicate, and think. Cambridge: MA.: Da Capo Press.
Gross, JJ. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271-299.
Gross, JJ. (2001). Emotion Regulation in Adulthood: Timing Is Everything. Current Directions in Psychological Science, 10(6), 214–219.
Gullone, E., & Taffe, J. (2012). The emotion regulation questionnaire for children and adolescents (ERQ-CA) : A psychometric evaluation. Psychological Assessment, 24(2), 409-417.
Hongsanguansri, S., & Kiatrungrit, K. (2015). Attention-deficit/hyperactivity disorder. In M. L. Lotrakul & P. Sukanich (Eds.), Ramathibodi psychiatry (pp. 541–551). Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University. [in Thai]
Isaac, V., Lopez, V., & Escobar, M. J. (2024). Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD). Frontiers in Psychiatry, 14, Article 1336040.
Kiani, B., Abedi, A., & Roghani, M. (2024). Cognitive emotion regulation strategies in adolescents with ADHD: The role of reappraisal and suppression. Journal of Child and Adolescent Mental Health, 36(1), 15–28.
Krisanapant, S., Pornnopadol, C., Singhakan, S., & Atsariyasing, W. (2021). A pilot study: The effectiveness of the mindfulness training program to reduce ADHD symptoms among 12-15 year-old adolescents with the risk of ADHD. Journal of the Psychiatric Association of Thailand, 60(4), 551-61. [in Thai]
Mardomingo Sanz, M. J., Montañés Rada, F., Nebot Valenzuela, E., & Soler López, B. (2020). Emotional dysregulation and quality of life in adolescents with attention deficit hyperactivity disorder: The Emotical Study. Journal of Pediatrics & Child Health Care, 5(1), Article 1030.
Ooraikul, P., Chandarasiri, P., & Prasartpornsirichoke, J. (2024). The Association Between Child Emotion Regulation, Child Mental Health Status, and Parental Competence in School-Aged Children in Bangkok, Thailand. Journal of the Psychiatric Association of Thailand, 69(2), 121-136. [in Thai]
Pansri, R., & Charnsil, C. (2021). Prevalence and Factors Associated with Depression among Children and Adolescents with ADHD at Maharaj Nakorn Chiang Mai Hospital. Journal of the Psychiatric Association of Thailand, 66(2), 107–122. [in Thai]
Photiyen, K. (2021). Psychological counseling: An important tool for solving students’ problems. Silpakorn University Journal of Education, 19(2), 11–27. [in Thai]
Pornnoppadol, C. (2018). Attention deficit hyperactivity disorder (Vol. 1). Bangkok: Siriraj Press, Faculty of Medicine, Mahidol University. [in Thai]
Roghani, F., Peymani, J., & Jadidi, M. (2021). The Effectiveness of Floor time Play Therapy on Improving Executive Functions and Cognitive Emotion Regulation in Children with Attention Deficit/Hyperactivity Disorder (ADHD). International Journal of Education and Applied Sciences, 3(3), 116-132.
Sahi, R. S., Eisenberger, N. I., & Silvers, J. A. (2023). Peer facilitation of emotion regulation in adolescence. Developmental Cognitive Neuroscience, 62, Article 101262.
Sánchez, M., Lavigne, R., Romero, J. F., & Elósegui, E. (2019). Emotion regulation in participants with attention deficit hyperactivity disorder, before and after an emotion regulation intervention. Frontiers in Psychology, 10, Article 1092.
Soler-Gutiérrez, A. M., Pérez-González, J. C., & Mayas, J. (2023). Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PLOS ONE, 18(1), Article 0280131.
Vacher, C., Goujon, A., Romo, L., & Purper-Ouakil, D. (2020). Efficacy of psychosocial interventions for children with ADHD and emotion dysregulation: A systematic review. Psychiatry Research, 291, Article 113151.
Vuttinunt, P., & Phophichit, N. (2021). Counseling approach based on behavioral theory. Journal of Buddhist Psychology, 6(1), 10–18. [in Thai]
Yotanyamaneewong, S. (2020). Adolescent psychology: Teaching material [Unpublished teaching- document]. Chiang Mai: Department of Psychology, Faculty of Humanities, Chiang Mai University. [in Thai]