The Effectiveness of Film Therapy (Inside-Out Film) on Separation Anxiety of Children Referred to Mashhad Counseling Centers : A Case Report


1 Assistant Professor of Educational Psychology, Kavian Institute of Higher Education, Mashhad, Iran

2 Phd student, Clinical Psychology, Faculty of Education Sciences and Psychology, University of Shiraz, Shiraz,,,Iran

3 M.A student, Clinical Psychology, Faculty of Education Sciences and Psychology, Shahid Beheshti University of Tehran, Tehran, Iran


Introduction: Separation anxiety disorder is considered to be the most common psychiatric disorder in children that
seriously affects their mental health. So adopting treatment approaches for this disorder is very important. The purpose of this study was the effectiveness of filmtherapy (Inside-Out Film) on separation anxiety disorder (SAD) of Children Referred to Mashhad Counseling Centers.
Materials and Methods: The research method is single case study and A-B-A design. The sample people were 3 girls 11-12 years old with separation anxiety disorder in Mashhad in the academic year 2018- 2019 who referred to Ehya clinic with separation anxiety complaint that had been previously diagnosed by a psychiatrist. They were selected through purposive sampling method. The tools were Structured Clinical Interview (SCID-I) and Zang anxiety questionnaire. To analyze the data, the method of diagrams and calculating the recovery rate and the index of non-overlapping data percentage (PAND) were used to evaluate the effect size.
Results: The anxiety scores from Pre-test and post-test was reduced from 59 to 48 with recovery rate (23%) in the first patient, in the second patient from 52 to 44 with recovery rate (18%) and in the third patient from 50 to 40 with a recovery rate (25%).
Conclusion: The (inside out) film can be used as an effective way to reduce separation anxiety in children.


1. Vaughan, J. Coddington, J.A. Ahmad, A.H. Ertel, M. Separation Anxiety Disorder in school –age children: What health care providers should know. Journal of pediatric health care. (2017).31(4)433-440. 2. Klykylo, W. M., Kay, J. L. Clinical Child Psychiatry, Second Edition, London: British Library. (2005). 3. Mash, E.G. &Wolff, A.D. Psychological morbid child, translated by Mozaffari M.M. Forughaldin A. Tehran: Publication of Roshd. (2010); 212-90. (Persian). 4. Maltese , A.&Cerroni, F.&Romano , P.&Russo,D.& Salerno ,M.&Galli,B. Et al. Anxiety disorders in developmental age .Actamedica Mediterranea. (2018).34(4).937-943. 5. Dabkowska, D., Araszkiewicz, A., Dabkowska, A., & Wikosc, M. Separation anxiety in children and adolescents. In S. Sleek (Ed.), Different views of anxiety disorder. (2011). (pp. 313-338). Shanghai, China: Intec China. 6. Hannesdottir, D.K. &Sigurjonsdottir, S.B.7Njardvik, U. & Ollendick.H. Child psychiatry &Human development. (2018).V.49, 6Pp 888-896. 7. Matthies, S. &Schiele, M.A. &Koentges, C. &Pini, S. Please don’t leave. Seperation anxiety and related traits in borderline personality disorder current psychiatry reports. (2018).20(10):83. 8. Shroeder, C.S. Gordon, B.N. Assessment and treatment of children problems. A Clinical Guide .Translated by: Mehrdad Firoozbakht.Danjeh Pub. (2018). 9. Egeci, S&Gencoz, F. (2017).Use of cinema therapy in dealing with relationships promlems.The Arts in Psychotherapy.53. 64-71. 10. Makipea, P. (1999).Movie therapy .University of Iceland, Institute of Continuing Education Internet. 11. Milrod, B, .Markowitz, J, C. Gerber, A, J., Cyranowski, J. Altemus, M. Shapiro, T. Hofer, M. Glatt, C. Childhood Separation Anxiety and the Pathogenesis and Treatment of Adult Anxiety. Mechanisms of Psychiatric Illness. (2014). 171:34–43). 12. Wolz, B. Emotion picture magic: A movie lover’s guide to healing and transformation. (2005). Centennial, Colorado: Glenbridge. 13. Fredricks, R. How cinema therapy works. Mind Body Net Work. (2018). 14. Zhe Wu, A. Appling cinema therapy with adolecents and a cinema therapy workshop. Atwo paper alternative department thesis presented to the faculty of California state university, East Bay. (2008). 15. Strong, P. &Lotter, G. Reel help for real life: Film therapy and beyond .HTS Tealogical studies. (2015). 71(3) 16. Hankir, A.r&Holloway, D. &Zaman, R. &Agius, M. Cinema therapy and film as an educational tool in undergraduate psychiatry teaching: A case report and review of literature. Psychiatria Danubina. (2015). Vol27, Supp.1.Pp136 17. Wolz, B. Cinema therapy- Using the power of imagenery in films. Centennial, Colorado: Glenbridge. (2006). 18. Sharp, C. & Smith, J.V. & Cole, A. Cinematherapy: Metaphoriailly promoting therapeutic Change.Counselling psychology Quartery. (2002).15(3), 269-276. 19. Silverman NA, Sabiston Jr DC. Mediastinal masses. Surgical Clinics of North America. 1980 Aug 1; 60(4):757-77. 20. James, M.J. The relationship between state transportation, personality triats and symptom reduction after a movie intervention: Implications for cinematherapy. (2016). 21. Puranik, V. Why psychological horror movies can help soothe anxiety and increase mental helth. (2017). 22. Molaei, A. Abedin, A. Heydari, B. The effect of group film therapy on reducing the severity of mourning experience of adolescent girls, aged 19-17, Tehran. Master thesis. Faculty of Psychology and Educational Sciences. Shahid Beheshti University. (2009). (Persian). 23. Pourreza, M. Fadaei, F. Hashemiyan, K. The effect of comedy films in reducing depression in schizophrenic patients. Journal of Rehabilitation. (2004). 5(2). 12-15. 24. Watts C. Class Action. InUB Law Forum 2006 (Vol. 19, No. 1, p. 145). 25. Canon, K. "Feed” movie reiew: The eating disorder film that should be getting more attention. (2017). 26. Rosenfield, R. (2018).Cinematherapy with inside out: A theorical &practical guide. 27. American Psychiatric Association. Anxiety Disorders. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: APA; 2000:429-48. 28. Ghanizadeh, A., Mohammadi, M. R., Yazdanshenas, A. Psychometric properties of the Farsi translation of the kiddie schedule for affective disorders and schizophrenia present and lifetime version. BMC Psychiatry. (2006). 29. Shahrivar, Z., Kousha, M., Moallemi, S., Tehrani-Doost, M., Alaghband-Rad, J. The Reliability and Validity of Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Life-time Version– Persian Version. Journal of Child and Adolescent Mental Health Volume, (2008). 15 (2): 97-102. 30. Hossein-Sabet F. Effectiveness of patience training in anxiety, depression and happiness. Studies in Islam and Psychology. 2008; 1(2): 79-92. [Persian] 31. Marsick E. Cinematherapy with preadolescents experiencing parental divorce: A collective case study. The Arts in Psychotherapy. 2010 Sep 1; 37(4):311-8. 32. Abedin, A. &Molaie.A. The effectiveness of group movie therapy (GM T) on parental stress reduction in mothers of children with mild mental retardation in Tehran .Science Direct. (2010). 988-993. 33. Kim YH, Kang YS, Lee HS, Choi W, You IC, Yoon KC. Effectiveness of combined tear film therapy in patients with evaporative dry eye with short tear film breakup time. Journal of Ocular Pharmacology and Therapeutics. 2017 Oct 1; 33(8):635-43. 34. Setiawati, D. &Winingsih. Cinematherapy to improve the consuler‘s understanding about dealing with feeling skills for students .Advances in social science .Education&Humanities. Research, (2017). V173.1 st International conference on education innovation.