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Play interventions significantly reduce anxiety and depressive symptoms in children with cancerPlay Interventions Reduce Anxiety and Depression in Children with Cancer

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Key Takeaway
Consider tailored play interventions to reduce anxiety and depressive symptoms in children with cancer.

This meta-analysis of 23 studies involving 1541 children with cancer evaluates the impact of various play interventions, including medical play, group play, online group, and video play. The analysis found that play interventions significantly alleviated anxiety (SMD = -1.84; 95%CI: -2.35 to -1.32, P < 0.001) and depressive symptoms (SMD = -1.62; 95%CI: -2.14 to -1.11, P < 0.001).

Subgroup analyses revealed specific benefits for different modalities. Medical play was associated with the greatest improvement in anxiety (SMD = -1.87; 95%CI: -2.56 to -1.18, P < 0.001). Group play showed an optimal effect for reducing depressive symptoms (SMD = -2.09; 95%CI: -2.49 to -1.70, P < 0.001, I = 0%).

Clinical application suggests tailoring the intervention to the child's primary symptom. Offline medical or group play may be suitable for severe anxiety, while online group or video play may address prominent depressive symptoms. The evidence supports the use of tailored play interventions for pediatric oncology patients, though the specific limitations of the included studies were not reported.

How this fits prior evidence

This meta-analysis addresses a gap in managing psychological distress in pediatric oncology patients. While prior evidence indicates that 85.4% of oncology professionals lack training in integrative medicine, this finding suggests that specific play interventions can effectively target anxiety and depressive symptoms. Furthermore, while a digital intervention (eREACH) was shown to be non-inferior for anxiety in cancer patients, this study highlights the specific efficacy of play-based modalities for children.

A large review of 23 different studies looked at how play can help children with cancer. The study included over 1,500 children. Researchers found that various types of play, including medical play, group play, online group play, and video play, all helped to reduce symptoms of anxiety and depression.

Specific types of play showed different benefits. Medical play was found to be especially effective at reducing anxiety. Group play was found to be very effective at reducing symptoms of depression. These findings suggest that choosing the right type of play can target specific emotional needs in young patients.

Because these results come from a meta-analysis of many studies, they provide a broad look at the benefits of play. However, the best approach depends on the child's specific needs. For example, children with severe anxiety might benefit from offline medical or group play three times a week. Children with more depressive symptoms might find more help through online group or video play.

What this means for you:
Tailored play activities can significantly reduce anxiety and depression in children with cancer.

Common questions

What types of play were found to help children with cancer?

The study looked at several types of play, including medical play, group play, online group play, and video play. All of these types were found to significantly alleviate both anxiety and depressive symptoms in children with cancer. Different types of play may be more effective depending on the specific symptoms a child is experiencing.

Which play is best for children with high anxiety?

The research suggests that medical play and group play are particularly effective for children with severe anxiety symptoms. For these children, the study suggests that offline medical or group play performed three times a week may be a helpful approach to manage their anxiety.

How does group play help children with depression?

Group play was found to have an optimal effect on reducing depressive symptoms in children. For children showing prominent signs of depression, the study suggests that online group play or video play may be particularly suitable interventions to help manage those symptoms.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJan 2026
View Original Abstract ↓
BACKGROUND: Childhood cancer is the second leading cause of pediatric death. Diagnosis and treatment frequently trigger anxiety and depressive symptoms. Play interventions match children's developmental needs to relieve distress but vary in efficacy. This meta-analysis quantified such interventions' effects on symptom improvement in children with cancer. OBJECTIVE: To characterize play intervention designs and quantify their effects on anxiety and depressive symptoms among children with cancer. METHODS: Systematic searches covered 12 databases from inception to April 27, 2026. Independent screening, data extraction, and quality appraisal were completed by two researchers, and meta-analyses were performed via RevMan 5.4 and Stata 18.0. RESULTS: Overall, 23 studies involving 1541 children with cancer were included. Pooled analyses showed that play interventions significantly alleviated anxiety (SMD = -1.84, 95%CI: -2.35 to -1.32, P < 0.001) and depressive symptoms (SMD = -1.62, 95%CI: -2.14 to -1.11, P < 0.001) in pediatric cancer patients. Subgroup analyses indicated medical play yielded the greatest improvement in anxiety (SMD = -1.87, 95%CI: -2.56 to -1.18, P < 0.001), while group play exerted the optimal effect on depressive symptoms (SMD = -2.09, 95%CI: -2.49 to -1.70, P < 0.001, I = 0%). CONCLUSION: As practical non-pharmacological mental health interventions for pediatric oncology, play interventions ease anxiety and depressive symptoms in children with cancer. IMPLICATIONS TO PRACTICE: Tailored play interventions are recommended for children with cancer. Thrice-weekly offline medical or group play suits children with severe anxiety symptoms, while online group or video play fits those with prominent depressive symptoms.
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