Exploring Similarities and Differences of Symbols Selection and Narrative Themes in Sandtray Therapy Among Thais with and without Depression: A Pilot Study

This pilot study investigates the symbolic and narrative patterns in Sandtray to explore its potential as an alternative assessment tool for depression in the Thai working-age population. Despite the small sample size, mixed method analysis of 30 participants (15 with depression and 15 without) revealed 17 distinctive symbols and 18 themes that were uniquely associated with the depressed group. The symbolic meanings and narrative themes that emerged, such as perceived lack of support, disorganized attachment styles, trauma, introspection, social disconnection, and preoccupation with the past, align with the established symptomatology of depression. These findings provide preliminary support for the use of Sandtray as a complementary assessment tool for depression and lay the groundwork for future research in this area.