**2. Effects of collaborative block creation on social skills and trust**

In this study, we examined the effects of collaborative block creation from the perspective of social skills and trust. The evidence is based on Kato et al. [17]. We focused on the psychological aspects of social skills, trust in others, and trust in oneself, which were examined during the activity. It is important to examine the effect using control group when we apply new technique in the clinical settings. The participants of this study were healthy high school students without any diagnosis of developmental and mental disorders. Our hypothesis proposed that social skills, trust in others, and trust in oneself would significantly increase through collaborative expression through block creation.

#### **2.1. Participants**

Art-based social skills training is useful for students with maladaptation or for those facing difficulty in social communication. For example, Walsh [1] proposed a short-term intervention in social skills training for adolescent students with social-emotional development delays. Most group members showed some improvements in social skills. Chin et al. [2] provided an innovative combination of treatment—art therapy, social skills training, and video therapy—for dropout adolescents. The results suggested that the combination significantly elevated their feelings of self-worth and self-esteem. In clinical situation, art-based program is employed for clients with brain disorder. Agnihotri et al. [3] examined the effect of artbased programs for adolescents with childhood brain disorder. They revealed that intervention participants showed improvements with regard to pragmatic communication skills and social and participation goals. Furthermore, Agnihotri et al. [4] showed the feasibility and effectiveness of a theater skills training program to facilitate social skills and participation for

Art-based activity is effective in the area of social skills training for people with developmental disorders. Autism spectrum disorder (ASD) is one of the core symptoms of developmental disorders. According to the fifth edition of the *Diagnostic and Statistical Manual of Mental Disorders*, a central feature of ASD is a persistent deficit in both social communication and interaction. Another trait involves restricted and repetitive patterns of behavior, interests, or activities. Activities involving group approaches help facilitate social skills in children and adolescents with ASD. Martin [5] categorized art therapy approaches used for clients with ASD. The categories include object relations [6], developmental approaches [7], developmental/behavioral approaches [5], and psychotherapy [8, 9]. Schweizer, Knorth, and Spreen [10] reviewed case studies based on the Context and Outcomes in Art Therapy (COAT) model. The results indicated that art therapy may add to a more flexible and relaxed attitude, a better self-image, and improved communicative and learning skills in children with ASD. Moreover, Gazeas [11] reviewed the outcomes of art therapy from previous studies. Gazeas [11] found that art therapy improves the ability to relate, socialize, and improve joint attention skills of individuals with ASD. Individual case studies have supplied evidences of increasing social skills. For example, Emery [7] presented the art therapy treatment of a boy diagnosed with autism without mental retardation. The case study explored the value of art therapy interventions in the young boy's development and his ability to relate to others. The boy's growth is highlighted by discussing three of his drawings that reflect his progress in developing object constancy. Durrani [12] conducted the case study and proposed that an art therapy intervention may facilitate sensory modulation and self-regulation. This would help lower anxiety levels, aid attachment to the therapist, and improve social engagement in general. Schleien et al. [13] organized a group of children with autism and nondisabled peers at a children's museum; they participated in monthly art activities. The results of this investigation supported the use of inclusive art classes as a means for promoting social interactions directed toward children with autism by their nondisabled peers. Kempe [14] applied drama to teach social skills in special school setting and suggested that it can be a powerful learning medium for children with ASD. Several materials such as painting and drama are used as mediums for communication. Collaborative block creation has been found to be effective in addressing deficient social skills. The approach used by LeGoff [15], known as "LEGO® therapy," has been extensively

adolescents with childhood brain disorder.

36 Socialization - A Multidimensional Perspective

Thirty-nine Japanese high school students participated in this study (6 males and 33 females; all participants were either 16 or 17 years old), and they were randomly divided into groups of 3 or 4.
