The Impact of Trauma-Informed Sports-Based Intervention on Emotion Regulation, Self-Esteem, and Peer Relationships in Adolescents With Substance Use Disorder

The study was conducted with adolescents aged 14-18 with substance use disorder in a ÇEMATEM, according to the inclusion and exclusion criteria. A total of 147 adolescents with substance use disorder were included in the study. These individuals were randomly assigned to two groups: intervention and control groups. Pre-test data were collected in a quiet room at the ÇEMATEM by researches between November 15 and 20, 2025 from both the intervention and control groups using the "Personal Information Form", "Emotion Regulation Scale for Adolescents", "Rosenberg Self-Esteem Scale" and "Peer Relationships Scale" on a self-report basis. The Trauma-Informed Sports-Based Intervention was administered to the intervention group between November 2025 and January 2026 for 8 weeks, five days a week, consisting of three days of psychoeducation and two days of sports-based practice, in sessions lasting 45-60 minutes each. At the end of the Trauma-Informed Sports-Based Intervention, both the intervention and control groups were administered the "Emotion Regulation Scale for Adolescents", "Rosenberg Self-Esteem Scale" and "Peer Relationships Scale" as a post-test on January, 2026. The control group received no intervention during the 8-week program.

• The Trauma-Informed Sport-Based Intervention Program (Behavioral): The Trauma-Informed Sport-Based Intervention Program The program was structured according to trauma-informed care principles and aimed to enhance emotion regulation, self-esteem, and peer relationships. It integrated cognitive behavioral psychoeducation with sport-based activities. The intervention was conducted five days a week (Psychoeducation sessions were conducted three days per week, while sport-based activities were implemented two days per week), each session lasting 45-60 minutes, over 8 weeks. The program consisted of four core components: (1) Emotion regulation and anger management: Developing skills to recognize, express, and regulate emotions. (2) Behavioral (social skills): Enhancing peer relationships, empathy, and communication skills. (3) Cognitive component: Increasing self-awareness and restructuring maladaptive thoughts. (4) Sport-based component: Cooperative games, rhythmic exercises, coordination activities, and body awareness practices.

Primary outcomes

• Emotion regulation total mean score [From enrollment to the end of the trauma-informed sports-based intervention at 8 weeks.]: Emotion regulation was assessed using the Emotion Regulation Scale for Adolescents, multidimensional structure assessing various aspects of emotion regulation processes. Total scores range from 18 to 90, with higher scores indicate greater difficulties in emotion regulation.
• Self-esteem total mean score [From enrollment to the end of the trauma-informed sports-based intervention at 8 weeks.]: Self-esteem was assessed using the Rosenberg Self-Esteem Scale, consists of 10 items rated on a 4-point Likert scale. Higher scores indicate higher levels of self-esteem. In the Turkish validity and reliability study of the scale, scores of 0-1 were classified as high self-esteem, scores of 2-4 as moderate self-esteem, and scores of 5-6 as low self-esteem.
• Peer Relationships total mean score [From enrollment to the end of the trauma-informed sports-based intervention at 8 weeks.]: Peer Relationships was assessed using the Peer Relationships Scale, the final version of the scale consists of 22 items across five subscales: Companionship, Conflict, Help, Protection, and Closeness. Total scores range from 1 to 5, with Scores are calculated as the mean of total or subscale scores, with higher scores indicating better peer relationship quality.

Sex: All, ages: 14 Years to 18 Years

Inclusion Criteria were:

* receiving treatment at ÇEMATEM,
* aged 14-18 years,
* diagnosed with substance use disorder,
* scoring ≤54 on the emotion regulation scale,
* having sufficient cognitive capacity for communication,
* willingness to participate.

Exclusion Criteria included:

* presence of neurological, sensory, or physical impairments,
* severe psychiatric comorbidities (e.g., psychotic disorders),
* clinical conditions preventing participation.

Participants who missed at least two sessions of the intervention were excluded.