Determining the Effectiveness of Short-Term Intensive Psychodynamic Therapy on Mourning and Psychological Distress in Bereaved People Recovered from COVID-19

Momeni , Arya; Keshavarzi Arshadi , Farnaz; Kooshki, Shirin; Askarian, Mahnaz

Volume 14 - Articles-1403 MEJDS (2024) 14: 119 | Back to browse issues page

Ethics code: IR.IAU.CTB.REC1400.117

Mendeley

Zotero

RefWorks

Momeni A, Keshavarzi Arshadi F, Kooshki S, Askarian M. Determining the Effectiveness of Short-Term Intensive Psychodynamic Therapy on Mourning and Psychological Distress in Bereaved People Recovered from COVID-19. MEJDS 2024; 14 :119-119
URL: http://jdisabilstud.org/article-1-3386-en.html

Determining the Effectiveness of Short-Term Intensive Psychodynamic Therapy on Mourning and Psychological Distress in Bereaved People Recovered from COVID-19

Arya Momeni¹

, Farnaz Keshavarzi Arshadi ^*²

, Shirin Kooshki³

, Mahnaz Askarian⁴

1- PhD Student in Health Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran
2- Associate Professor, Department of Psychology of Islamic Azad University, Central Tehran Branch, Tehran, Iran
3- Assistant Professor, Department of Psychology of Islamic Azad University, Central Tehran Branch, Tehran, Iran
4- Assistant Professor, Department of Psychology of Islamic Azad University, Ashtian Branch, Arak, Iran

Abstract: (620 Views)

Abstract
Background & Objectives: In 2019, during the coronavirus disease epidemic, restrictions on meetings and physical distancing from the patient led to an increase in psychological distress, including grief, among bereaved ones. Meanwhile, many researchers argue that coping with grief in the context of the COVID–19 pandemic might influence the grieving process. Therefore, it is expected that there is a higher risk of mental disorders or increased symptoms of grief and sadness. Such psychological distress affects personal mental and physical well–being and social functioning and places a financial burden on the individual, the healthcare system, and society. Thus, considering that complex grief requires professional treatment and can have many psychological consequences, such as depression, anxiety, and disruption in relationships or at work, it is necessary to treat it in the family members of the deceased. Therefore, this research was conducted to determine the effectiveness of short–term intensive psychodynamic therapy on the grief and psychological distress of people who have recovered from COVID–19.
Methods: This quasi–experimental research employed a pretest–posttest design with a control group. The statistical population of this research consisted of all recovered persons who mourned the disease COVID–19 in Tehran City, Iran, in 2022. Thus, according to the infectious disease specialist, at least 6 weeks had passed since their full recovery, and in addition, they had lost one of their relatives to COVID–19. The sample was selected using the snowball sampling. Finally, 30 people who volunteered to participate in the study were selected and randomly assigned to the experimental and control groups. The experimental group received 12–session training (90 minutes per session) of the short–term psychodynamic intensive protocol in 8 weeks. The first 8 sessions were held in 4 weeks (two sessions per week), and the subsequent 4 sessions, one session per week. The control group received no training. Two groups completed the Grief Experience Questionnaire (Barrett & Scott, 1989) and the Short Scale of Psychological Distress (Kessler et al., 2002) at the pretest and posttest. The content validity ratio (CVR) and the content validity index (CVI) were used to test the content validity quantitatively. The CVR results were accepted as 0.40. The CVI index was also calculated and confirmed at 0.49. The pretest and posttest results were entered into SPSS version 26 software for analysis. Descriptive statistics methods (mean, standard deviation, frequency, and percentage) and univariate analyses of covariance were used to test the research hypotheses.
Results: Most participants were between 20 and 30 years old (43%). In addition, most participants (43%) had a bachelor's degree. The longest duration of illness was one month for the pastor (66%). Regarding the relationship with the deceased, the relationship between father, mother, grandfather and grandmother was the most common (36%). In addition, the age of the deceased was mostly between 20 and 40 (33%). The results of the study show that intensive short–term psychodynamic therapy effectively influences the grief and psychological distress of people who have recovered from COVID–19. In the experimental group, it led to a significant decrease in grief and psychological distress (p<0.001). The effect coefficient of treatment for grief and psychological distress was 0.87 and 0.93, respectively, indicating the effectiveness of short–term intensive psychodynamic therapy on the grief and psychological distress of people who have recovered from COVID–19.
Conclusion: The results of the present study showed that short–term intensive psychodynamic therapy in a group setting is an effective therapy for improving the grief and psychological distress of bereaved people who have recovered from COVID–19.

Keywords: Short–term intensive psychodynamic therapy, Mourning, Psychological distress, COVID–19

Full-Text [PDF 310 kb] (287 Downloads)

Type of Study: Original Research Article | Subject: Psychology

References

1. Jeitziner MM, Camenisch SA, Jenni–Moser B, Schefold JC, Zante B. End–of–life care during the COVID–19 pandemic–what makes the difference? Nurs Crit Care. 2021;26(3):212–4. [DOI]

2. Gesi C, Carmassi C, Cerveri G, Carpita B, Cremone IM, Dell’Osso L. Complicated Grief: what to expect after the coronavirus pandemic. Front Psychiatry. 2020;11:489. [DOI]

3. Nakajima S. Complicated grief: recent developments in diagnostic criteria and treatment. Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. [DOI]

4. Thimm JC, Kristoffersen AE, Ringberg U. The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population–based study. Eur J Psychotraumatol. 2020;11(1):1844440. [DOI]

5. Eisma MC, Tamminga A, Smid GE, Boelen PA. Acute grief after deaths due to COVID–19, natural causes and unnatural causes: an empirical comparison. J Affect Disord. 2021;278:54–6. [DOI]

6. Breen LJ, Lee SA, Neimeyer RA. Psychological risk factors of functional impairment after COVID–19 deaths. J Pain Symptom Manage. 2021 Apr;61(4):e1–4. [DOI]

7. Donovan B, Ashby S, Hanna J, Cowdry T, Thorpe J, Hughes E, et al. "Untold Distress" – How did the COVID–19 pandemic affect those who had previously experienced an epilepsy–related bereavement? Epilepsy Behav. 2023;139:109071. [DOI]

8. Johnson CC, Suchyta MR, Darowski ES, Collar EM, Kiehl AL, Van J, et al. Psychological sequelae in family caregivers of critically III intensive care unit patients. a systematic review. Ann Am Thorac Soc. 2019;16(7):894–909. [DOI]

9. McGiffin JN, Galatzer–Levy IR, Bonanno GA. Is the intensive care unit traumatic? what we know and don't know about the intensive care unit and posttraumatic stress responses. Rehabil Psychol. 2016;61(2):120–31. [DOI]

10. Hohls JK, König HH, Raynik YI, Hajek A. A systematic review of the association of anxiety with health care utilization and costs in people aged 65 years and older. J Affect Disord. 2018;232:163–76. [DOI]

11. Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. Lancet. 2007;370(9603):1960–73. [DOI]

12. Davidson JE, Aslakson RA, Long AC, Puntillo KA, Kross EK, Hart J, et al. Guidelines for family–centered care in the neonatal, pediatric, and adult ICU. Crit Care Med. 2017;45(1):103–28. [DOI]

13. Abbass AA. Intensive short–term dynamic psychotherapy of treatment–resistant depression: a pilot study. Depress Anxiety. 2006;23(7):449–52. [DOI]

14. Mishan J. Co–creating change: effective dynamic therapy techniques. Psychodynamic Practice. 2015;21(4):362–7. [DOI]

15. Sripada B. Essential psychoanalysis: toward a re–appraisal of the relationship between psychoanalysis and dynamic psychotherapy. Psychodyn Psychiatry. 2015;43(3):396–422. [DOI]

16. Gabbard GO. Psychodynamic psychiatry in clinical practice: DSM–5. Washington, DC: American Psychiatric Publ; 2014.

17. Gordillo F, Mestas L, Arana JM, Pérez MÁ, Escotto EA. The effect of mortality salience and type of life on personality evaluation. Eur J Psychol. 2017;13(2):286–99. [DOI]

18. Steinert C, Munder T, Rabung S, Hoyer J, Leichsenring F. Psychodynamic therapy: as efficacious as other empirically supported treatments? a meta–analysis testing equivalence of outcomes. Am J Psychiatry. 2017;174(10):943–53. [DOI]

19. Alirezaee S, Shariatnia K, Akbari H. Comparing the effectiveness cognitive–behavioral therapy and intensive short– term dynamic psychotherapy in reducing death anxiety. Journal of Preventive Medicine. 2022;9(4):390–401. [Persian] [DOI]

20. Ahmadi F, Vatankhah Amjad F, Kazemi Rezaei A, Mohammadi S. The effectiveness of intensive short–term dynamic psychotherapy (ISTDP) in symptoms depression, anxiety, posttraumatic stress and guilt felling in bereaved people from the disease COVID–19. Quarterly Journal of Nursing Management. 2021;10(3):69–81. [Persian] [Article]

21. Heshmati R, Wienicke FJ, Driessen E. The effects of intensive short–term dynamic psychotherapy on depressive symptoms, negative affect, and emotional repression in single treatment–resistant depression: a randomized controlled trial. Psychotherapy (Chic). 2023;60(4):497–511. [DOI]

22. Abed M, Hossein J, Shahrbanoo S, Masoud GL, Hajhosseini M. Effectiveness of intensive short–term psychodynamic psychotherapy on reduced death anxiety, depression and feeling of loneliness among women with breast cancer. Journal of Advanced Pharmacy Education and Research. 2020;10(1–2020):120–7. [Persian]

23. Bakhshi Bajestani A, Shahabizadeh F, Vaziri S, Lotfi Kashani F. The effectiveness of short–term psychoanalysis treatment in decreasing psychological distress and psychosomatic symptoms in patients with gastrointestinal dysfunction with personality type D. Journal of North Khorasan University of Medical Sciences. 2022;13(4):1–11. [Persian] [DOI]

24. Delavar A. Educational and psychological research. Tehran: Virayesh Publication; 2009.‌ [Persian]

25. Barrett TW, Scott TB. Development of the grief experience questionnaire. Suicide Life Threat Behav. 1989;19(2):201–15. [DOI]

26. Bailley SE, Dunham K, Kral MJ. Factor structure of the grief experience questionnaire (GEQ). Death Stud. 2000;24(8):721–38. [DOI]

27. Mehdipour S, Shahidi S, Roshan R, Dehghani M. The validity and reliability of "grief experience questionnaire" in an iranian sample. Clinical Psychology and Personality. 2009;7(2):35–48. [Persian] [Article]

28. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, et al. Short screening scales to monitor population prevalences and trends in non–specific psychological distress. Psychol Med. 2002;32(6):959–76. [DOI]

29. Furukawa TA, Kessler RC, Slade T, Andrews G. The performance of the K6 and K10 screening scales for psychological distress in the Australian national survey of mental health and well–being. Psychol Med. 2003;33(2):357–62. [DOI]

30. Yaghubi H. Psychometric properties of the 10 questions version of the Kessler psychological distress scale (K–10). Journal of Applied Psychological Research. 2016;6(4):45–57. [Persian] [Article]

31. Abbass AA, Town JM. Alliance rupture–repair processes in intensive short–term dynamic psychotherapy: working with resistance. J Clin Psychol. 2021;77(2):398–413. [DOI]

32. Abbass A, Town JM. Intensive short–term dynamic psychotherapy. In: Clarke DD, Schuniner H, Clark–Smith M, Abbass A. Psychophysiologic disorders: trauma informed, interprofessional diagnosis and treatment. Independently published; 2019. pp: 247–76.

33. Alirezaee S, Shariat Nia K, Akbari H. Comparison of the effectiveness of cognitive–behavioral psychotherapy and intensive short–term dynamic psychotherapy on self–compassion in cancer patients. EBNESINA. 2022;24(4):43–53. [Persian] [DOI]

34. Abbass A, Bernier D, Kisely S, Town J, Johansson R. Sustained reduction in health care costs after adjunctive treatment of graded intensive short–term dynamic psychotherapy in patients with psychotic disorders. Psychiatry Res. 2015;228(3):538–43. [DOI]

35. Mikail SF, Hewitt PL, Flett GL, Ge S. Group dynamic–relational therapy for perfectionism. Res Psychother. 2022;25(3):635. [DOI]

36. Lindgren M. Beyond borders: exploring the concept of knowledge transfer in aid : lessons from transferring the panzi model for survivors of CRSV from the DRC to Ukraine [Thesis for M.Sc. in Himan Rights]. [Uppsala, Sweden]: Uppsala University; 2024. [Article]

37. Ajilchi B, Nejati V, Town JM, Wilson R, Abbass A. Effects of intensive short–term dynamic psychotherapy on depressive symptoms and executive functioning in major depression. J Nerv Ment Dis. 2016;204(7):500–5. [DOI]

38. Kahn T. Patients' expectations’ effects on treatment outcome in major depressive disorder (MDD) in intensive short–term dynamic psychotherapy (ISTDP) [Thesis for B.A. in Psychology]. [California, US]: Claremont Colleges; 2020.

39. Roggenkamp H, Abbass A, Town JM, Kisely S, Johansson R. Healthcare cost reduction and psychiatric symptom improvement in posttraumatic stress disorder patients treated with intensive short–term dynamic psychotherapy. European Journal of Trauma & Dissociation. 2021;5(3): 100122. [DOI]

40. Naghibi SH, Pourhosein R, Sarafraz MR, Sadeghinia A. Effectiveness of intensive short–term dynamic psychotherapy on defense mechanisms of patients with atopic dermatitis. Journal of Research in Psychological Health. 2023;16(3). [Persian]

41. Sorensen B, Abbass A, Boag S. ISTDP and its contribution to the understanding and treatment of psychotic disorders. Psychodyn Psychiatry. 2019;47(3):291–316. [DOI]

42. Abbass A, Town J, Holmes H, Luyten P, Cooper A, Russell L, et al. Short–term psychodynamic psychotherapy for functional somatic disorders: a meta–analysis of randomized controlled trials. Psychother Psychosom. 2020;89(6):363–70. [DOI]

43. Davanloo H. Management of tactical defenses in intensive short–term dynamic psychotherapy, part I: overview, tactical defenses of cover words and indirect speech. International Journal of Short–Term Psychotherapy. 1996;11(3):129–52. [DOI]