Abstract
Background & Objectives: Adolescence is an important and outstanding stage of a person's social and psychological growth and development. The prevalence of non–suicidal self–harm is alarmingly increasing in the adolescent and youth population. In the occurrence of self–injurious behavior, several factors such as age, marital status, education level, unemployment, personality disorders, drug abuse, maladaptive emotion regulation, history of exposure to traumatic events in life, and family dysfunction have been mentioned. One of the most important factors is interpersonal needs. When it is possible to identify a treatment that is more effective than other treatments from among different and effective psychological approaches and interventions in terms of experimental research, it will help psychologists and therapists who work in the field of adolescent self–harm problems to use the results of such research and find which type of treatment is more effective. Therefore, this research was conducted to compare the effectiveness of emotion–oriented therapy and acceptance and commitment therapy on the interpersonal needs of hospitalized adolescents with self–injury.
Methods: This research was applied in terms of purpose and single subject type with A–B–A design and multiple baseline and one–year follow–up period. The statistical population comprised adolescents aged 14 to 19 years admitted to the Psychiatric Department of Baghiyatollah Azam Hospital in Tehran City, Iran, in 2021–2022. Eight people from the statistical population were selected as a sample using purposeful sampling and were included in the first stage (A) of the baseline, the second stage (B) of the experiment, and the third stage (A) of follow–up. One group received emotional therapy, and the other group received acceptance and commitment therapy by the researcher (expert in emotional therapy and acceptance and commitment therapy courses) in the hospital consultation room. The inclusion criteria were as follows: age range from 14 to 19 years, history of non–suicidal self–injurious behavior at least once in the last month, completion of the treatment consent form, not participating in individual or group therapy sessions, ability to attend therapy sessions once a week, 8 sessions for emotion–oriented therapy and acceptance and commitment therapy. The exclusion criteria included an absence of more than two consecutive sessions and an unwillingness to continue the sessions. The research tool was the Interpersonal Needs Questionnaire (Van Orden et al., 2012). The sessions included eight 90–minute sessions of acceptance and commitment therapy and eight 90–minute sessions of emotion–oriented therapy. The data were analyzed based on visual analysis and descriptive statistical indicators.
Results: The results showed that in the emotion–oriented therapy and in the neutral belonging variable, the subjects' scores in the intervention position (B) decreased (median and mean change indices) according to the treatment goals. The percentages of improvement in all four subjects in the last stage of treatment were 42.50, 50.93, 37.21, and 35.05, respectively, and the overall improvement in the last stage of treatment and follow–up was 41.42. In emotion–oriented therapy and in the variable of perception of feeling overwhelmed, the scores of the subjects in the intervention position (B) decreased (median and mean change indices) according to the treatment goals. The percentages of improvement in all four subjects in the last stage of treatment were 44.73, 50.38, 42.54, and 36.95, respectively, and the overall improvement in the last stage of treatment and follow–up was 43.65. In the acceptance and commitment therapy and the variable of neutral belonging, the subjects' scores in the intervention position (B) decreased (median and mean change indices) according to the treatment goals. The percentages of improvement in all four subjects in the last stage of treatment were 28.71, 30.85, 32.98, and 25.93, respectively, and the overall improvement in the last stage of treatment and follow–up was 29.61. In the acceptance and commitment therapy and the variable of perception of feeling overwhelmed, the scores of the subjects in the intervention position (B) decreased (median and average change indices) according to the treatment goals. The percentages of improvement in all four subjects in the last stage of treatment were 31.25, 33.33, 24.65, and 31.21, respectively, and the overall improvement in the last stage of treatment and follow–up was 30.11. Also, the results of the average percentage of overall recovery showed that emotion–oriented therapy is more effective than acceptance and commitment–based therapy in reducing neutral belonging and feeling overwhelmed in adolescents with self–injury.
Conclusion: Based on the results, emotion–oriented therapy and therapy based on acceptance and commitment are considered effective methods for improving the interpersonal needs of teenagers and can be used in counseling and educational centers. Emotion–oriented therapy is more effective than acceptance and commitment–based therapy in reducing neutral belonging and the feeling overwhelmed in adolescents with self–injury.
