Middle Eastern Journal of Disability Studies

fa مقایسهٔ اثربخشی درمان هیجان‌مدار و درمان مبتنی‌بر پذیرش و تعهد بر نیازهای بین‌فردی نوجوانان با خودجرحی بستری در بیمارستان Comparing the Effectiveness of Emotion-Oriented Therapy and Therapy Based on Acceptance and Commitment on the Interpersonal Needs of Hospitalized Adolescents with Self-injury روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article چکیده زمینه و هدف: دورهٔ نوجوانی، مرحلهٔ مهم و برجستهٔ رشد و تکامل اجتماعی و روانی فرد به‌شمار می‌رود. این پژوهش باهدف مقایسهٔ اثربخشی درمان هیجان‌مدار و درمان مبتنی‌بر پذیرش و تعهد بر نیازهای بین‌فردی نوجوانان با خودجرحی بستری در بیمارستان انجام شد. روش‌بررسی: پژوهش ازلحاظ هدف کاربردی و از نوع تک‌آزمودنی با طرح A-B-A همراه با خط پایهٔ چندگانه و دورهٔ پیگیری یک‌ساله بود. جامعهٔ آماری را نوجوانان بستری در بخش روان‌پزشکی بیمارستان بقیه‌الله اعظم‌(عج) شهر تهران در سال ۱۴۰۱-۱۴۰۰ تشکیل دادند. هشت نفر با روش نمونه‌گیری هدفمند انتخاب شدند و به‌طور تصادفی در دو گروه چهارنفره قرار گرفتند. یک گروه درمان‌ هیجان‌مدار و گروه دیگر درمان مبتنی‌بر پذیرش و تعهد را دریافت کرد. ابزار پژوهش پرسش‌نامهٔ نیازهای بین‌فردی (ون‌آردن و همکاران، ۲۰۱۲) بود. برنامهٔ مداخله‌ای به‌شکل انفرادی در هشت جلسهٔ نوددقیقه‌ای ارائه شد. اندازه‌گیری مجدد نیازهای بین‌فردی نوجوانان بعد از هر جلسه و در مرحلهٔ پیگیری صورت گرفت. داده‌ها براساس تحلیل دیداری و شاخص‌های آماری توصیفی تحلیل شد. یافته‌ها: نتایج مشخص کرد، در درمان هیجان‌مدار و درمان مبتنی‌بر پذیرش و تعهد، نمره‌های آزمودنی‌ها در متغیرهای تعلق‌پذیری خنثی و ادراک سربار بودن، در موقعیت مداخله (B) کاهش نزولی (شاخص‌های تغییر میانه و میانگین) درجهت اهداف درمان داشت. همچنین نتایج میانگین درصد بهبودی کلی نشان داد، درمان هیجان‌مدار درمقایسه با درمان مبتنی‌بر پذیرش و تعهد در کاهش تعلق‌پذیری خنثی و ادراک سربار بودن نوجوانان با خودجرحی مؤثرتر بود. نتیجه‌گیری: براساس نتایج، می‌توان در مراکز مشاوره و آموزشی از درمان هیجان‌مدار و درمان مبتنی‌بر پذیرش و تعهد به‌عنوان روش‌های مؤثر برای بهبود نیازهای بین‌فردی نوجوانان استفاده کرد؛ اما درمان هیجان‌مدار در کاهش تعلق‌پذیری خنثی و ادراک سربار بودن نوجوانان با خودجرحی، مؤثرتر است. 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. درمان هیجان‌مدار, درمان مبتنی‌بر پذیرش و تعهد, نیازهای بین‌فردی, خودجرحی Emotion–oriented therapy, Acceptance and commitment therapy, Interpersonal needs, Self–injury 79 79 http://jdisabilstud.org/browse.php?a_code=A-11-3789-1&slc_lang=fa&sid=1 Sepideh Karimpour Natanzi سپیده کریم‌پور نطنزی karompou_s@gmail.com 100319475328460063683 100319475328460063683 No PhD Student in Psychology, Shahrood Branch, Islamic Azad University, Shahrood, Iran دانشجوی دکترای تخصصی روان‌شناسی، واحد شاهرود، دانشگاه آزاد اسلامی، شاهرود، ایران Shokofeh Radfar شکوفه رادفر shokofehradfar2@gmail.com 100319475328460063684 100319475328460063684 Yes Associate Professor, Child and Adolescent Psychiatry, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Life Style Institute, Tehran, Iran دانشیار، فوق‌تخصص روان‌پزشکی کودک و نوجوان، مرکز تحقیقات علوم رفتاری، دانشگاه علوم‌پزشکی بقیه‌الله الاعظم(عج)، تهران، ایران Mahboobe Taher محبوبه طاهر mahboobe.taher@yahoo.com 100319475328460063685 100319475328460063685 No Assistant Professor, Department of Psychology, Shahrood Branch, Islamic Azad University, Shahrood, Iran استادیار، گروه روان‌شناسی، واحد شاهرود، دانشگاه آزاد اسلامی، شاهرود، ایران Esmat Davoudi-Monfared عصمت داودی منفرد davoodi_s@gmail.com 100319475328460063686 100319475328460063686 No Associate Professor, Health Management Research Center & Department of Community Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran دانشیار، مرکز تحقیقات مدیریت سلامت و گروه پزشکی اجتماعی، دانشکدهٔ پزشکی، دانشگاه علوم‌پزشکی بقیه‌الله الاعظم(عج)، تهران، ایران