اثربخشی درمان شناختی-رفتاری بر اضطراب کودکان در خانوادههای بازساختاریافته

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه آزاد اسلامی واحد اصفهان، خوراسگان، اصفهان، ایران.

2 استادیار، گروه روان‌شناسی دانشگاه آزاد اسلامی واحد اصفهان، خوراسگان، اصفهان، ایران. (نویسنده مسئول)

3 استادیار، گروه روان‌شناسی، دانشگاه آزاد اسلامی واحد اصفهان، خوراسگان، اصفهان، ایران.

4 استاد، گروه روان‌شناسی، دانشگاه آزاد اسلامی واحد اصفهان، خوراسگان، اصفهان، ایران.

چکیده

مقدمه: تداوم مشکلات کودکان در خانواده­های بازساختاریافته می‌تواند اختلالات اضطرابی این کودکان را به شدت افزایش دهد و بر زندگی آنها اثرات پایداری داشته باشد. پژوهش حاضر قصد دارد تا اثربخشی درمان شناختی-رفتاری را بر اضطراب کودکان خانواده­های بازساختاریافته بررسی نماید.
مواد و روش‌ها: این پژوهش از نوع نیمه­تجربی (طرح پیش‌آزمون، پس‌آزمون، پیگیری با گروه کنترل) بود. حجم نمونه شامل 20 کودک بود که به صورت هدفمند از میان واجدین شرایط ورود به پژوهش در شهرستان شهرضا در سال 1398، انتخاب و به صورت تصادفی در گروه­های آزمایش (10 کودک) و کنترل (10 کودک) جایگزین شدند. گروه آزمایش، تحت درمان شناختی-رفتاری کودکان ۷ تا ۱۴ سال بر اساس دستورالعمل سیلر قرار گرفتند که در 10 جلسه‌ 45 تا 60 دقیقه‌ای برگزار شد. داده‌ها توسط پرسشنامه ‌آخنباخ (فرم والدین) جمع‌آوری شد. از میانگین، انحراف معیار و آزمون تحلیل واریانس با اندازه­گیری مکرر برای گزارش نتایج استفاده شد.
یافته‌ها: میانگین نمره اضطراب در گروه درمان شناختی-رفتاری در پس‌آزمون (90/14) و پیگیری (20/14) نسبت به پیش‌آزمون (90/18) کاهش یافت، اما در گروه کنترل تفاوت محسوسی مشاهده نشد (پیش­آزمون:01/19، پس­آزمون:60/18 و پیگیری: 20/18). میانگین نمره ­اضطراب در کودکان گروه آزمایش در مقایسه با گروه کنترل (739/5= F)، اختلاف معنی­داری داشت (001/0=p).
نتیجه‌گیری: درمان شناختی-رفتاری می­تواند برای کاهش اضطراب در کودکان خانواده‌های بازساختاریافته استفاده گردد. به درمانگران توصیه می‌شود در جلسات درمانی از درمان شناختی-رفتاری برای درمان اختلالات اضطرابی کودکان استفاده نمایند.

کلیدواژه‌ها


عنوان مقاله [English]

The Effectiveness of Cognitive-Behavioral Therapy on Children's Anxiety in Restructured Families

نویسندگان [English]

  • M Bahrami 1
  • F Khayatan 2
  • H Farhadi 3
  • A Aghaei 4
1 Ph.D Student, Dept of Educational Sciences and Psychology, Islamic Azad University Isfahan,Khorasgan, Isfahan, Iran.
2 Assistant prof, Dept of Educational Sciences and Psychology, Islamic Azad University Isfahan, Khorasgan, Isfahan, Iran.
3 Assistant prof, Dept of Educational Sciences and Psychology, Islamic Azad University Isfahan, Khorasgan, Isfahan, Iran.
4 Prof, Dept of Educational Sciences and Psychology, Islamic Azad University Isfahan, Khorasgan, Isfahan, Iran.
چکیده [English]

Introduction:Failure to resolve children's problems in restructured families can dramatically increase anxiety disorders in these children and have a lasting impact on the child's life. The present study aims to investigate the effectiveness of cognitive-behavioral therapy on children’s anxiety in restructured families.
Materials and Methods: This research was of a quasi-experimental (pre-test, post-test, and follow-up with the control group). The sample size consisted of 20 children in Shahreza city in 2019, who were selected using purposeful sampling among eligible children; they were randomly assigned into two groups of experimental (10 children) and control (10 children). The children in the experimental group received cognitive-behavioral therapy for children of 7 to 14 years old according to the instruction of Seiler (2008), which was held in 10 sessions of 45 to 60 minutes. The Achenbach questionnaire (parental form) was used to collect data. The data were reported in two descriptive and inferential sections. Mean and standard deviation were used in the descriptive part, and repeated measures analysis of variance was used in the inferential section.
Results: The results showed that the mean score of anxiety in children in the experimental group was significantly different from the control, and the cognitive-behavioral intervention was effective (p=0/001).
Conclusions: Based on the results of this study, cognitive-behavioral therapy can be used to reduce children's anxiety in restructured families. Therefore, therapists are advised to use it in the treatment of anxiety disorders among children in structured families.

کلیدواژه‌ها [English]

  • Anxiety
  • Restructured families
  • Cognitive-behavioral therapy
  • Children
  1. Hoenayi RK, Salifu Yendork J. “I Wouldn’t Say We Were Treated Equally”: Experiences of Young Adult Stepchildren in the Ghanaian Context. Journal of Divorce & Remarriage 2018;59(7):539-54.
  2. Jensen TM, Shafer K, Holmes EK. Transitioning to stepfamily life: The influence of closeness with biological parents and stepparents on children's stress. Child & Family Social Work 2017;22(1):275-86.
  3. van Eeden-Moorefield B, Pasley BK. Remarriage and stepfamily life.  Handbook of marriage and the family. 1nd ed. Springer; 2013: 517-46.
  4. Shafer K, Jensen TM, Holmes EK. Divorce stress, stepfamily stress, and depression among emerging adult stepchildren. Journal of child and family studies 2017;26(3):851-62.
  5. Mousavi S, Fatehizadeh M, Jazayeri R. (dissertation). Detection of Damage to Mixed Families and Comparison of the Effectiveness of its Based Counseling Package with the Smart Steps Counseling Package. Isfahan: University of Isfahan;2018: 210-32.[Persian]
  6. Jensen TM, Lippold MA, Mills‐Koonce R, Fosco GM. Stepfamily relationship quality and children's internalizing and externalizing problems. Family process 2018;57(2):477-95.
  7. Mikucki-Enyart SL, Heisdorf SR. Obstacles and Opportunities Experienced by Adult Stepchildren in Later Life Stepfamilies. Journal of Divorce & Remarriage 2020;61(1):41-61.
  8. Gates AL. Stepmothers’ Coparenting Experience with the Mother in Joint Custody Stepfamilies. Journal of Divorce & Remarriage 2019;60(4):253-69.
  9. Fosco GM, Feinberg ME. Cascading effects of interparental conflict in adolescence: Linking threat appraisals, self-efficacy, and adjustment. Development and psychopathology 2015;27(1):239-52.
  10. Ganong L, Coleman M, Chapman A, Jamison T. Stepchildren claiming stepparents. Journal of Family Issues 2018;39(6):1712-36.
  11. Uzunca B. Biological Children Versus Stepchildren: Interorganizational Learning Processes of Spinoff and Nonspinoff Suppliers. Journal of management 2018;44(8):3258-87.
  12. McGuire JF, Storch EA. An inhibitory learning approach to cognitive-behavioral therapy for children and adolescents. Cognitive and behavioral practice 2019;26(1):214-24.
  13. Silk JS, Pramana G, Sequeira SL, Lindhiem O, Kendall PC, Rosen D, et al. Using a Smartphone App and Clinician Portal to Enhance Brief Cognitive Behavioral Therapy for Childhood Anxiety Disorders. Behavior Therapy 2020; 51(1):69-84.
  14. Dewald-Kaufmann J, de Bruin E, Michael G. Cognitive Behavioral Therapy for Insomnia (CBT-i) in School-Aged Children and Adolescents. Sleep medicine clinics 2019;14(2):155-65.
  15. Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research 2012;36(5):427-40.
  16. Silk JS, Tan PZ, Ladouceur CD, Meller S, Siegle GJ, McMakin DL, et al. A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders. Journal of Clinical Child & Adolescent Psychology 2018;47(4):542-54.
  17. Vigerland S, Serlachius E, Thulin U, Andersson G, Larsson J-O, Ljótsson B. Long-term outcomes and predictors of internet-delivered cognitive behavioral therapy for childhood anxiety disorders. Behaviour research and therapy 2017;90:67-75.
  18. Gall G, Joyce P, Gall B, Meredith D, Borg G, Walter R. Applying educational research: A practical guide. 1nd ed.United States: Boston, Pearson Education; 2005:32-7.
  19. Seiler L. Cool Connections with cognitive behavioral therapy: Encouraging self-esteem, resilience and well-being in children and young people using CBT approaches. London: Jessica Kingsley Publishers; 2008:132-47.
  20. Achenbach TM. Manual for the young adult self-report and young adult behavior checklist.1nd ed. United States: University of Vermont; 1997:200-10.
  21. Achenbach TM, Rescolar LA. Ratings of relations between DSM-IV diagnostic categories and items of the CBCL/6-18, TRF, and YSR .1nd ed .United States: University of Vermont; 2001:27-44.
  22. Minaei A. Adaptation and Normalization of Achenbach Child Behavioral Checklist, Self-Assessment Questionnaire and Teacher Report Form. Research on Exceptional Children 2006;19(1):529-58.[Persian]
  23. Carlson JM, Dikecligil GN, Greenberg T, Mujica-Parodi LR. Trait reappraisal is associated with resilience to acute psychological stress. Journal of Research in Personality 2012;46(5):609-13.
  24. Troy AS. (dissertation). Cognitive reappraisal ability as a protective factor: Resilience to stress across time and context. United States: University of Denver; 2012:107-10.
  25. Garnefski N, Kraaij V. Relationships between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual differences 2006;40(8):1659-69.
  26. Sukhodolsky DG, Kassinove H, Gorman BS. Cognitive-behavioral therapy for anger in children and adolescents: A meta-analysis. Aggression and violent behavior 2004;9(3):247-69.
  27. Yeganeh T, Hosseinkhanzadeh AA, Zarbakhsh MR. Effectiveness of Social Skill Training via Cognitive-Behavioral Approach on Reducing Symptoms of ADHD Disorder in Students. Soc Cogn 2014;3(1):57-72. [Persian]
  28. Perihan C, Burke M, Bowman-Perrott L, Bicer A, Gallup J, Thompson J, et al. Effects of Cognitive Behavioral Therapy for Reducing Anxiety in Children with High Functioning ASD: A Systematic Review and Meta-Analysis. Journal of autism and developmental disorders 2019:1-15.