اثربخشي رفتار درماني ديالكتيكي گروهي بر افزايش تاب‌ آوري معلولان جسمي‌ حركتي

Effect of Group Dialectical Behavior Therapy on the Resiliency of People with physical Disability

زمينه و هدف: معلوليت جسمي‌حركتي به‌عنوان عامل خطر براي مشكلات سلامت روان عمل مي‌كند؛ لذا بررسي مداخلات روان‌شناختي مؤثر در ارتقاي سلامت روان اين افراد اهميت مي‌يابد. ازاين‌رو پژوهش حاضر با هدف بررسي اثربخشي رفتاردرماني ديالكتيكي گروهي بر افزايش تاب‌آوري معلولان جسمي‌حركتي انجام شد. روش‌بررسي: اين پژوهش مطالعه‌اي نيمه‌آزمايشي از نوع طـرح پيش‌آزمون‌پس‌آزمون همراه با گروه كنترل بود. جامعهٔ آماري پژوهش را تمامي معلولان جسمي‌حركتي شهرستان قروه استان كردستان تشكيل دادند. از اين ميان به‌شكل تصادفي ساده 218 نفر انتخاب‌ شده و پرسشنامهٔ تاب‌آوري روي آن‌ها اجرا شد. 24 نفر از كساني كه نمرهٔ تاب‌آوري آن‌ها كمتر از ساير شركت‌كنندگان بود و معيارهاي ورود به پژوهش را داشتند انتخاب و به‌صورت تصادفي به دو گروه كنترل و آزمايش تقسيم شدند. گروه آزمايش به‌مدت هشت جلسه تحت‌مداخلهٔ رفتاردرماني ديالكتيكي گروهي قرار گرفت. اين جلسات هفته‌اي يك‌بار و به‌مدت يك‌و‌نيم ساعت برگزار شد. در اين مدت گروه كنترل هيچ مداخله‌اي دريافت نكرد. آزمودني‌هاي پژوهش توسط مقياس تاب‌آوري كانر و ديويدسون (CD-RISC) پيش از شروع درمان و در پايان درمان و پس از اتمام مرحلهٔ پيگيري يك‌ماهه ارزيابي شدند. جهت تحليل داده‌ها از آمار توصيفي و استنباطي (تحليل واريانس با اندازه‌گيري مكرر) استفاد شد. نتيجه‌گيري: براساس يافته‌هاي اين پژوهش مي‌توان گفت كه رفتاردرماني ديالكتيكي گروهي در افزايش تاب‌آوري معلولان جسمي‌حركتي مؤثر است و به روان‌شناسان باليني توصيه مي‌شود در اين رابطه از اين مداخله بهره گيرند.

Background and objective: The current global estimates show that persons with disability constitute about 15 percentage of population around the world. People with physical disability are more susceptible to mental health problems. They experience more psychological problems than normal population. Thus, it is necessary to recognize dangerous and protective factors for such people. The findings of previous studies have presented resiliency works as protective factor in relation with the heath of persons with disability as it modifies negative psychological consequences. Resiliency has been emphasized in working with persons with physical disability. The Dialectical Behavior Therapy has been suggested as effective method to improve resiliency. Accordingly, this investigation was conducted to study the effect of Group Dialectical Behavior therapy on increasing the resiliency of people with physical disability. Methods: This is a time series pretest-posttest control group quasi-experimental study. The population of the present study included all the peoples with physical disability from Qorveh County, Kurdistan Province. Random sampling was used to recruit 218 participants. The research instrument was the Connor and Davidson Resilience Scale (CD-RISC). A total of 24 participants who scored lower on the resiliency test than the average of other participants were judged to meet the inclusion criteria. The participants were assigned to control and experiential groups in equal numbers. The experiential group received eight weekly sessions in Dialectical Behavior therapy. The duration of each session was an hour and a half following Linhan’s treatment protocol. The control group did not receive any intervention. Descriptive (Means, Variance and Standard deviance) and inferential statistics (ANOVA with repeated measures) were used to analyze the data. Results: The results show that there is a significant difference between the experimental and control groups in resiliency immediately after the conclusion of the intervention and in a month thereafter (P<0.001) in favor of the experimental group. Conclusion: It can be concluded that Group Dialectical Behavior Therapy is an effective method to increase the resiliency of people with physical disability. The method is suggested to clinical psychologists, psychiatrists and other mental health professionals.