اثربخشی درمان مبتنی بر پذیرش و تعهد بر میزان پذیرش و سبکهای دفاعی والدین کودکان اوتیسم با مکانیسم دفاعی انکار

زمینه و هدف: برای والدین دارای فرزند مبتلا به اختلالات طیف اوتیسم، پذیرش بیماربودن فرزندشان دشوار است. هدف از انجام این پژوهش تعیین اثربخشی درمان مبتنی بر پذیرش و تعهد بر میزان پذیرش و سبک های دفاعی مادران دارای فرزند اوتیسم با مکانیسم دفاعی انکار بود. روش بررسی: پژوهش حاضر نیمه آزمایشی با طرح پیش آزمون-پس آزمون با گروه کنترل بود.جامعهٔ آماری را مادران کودکان مبتلا به اختلال طیف اوتیسمی مراجعه کننده به مراکز کودکان استثنایی شهرستان اصفهان در سه ماههٔ اول سال 1394، تشکیل دادند. بااستفاده از روش نمونه گیری دردسترس، 40 زن انتخاب شدند که حداقل دارای یک فرزند اوتیسم بوده و در مقیاس انکار نمرهٔ بیشتری کسب کرده بودند. پرسشنامه های سبک های دفاعی dsq و پذیرش و عمل، نسخهٔ دوم aaq2، برای آن ها به کار گرفته شد؛ سپس به صورت تصادفی به دو گروه آزمایش و کنترل تقسیم شدند. گروه آزمایش در هشت جلسهٔ 90دقیقه ای تحت درمان مبتنی بر پذیرش و تعهد قرار گرفت. مجدداً از هردو گروه پس آزمون به عمل آمد. از روش تحلیل کوواریانس به منظور تحلیل نتایج استفاده شد. یافته ها: نتایج نشان داد که پذیرش مادران تحت مداخله به طور معناداری افزایش یافته (0٫032=p) و میزان استفادهٔ آنان از سبک های دفاعی رشدنایافته کمتر شده است (0٫011=p). نتیجه گیری: برمبنای نتایج این پژوهش می توان به درمان گران درحیطهٔ کار با والدین دارای فرزند مبتلا به اوتیسم توصیه کرد: درمان مبتنی بر پذیرش و تعهد را جهت افزایش پذیرش مادران و کاهش استفاده از سبک های دفاعی رشدنایافته به کار گیرند.

The Effectiveness of Intervention of Treatment Based on Acceptance-Commtment Therapy on the Rate of Parent,s Acceptance of Autistic Children and Their Denial-Defense Mechanism

AbstractObjective: Autism spectrum disorder is a nerve growth disorder that is classified as affecting social interaction including limited interests, repetitive activities and behavioral patterns. This disorder initiates prior to age 36 months, and generally manifests itself when the patients are less than three years old. Autism is one the most chronic and unknown children disorder with many unknown aspects. It is necessary to devote a noticeable amount of research and clinical practice to this disorder due to its large spread (1% among the population) and its chronic nature. Parents like to have healthy and successful children; therefore, accepting that their children are sick is difficult for them and often provokes denial. By the time parents accept their children rsquo;s problem, they don rsquo;t know how to help them. Acceptance and Commitment therapy (ACT) is one of the third wave's cognitive behavioral therapies and is currently being used in the treatment of a number of psychological conditions and disorders. It also enhances psychological flexibility and subsequently improves individual rsquo;s mental health. Acceptance and Commitment therapy invites people to open up to unpleasant feelings, and learn not to overreact to them, and not to avoid situations where they are invoked. This research investigates the effect of Acceptance and Commitment therapy on acceptance and defense style in mothers of autistic children with denial defense style. Methods: This is a twogroup pretestposttest quasiexperimental study. The population consisted of all clients with autism spectrum referring to special children rsquo;s school in 2015. Convenience sampling was used to recruit 40 participants. The participants were assigned to the experimental and control groups in equal numbers. The experimental group received Acceptance and Commitment Therapy in 8 sessions each 90 minutes. The research instruments were Defense Style Questionnaire (DSQ) and Acceptance and Action Questionnaire2(AAQ2). DSQ questionnaire was developed by Bond in 1983 to evaluate 3 defense mechanisms: mature, immature and neurotic styles. AAQ2 was developed by Abbasi in Iran. Alpha Cronbach for this questionnaire is 0/89. Covariance analysis was used to examine the research hypotheses.Results: The results showed that Acceptance and Commitment therapy can increase acceptance in mothers of autistic children. The mean scores for acceptance measure in the experimental group increased from 18.2 in pretest to 28 in the posttest, while in control group it increased from 16.8 in the pretest to 17.2 in the posttest. Covariance analysis showed that there was a significant difference between two groups (p=0.032) on this measure. However, there was no significant difference between two groups in commitments of mothers . The mean score for commitment measure in the experimental group increased from 7.9 in the pretest to 11.3 in the post test. In the control group the same mean score increased from 9.7 in the pretest to 9.6 in the post test. The result showed that Acceptance and Commitment therapy can reduce use of immature defense styles in mothers of autistic children (p=0.011). Also, the results of covariance analysis showed that there was no significant difference between mature and neurotic defense styles in experimental and control groups in the posttest. Conclusion: In acceptance and commitment therapy, the participants are encouraged to improve their commitment to have healthier lives, including behavioral strategies when facing negative thoughts and emotions. Therefore, ACT can have effective influence on adjustment of parents.