مقایسهٔ اثربخشی درمان‌های شناختی-رفتاری و پذیرش و تعهد بر مشکلات روان‌شناختی و بهزیستی ذهنی مادران دارای کودک مبتلا به اختلال طیف اوتیسم

زمینه و هدف: با وجود انجام مطالعات متعدد دربارۀ مشکلات روان‌شناختی و بهزیستی ذهنی مادران دارای کودک مبتلا به اختلال طیف اوتیسم، انجام پژوهش در زمینهٔ مقایسهٔ اثربخشی درمان‌‌های شناختی-رفتاری و پذیرش و تعهد بر متغیرهای مذکور در مادران یادشده، مغفول مانده است؛ ازاین‌رو، پژوهش حاضر با هدف مقایسهٔ اثربخشی درمان‌های شناختی-رفتاری و پذیرش و تعهد بر مشکلات روان‌شناختی و بهزیستی ذهنی مادران دارای کودک مبتلا به اختلال طیف اوتیسم صورت گرفت.روش‌بررسی: پژوهش حاضر به‌شیوهٔ نیمه‌آزمایشی با طرح پیش‌آزمون و پس‌آزمون همراه با گروه گواه و دورۀ پیگیری انجام شد. جامعهٔ آماری را تمامی مادران دارای کودک مبتلا به اختلال طیف اوتیسم مراجعه‌کننده به انجمن اوتیسم استان گیلان در سال 1398 به تعداد 156 نفر تشکیل دادند. از بین آن‌ها، 51 نفر از افراد داوطلب واجد شرایط به‌صورت تصادفی در سه گروه هفده‌نفری (درمان شناختی-رفتاری، درمان مبتنی‌بر پذیرش و تعهد، گواه) وارد مطالعه شدند. برای جمع‌آوری داده‌ها، مقیاس اضطراب، افسردگی و استرس (لاویبوند و لاویبوند، 1995) و پرسش‌نامهٔ بهزیستی ذهنی (کی‌یز و ماگیارمو، 2003) به‌کار رفت. داده‌ها با استفاده از آزمون تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی در سطح معناداری 0٫05 در نرم‌افزار ssps نسخهٔ 24 تحلیل شد. یافته‌ها: تفاوت معنادار بین درمان‌های شناختی-رفتاری و پذیرش و تعهد با گروه گواه برای مشکلات روان‌شناختی و بهزیستی ذهنی مشاهده شد (0٫001>p)؛ اما بین اثربخشی درمان‌های مذکور تفاوت معناداری وجود نداشت (0٫05p). همچنین تفاوت آماری معناداری بین میانگین‌های پس‌آزمون و پیگیری مشاهده نشد که ماندگاری تاثیر درمان‌های مذکور را در مرحلهٔ پیگیری نشان داد (0٫05

comparing the effectiveness of cognitive-behavioral therapy and treatment based on acceptance and commitment on psychological problems, mental wellbeing of mothers with children affected with autism spectrum disorder

background & objectives: nervous stress caused by children’s developmental and behavioral defects, such as autism spectrum disorder (asd), negatively impacts individual and family life and damages parental efficiency. numerous studies have been performed on psychological problems and the mental wellbeing of mothers with children with asd. however, no study compared the effectiveness of cognitive–behavioral therapy with acceptance and commitment therapy based on psychological and mental health problems of mothers with asd children. this study aimed to compare the effectiveness of cognitive–behavioral therapy and treatment based on acceptance and commitment on psychological problems and mental wellbeing of mothers with asd children.methods: the present quasi–experimental study has a pretest–posttest and follow–up design with a control group. the study’s statistical population included all mothers with children with asd (boys and girls), referred to the autism association of guilan province, iran, in 2019 (n=156 mothers). among the study population, 51 mothers whose children received a definitive diagnosis of asd and scored higher than the cut–off point (31.5) in psychological problems and a low score (90) in mental wellbeing were selected. they were randomly assigned to three groups of 17 mothers in each group: the cognitive–behavioral therapy group, the acceptance and commitment–based treatment group, and the control group. for the intervention groups, 12 sessions of 60 minutes of cognitive–behavioral therapy (one session every 5 days for a total of 2 months) and treatment based on acceptance and commitment, 8 sessions of 60 minutes (one session per week for a total of 2 months) were held. in this study, the following tools and protocols were used to collect the required data as well as therapeutic interventions: depression anxiety stress scale (lovibond & lovibond, 1995), mental wellbeing questionnaire (keyes & magyar–moe, 2003), cognitive–behavioral therapy protocol (hawton et al., 1990), and acceptance and commitment therapy protocol (hayes et al., 1999). regarding the descriptive statistics, mean and standard deviation, and regarding the inferential statistics, repeated measures analysis of variance and bonferroni post hoc test were performed using spss24 software. the significance level was considered 0.05 for all tests. results: the results showed that cognitive–behavioral therapy and acceptance and commitment therapy decreased psychological problems (p<0.001) and improved mental wellbeing (p=0.049). also, the group × time interaction caused a decrease in psychological problems (p<0.001) and an increase in mental wellbeing (p<0.001) over time compared to the control group. according to the bonferroni post hoc test, there was a significant difference between cognitive–behavioral therapy and acceptance and commitment therapy with the control group for both variables of psychological problems and mental wellbeing (p<0.001). however, there was no significant difference between the effectiveness of the mentioned therapies in reducing psychological problems (p=0.628) and improving mental wellbeing (p=0.920). also, the average scores of the pretest with posttest and pretest with follow–up showed the effect of cognitive–behavioral therapy and acceptance and commitment therapy on reducing psychological problems and improving mental wellbeing (p<0.001). there was no statistically significant difference between the average scores of the posttest and follow–up stages for the variables of psychological problems (p=0.124) and mental wellbeing (p=0.176), which showed the persistence of the effects of the mentioned treatments in the follow–up stage.