بررسی اثربخشی درمان ترکیبی هیجان‌مدار و حل‌مسئله در کاهش افسردگی و افکار خودکشی مادران با فرزند معتاد

زمینه و هدف: آسیب‌پذیری روانی‌اجتماعی مادران درقبال اعتیاد فرزندان بیشتر از سایر افراد است. آسیب‌پذیری مادران دارای فرزند معتاد می‌تواند زمینهٔ بروز افکار خودکشی و رفتار خودآسیبی را فراهم کند؛ ازاین‌رو هدف پژوهش حاضر تعیین اثربخشی درمان ترکیبی هیجان‌مدار و حل‌مسئله در کاهش افسردگی و افکار خودکشی مادران دارای فرزند معتاد بود. روش‌بررسی: روش پژوهش نیمه‌‌آزمایشی با طرح پیش‌آزمون و پس‌آزمون و پیگیری یک‌ماهه بود. جامعهٔ ‌آماری را مادران افسرده و دارای فرزند معتاد در کمپ مسیر سبز شهر سبزوار در شش‌ماههٔ اول سال 1399 تشکیل دادند. چهل نفر داوطلب واجد شرایط وارد مطالعه شدند و در گروه‌های بیست‌نفرهٔ آزمایش و گواه قرار گرفتند. ابزارهای پژوهش پرسش‌نامهٔ افسردگی بک (بک، 1996) و مقیاس افکار خودکشی بک (بک و همکاران، 1988) بود که در سه مرحله در هر دو گروه اجرا شد. گروه آزمایش برنامهٔ درمان ترکیبی هیجان‌مدار و آموزش حل‌مسئله را در پانزده جلسهٔ هفتگی نوددقیقه‌ای دریافت کرد. داده‌ها با استفاده از تحلیل اندازه‌‌های تکراری در نرم‌افزار spss نسخهٔ 23 تحلیل شدند. یافته‌ها: درمان ترکیبی هیجان‌مدار و حل‌مسئله می‌تواند تمایل به مرگ (0٫001>p)، آمادگی برای خودکشی (0٫001>p)، کتمان خودکشی (0٫001>p)، افکار خودکشی (0٫001>p) و افسردگی (0٫001>p) را کاهش دهد. این تاثیر در مرحلهٔ پیگیری یک‌ماهه پایدار ماند (0٫001>p). نتیجه‌گیری: نتایج پژوهش حاضر نشان داد، درمان ترکیبی هیجان‌مدار و آموزش حل‌مسئله در کاهش افسردگی و افکار خودکشی مادران دارای فرزند معتاد تاثیر دارد؛ بنابراین باتوجه به کارآمدی این برنامهٔ درمانی، پیشنهاد می‌شود برای کاهش افسردگی و افکار خودکشی مادران دارای فرزند معتاد از برنامهٔ مذکور استفاده شود.

studying the effectiveness of combinational therapy of emotion-focused and problem solving on decreasing depression and suicide ideation in mothers with addicted children

abstractbackground & objectives: one of the factors that affects the mental health of parents in the family is living with an addicted child. in these families, women are more vulnerable than fathers. they are more involved in negative emotions and feelings than men, experiencing more stress, anxiety, depression, and negative and dysfunctional thoughts. high vulnerability of mothers with addicted children can lead to psychological and social disorders such as suicidal ideation and self–harming behavior. the social and psychological vulnerability of mothers with addicted children is greater than that of the general population. considering the high prevalence of addiction in iran and its destructive psychological, social, and economic effects on the family, especially mothers, the present study aimed to determine the effectiveness of combinational therapy of emotion–focused and problem–solving on decreasing depression and suicide ideation in mothers with addicted children. methods: this quasi–experimental study employed a pretest–posttest and a one–month follow–up design with a control group. the study population included depressed mothers with addicted children living in sabz masir camp of sabzevar city, iran, in 2021. forty volunteer participants who met the inclusion criteria were selected and randomly assigned to two groups: experimental and control (each 20 mothers). the inclusion criteria included women with addicted children, obtaining a score of 30 or higher on the depression inventory, having a minimum diploma level, attending meetings, and being willing to do homework and exercises. the exclusion criteria included having a physical illness or underlying mental disorder other than depression, lack of cooperation in the research stages, absence in two consecutive sessions, and taking antidepressant medication before the session. the research tools included the beck depression questionnaire (beck, 1996). the validity of the initial version of this questionnaire was reported to be 0.79. the internal stability of the whole instrument was 0.86, and its alpha coefficients were reported for the patient group as 0.86 and for the non–patient group as 0.81. the other research tool was the beck scale for suicide ideation (beck et al., 1988). beck et al. reported that the internal correlation of this test was 0.89, and the reliability of the retest was 0.83. also, the concurrent validity of the beck scale for suicide ideation with the general health questionnaire was 0.76, and its reliability using the cronbach alpha method was 0.95. the tests were administered in three stages for two groups. the combinational therapy was administered to the experimental group during eight weekly sessions (90 minutes for each session). the obtained data were analyzed using mixed model repeated measures analysis variance. timulak et al. (2018) combined emotion–oriented and solution–based treatment programs based on emotion–focused and problem–solving methods. the content validity of which has been confirmed.results: combinational therapy based on emotion–focused and problem–solving can decrease the wish to die (p<0.001), desire to suicide attempt (p<0.001), covert attempt (p<0.001), suicide ideation (p<0.001), and depression (p<0.001). also, these effects remained stable at follow–up (p<0.001). conclusion: the results of this study showed that the combination of emotion–focused therapy and problem–solving training is effective in reducing depression and suicidal ideation of mothers with addicted children. considering the effectiveness of this treatment program, it is recommended to use this program to reduce depression and suicidal thoughts of mothers with addicted children. to explain the effect of combination therapy, it can be said that cognition and emotions are two very important and basic aspects of human life. the basis of most human behaviors and their interactions are evident. therefore, to better understand suicidal behaviors and their behavioral correlations, it is necessary to study both the cognition and emotion constructs.