مقایسه اثربخشی ماتریکس درمان پذیرش و پایبندی با درمان شناختی- رفتاری مبتنی بر الگوی هافمن بر اختلال اضطراب اجتماعی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی بالینی دانشگاه آزاد اسلامی واحد شیراز، شیراز، ایران

2 استادیار، گروه روانشناسی دانشگاه آزاد اسلامی واحد شیراز، شیراز، ایران

3 استادیار.گروه روان شناسی. دانشگاه آزاد اسلامی. واحد شیراز. شیراز. ایران

4 استادیار، گروه روان‌شناسی دانشگاه آزاد اسلامی واحد شیراز، شیراز، ایران

چکیده

مقدمه: اختلال اضطراب اجتماعی، یکی از سخت‌ترین اختلال‌های اضطرابی در مقاومت به درمان است. بنابراین بکارگیری درمان تجربی فراتشخیصی یکپارچه‌نگر ضروری است. پژوهش حاضر با هدف ارزیابی و اثربخشی ماتریکس درمان پذیرش و پایبندی و درمان شناختی- رفتاری مبتنی بر الگوی هافمن بر اختلال اضطراب اجتماعی انجام شد. روش‌: این پژوهش از نوع کارآزمایی بالینی با طرح آزمایشی تک آزمودنی با خط پایه چندگانه ناهمزمان بود که به روش نمونه‌گیری هدفمند در طی 12 جلسۀ 60 دقیقه‌ای با پیگیری 2 ماهه بر روی 6 دانشجوی مبتلا به اختلال اضطراب اجتماعی اجرا شد. برای مقایسه نتایج این دو الگوی درمانی از مقیاس اضطراب اجتماعی لیبویتز، مقیاس خود شفقت‌ورزی- فرم کوتاه ریس و همکاران، پرسشنامۀ انعطاف-پذیری پذیرش و عمل- نسخۀ دوم بوند و‌ همکاران، و پرسشنامه زندگی ارزشمند ویلسون و همکاران استفاده شد. داده‌ها به روش ترسیم دیداری، درصد بهبودی، شاخص تغییر پایا و شاخص‌های شش‌گانه کارایی بالینی تحلیل شدند. یافته‌ها: نتایج نشان داد که در گروه ماتریکس اکت میزان درصد بهبودی کلی پس از درمان در متغیر اضطراب اجتماعی 63.1%، متغیر انعطاف‌پذیری 66.6%، متغیر زندگی ارزشمند 62.5% و در متغیر خود شفقت‌ورزی، 68.5% و در گروه درمان شناختی رفتاری هافمن میزان درصد بهبودی کلی پس از درمان در متغیر اضطراب اجتماعی 61.2%، متغیر انعطاف‌پذیری 58.8%، متغیر زندگی ارزشمند 32.8% و در متغیر خود شفقت‌ورزی، 23.9% به دست آمد. نتیجه‌گیری: این پژوهش از اثربخشی بالاتر ماتریکس اکت در زندگی ارزشمند و خود شفقت-ورزی در مقایسه با درمان شناختی- رفتاری مبتنی بر الگوی هافمن در دانشجویان با اختلال اضطراب اجتماعی حمایت می‌کند.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of the Effectiveness of Acceptance and Commitment Therapy Matrix with Cognitive-Behavioral Therapy Based on Hofmann Model on Social Anxiety Disorder

نویسندگان [English]

  • hamid asadi 1
  • Masoud Mohammadi 2
  • Ghasem Naziri 3
  • Azam Davoodi 4
1 PhD student in Clinical Psychology, Islamic Azad University, Shiraz Branch, Shiraz, Iran
2 Assistant Professor, Department of Psychology, Islamic Azad University, Shiraz Branch, Shiraz, Iran
3 Assistant Professor, Department of Psychology, Islamic Azad University, Shiraz Branch, Shiraz, Iran
4 Assistant Professor, Department of Psychology, Islamic Azad University, Shiraz Branch, Shiraz, Iran
چکیده [English]

Introduction: Social anxiety disorder is one of the most difficult anxiety disorders in resistance to therapy.Therefore, the use of unified transdiagnostic experimental therapy is essential.The present study aimed to evaluate the effectiveness of the ACT Matrix and CBT based on the Hofmann's model on social anxiety disorder.Method:This study was a clinical trial with a single-case experimental study non-concurrent multiple baseline design, who performed on 6 students with social anxiety disorder who were selected based on purposive random sampling. The treatment lasted for 12 sessions (60 minutes) with two-month follow-up. To compare the results of these two treatment models, the Social Anxiety Scale (Liebowitz),Self-Compassion Scale-Short Form (Raes & et‌‌al) Acceptance and Action Questionnaire (Second Version, (Bond & et‌ al) and the Valued Living Questionnaire (Wilson & et‌al) were used. Data were analyzed by visual drawing, recovery percentage,stable change index and six indicators of clinical efficiency.Findings:In the ACT Matrix group, the percentage of overall recovery after treatment in the variable of Social Anxiety is 63.1%, variable of Flexibility 66.06%,variable of Valued Living 62.50%, variable of Self-Compassion 68.50% and In the CBT Hofmann's group, the percentage of overall recovery after treatment in the variable of Social Anxiety was 61.20%, variable of Flexibility 58.80%,variable of Valued Living 32.80%, variable of Self-Compassion 23.90%. Conclusion:This study supports the higher effectiveness of the ACT Matrix to compared CBT based on the Hofmann's model in Valued Living and Self-Compassion in students with social anxiety disorder.

کلیدواژه‌ها [English]

  • Social Anxiety Disorder
  • Self-Compassion
  • Valued Living
  • Acceptance and Commitment Therapy Matrix
  • Cognitive-Behavioral Therapy

مراجع

  1. منابع

    1. Caouette JD, Guyer AE. Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience. Developmental cognitive neuroscience. 2014;8:65-76.
    2. Rapee RM, MacLeod C, Carpenter L, Gaston JE, Frei J, Peters L, Baillie AJ. Integrating cognitive bias modification into a standard cognitive behavioural treatment package for social phobia: a randomized controlled trial. Behaviour research and therapy. 2013;51(4-5):207-15.
    3. Edition F. Diagnostic and statistical manual of mental disorders. Am Psychiatric Assoc. 2013;21.
    4. Lipsitz J, Markowitz J, Cherry S. Manual for interpersonal psychotherapy of social phobia. Unpublished Manuscript Columbia University College of Physicians and Surgeons. 1997.
    5. Alden LE. Interpersonal perspectives on social phobia. The essential handbook of social anxiety for clinicians. 2005:167-92.
    6. Rapee RM, MacLeod C, Carpenter L, Gaston JE, Frei J, Peters L, Baillie AJ. Integrating cognitive bias modification into a standard cognitive behavioural treatment package for social phobia: A randomized controlled trial. Behaviour research and therapy. 2013 May 1;51(4-5):207-15.
    7. Rapee RM, Schniering CA, Hudson JL. Anxiety disorders during childhood and adolescence: origins and treatment. Annual review of clinical psychology. 2009 Apr 27;5:311-41.
    8. Spence SH, Donovan CL, March S, Kenardy JA, Hearn CS. Generic versus disorder specific cognitive behavior therapy for social anxiety disorder in youth: A randomized controlled trial using internet delivery. Behaviour research and therapy. 2017;90:41-57.
    9. 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.
    10. Craske MG, Niles AN, Burklund LJ, Wolitzky-Taylor KB, Vilardaga JC, Arch JJ, Saxbe DE, Lieberman MD. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators. Journal of consulting and clinical psychology. 2014;82(6):1034-48.
    11. Herbert JD, Dalrymple K. Social anxiety disorder 2. Encyclopedia of cognitive behavior therapy: Springer; 2005. p. 368-72.
    12. Moscovitch DA. What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice. 2009;16(2):123-34.
    13. McEvoy PM, Perini SJ. Cognitive behavioral group therapy for social phobia with or without attention training: a controlled trial. Journal of anxiety disorders. 2009;23(4):519-28.
    14. Orsillo SM, Roemer L. Acceptance-and mindfulness-based approaches to anxiety: Conceptualization and treatment: Springer Science & Business Media; 2007.
    15. Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior therapy. 2013;44(2):180-98.
    16. Hayes SA, Orsillo SM, Roemer L. Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behaviour research and therapy. 2010;48(3):238-45.
    17. Bennett R, Oliver JE. Acceptance and commitment therapy: 100 key points and techniques. Routledge; 2019 Mar 27.
    18. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: The process and practice of mindful change: Guilford Press; 2011.
    19. Gerhart JI, Baker CN, Hoerger M, Ronan GF. Experiential avoidance and interpersonal problems: A moderated mediation model. Journal of Contextual Behavioral Science. 2014;3(4):291-8.
    20. Sloshower J, Guss J, Krause R, Wallace RM, Williams MT, Reed S, Skinta MD. Psilocybin-assisted therapy of major depressive disorder using Acceptance and Commitment Therapy as a therapeutic frame. Journal of Contextual Behavioral Science. 2020 Jan 1;15:12-9.
    21. Werner H, Young C, Hakeberg M, Wide U. A behavioural intervention for young adults with dental caries, using acceptance and commitment therapy (ACT): treatment manual and case illustration. BMC Oral Health. 2020 Dec;20(1):1-8.
    22. Hazavei F, RobatMili S. The Effect of" Acceptance and Commitment Therapy" on Psychological Flexibility and Behavioral Inhibition of Adolescents with Social Anxiety Disorder. Journal of Health Promotion Management. 2020;8(6):85-91.
    23. Azadeh SM, Kazemi-Zahrani H, Besharat MA. Effectiveness of acceptance and commitment therapy on interpersonal problemsand psychological flexibility in female high school students with social anxiety disorder. Global journal of health science. 2016;8(3):131 (Persian).
    24. Wilson KG. Mindfulness for two: An acceptance and commitment therapy approach to mindfulness in psychotherapy: New Harbinger Publications; 2009.
    25. Eifert GH, Forsyth JP. Acceptance and commitment therapy for anxiety disorders: A practitioner's treatment guide to using mindfulness, acceptance, and values-based behavior change: New Harbinger Publications; 2005.
    26. Callaghan GM, Darrow SM. The role of functional assessment in third wave behavioral interventions: Foundations and future directions for a fourth wave. Current Opinion in Psychology. 2015;2:60-4.
    27. Bolsoni-Silva AT, Loureiro SR. The role of social skills in social anxiety of university students. Paidéia (Ribeirão Preto). 2014 Aug;24(58):223-32.
    28. Ayyash-Abdo H, Tayara R, Sasagawa S. Social anxiety symptoms: A cross-cultural study between Lebanon and the UK. Personality and Individual Differences. 2016 Jul 1;96:100-5.
    29. Gilbert P. An introduction to compassion focused therapy in cognitive behavior therapy. International Journal of Cognitive Therapy. 2010;3(2):97-112.
    30. Ozdemir B, Nesrin S. Examining the factors of self-compassion scale with canonical commonality analysis: Syrian sample. Eurasian Journal of Educational Research. 2017;17(70):19-36.
    31. Gilbert P. Introducing compassion-focused therapy. Advances in psychiatric treatment. 2009;15(3):199-208.
    32. Begley S. Change your mind, change your brain: How a new science reveals our extraordinary potential to transform ourselves: Random House Digital, Inc.; 2007.
    33. Cox BJ, Fleet C, Stein MB. Self-criticism and social phobia in the US national comorbidity survey. Journal of affective disorders. 2004;82(2):227-34.
    34. Werner KH, Jazaieri H, Goldin PR, Ziv M, Heimberg RG, Gross JJ. Self-compassion and social anxiety disorder. Anxiety, stress, and coping. 2012;25(5):543-58.
    35. Heimberg RG, Brozovich FA, Rapee RM. A cognitive behavioral model of social anxiety disorder: Update and extension. Social anxiety: Elsevier; 2010. p. 395-422.
    36. Allen AB, Leary MR. Self-Compassion, Stress, and Coping. Social and personality psychology compass. 2010;4(2):107-18.
    37. Esmaeili L, Amiri S, Reza Abedi M, Molavi H. The Effect of Acceptance and Commitment Therapy Focused on Self-Compassion on Social Anxiety of Adolescent Girls. Clinical Psychology Studies. 2018;8(30):117-37 (Persian).
    38. Roohi R, Soltani AA, Zinedine Meimand Z, Razavi Nematollahi V. The effect of acceptance and commitment therapy (act) on increasing the self-compassion, distress tolerance, and emotion regulation in students with social anxiety disorder. Quarterly Journal of Child Mental Health. 2019;6(3):173-87(Persian).
    39. Poursaleh A, HAMID N, DAVODI I. The effectiveness of Compassion Mind Training (CMT) on social anxiety Symptoms & psychological capitals among female students with social anxiety disorder of Shahid Chamran University of Ahvaz. 2020 (Persian).
    40. Wilson KG. The ACT matrix: A new approach to building psychological flexibility across settings and populations: New Harbinger Publications; 2014.
    41. Polk KL, Schoendorff B, Webster M, Olaz FO. The essential guide to the ACT Matrix: A step-by-step approach to using the ACT Matrix model in clinical practice: New Harbinger Publications; 2016.
    42. Mirsharifa SM, Mirzaian B, Dousti Y. The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome. Open Access Maced J Med Sci. 2019;7(3):421-7 (Persian).
    43. Nelson C. University student anxiety and stress–exploring the feasibility, suitability, and benefits of ACT matrix group workshops for university students experiencing anxiety and stress: Laurentian University of Sudbury; 2020.
    44. Peyamannia B. The Effectiveness of ACT Matrix with compassion on cognitive emotion regulation strategy in Students with Test Anxiety Disorders. The Journal of New Thoughts on Education. 2021 Jan 20;16(4).
    45. Johnson B, Christensen L. Educational research: Quantitative and qualitative approaches: Allyn & Bacon; 2000.
    46. First MB, Williams JB, Karg RS, Spitzer RL. User's guide for the SCID-5-CV Structured Clinical Interview for DSM-5® disorders: Clinical version. American Psychiatric Publishing, Inc.; 2016
    47. Fresco D, Erwin B, Heimberg R, Turk C. Social and specific phobias. New Oxford textbook of psychiatry. 2000:794-807.
    48. Atrifard, Mahdieh. Evaluation of Psychometric Characteristics of Libutz Social Anxiety Self-Reporting Scale in an Iranian Sample of Master of Clinical Psychology, Shahed University, 2012 (Persian).
    49. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Waltz T, Zettle RD. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behavior therapy. 2011;42(4):676-88.
    50. Abasi E, Fti L, Molodi R, Zarabi H. Psychometric properties of Persian version of acceptance and action questionnaire-II. 2013 (Persian).
    51. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clinical psychology & psychotherapy. 2011;18(3):250-5.
    52. Ghorbani N, Watson PJ, Chen Z, Norballa F. Self-compassion in Iranian Muslims: Relationships with integrative self-knowledge, mental health, and religious orientation. International Journal for the Psychology of Religion. 2012;22(2):106-18.
    53. Wilson KG, Sandoz EK, Kitchens J, Roberts M. The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. The Psychological Record. 2010;60(2):249-72.
    54. Akbari M. The Reliability and Validity of Persian version of the Valued Living Questionnaire: based on Acceptance and Commitment approach. 2018 (Persian).
    55. Hofmann SG, Otto MW. Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder specific treatment techniques: Routledge; 2017.
    56. Ingram RE, Hayes A, Scott W. Empirically supported treatments: A critical analysis. 2000.
    57. Fisher WW, Kelley ME, Lomas JE. Visual aids and structured criteria for improving visual inspection and interpretation of single-case designs. Journal of applied behavior analysis. 2003;36(3):387-406.
    58. Eisen SV, Ranganathan G, Seal P, Spiro A, 3rd. Measuring clinically meaningful change following mental health treatment. The journal of behavioral health services & research. 2007;34(3):272-89.
    59. Hamidpoor,Hasan. The Importance of Mothodlogy in Behavioral Cognitive Researchs.baztab danesh.2008, 349-56 (Persian).
    60. Yabandeh MR, Bagholi H, Sarvghad S, Kouroshnia M. Comparing the Effectiveness of Cognitive Behavioral Therapy with Acceptance and Commitment Therapy on Reduction of Social Anxiety Disorder Symptoms. 2019 (Persian).
    61. Khani ZO, Moghadam MF. Effect of Acceptance and Commitment Group Therapy on Social Ad-justment and Social Phobia Among Physically-Disabled Persons.
    62. Rostami M, Veisi N, Jafarian Dehkordi F, Alkasir E. Social anxiety in students with learning disability: Benefits of acceptance and commitment therapy. Practice in Clinical Psychology. 2014;2(4):277-84 (Persian).
    63. Hashemi-Nosratabad T, Mahmoud-Alilou M, Gholizadeh A. The Effectiveness of Cognitive Behavioral Therapy based on Hofmann’s Model on Fear of Negative Evaluation and Self-Focused Attention in Social Anxiety Disorder. Journal of Clinical Psychology. 2017;9(1):101-10 (Persian).
    64. Stangier U. New Developments in Cognitive-Behavioral Therapy for Social Anxiety Disorder. Current psychiatry reports. 2016;18(3):25.
    65. Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D. Efficacy of treatments for anxiety disorders: a meta-analysis. International clinical psychopharmacology. 2015;30(4):183-92.
    66. SHareh H, Roeinfard M, Haghi E. The effectiveness of Heimberg and Becker cognitive behavioral group therapy in improving female adolescents social anxiety and cognitive flexibility. 2014 (Persian).
    67. Blackledge JT, Ciarrochi J, Deane FP. Acceptance and commitment therapy: Contemporary theory research and practice: Australian Academic Press; 2009.
    68. Lutz A, Slagter HA, Dunne JD, Davidson RJ. Attention regulation and monitoring in meditation. Trends in cognitive sciences. 2008;12(4):163-9.

     

فایل ها

سابقه مقاله

  • تاریخ دریافت: 19 بهمن 1399
  • تاریخ بازنگری: 22 خرداد 1400
  • تاریخ پذیرش: 03 شهریور 1400

هم رسانی

ارجاع به این مقاله

آمار