اثربخشی درمان مبتنی بر پذیرش و تعهد (ACT) در درمان پریشانی زوج‌ها

نوع مقاله : مقاله کاربردی

نویسندگان

1 هیات علمی

2 کارشناس

چکیده

درمان مبتنی بر پذیرش و تعهد یک پیشرفت انقلابی در روان­شناسی است که ابتدا برای درمان اضطراب و افسردگی به وجود آمده است. اصول برآمده از درمان مبتنی بر پذیرش و تعهد می­تواند در دامنه وسیعی از مشکلات انسان از جمله ازدواج و زوج­درمانی مورد استفاده قرار گیرد. هدف از پژوهش حاضر بررسی اثربخشی درمان مبتنی بر پذیرش و تعهد (ACT) بر کاهش پریشانی و پریشانی بین فردی زوج­ها در میان زوج­های مراجعه­کننده­ی شهرستان دزفول بود. جامعه­ی پژوهش شامل کلیه­ی زوج­های مراجعه­کننده به کلینیک روان شناختی اداره آموزش و پرورش شهرستان دزفول در سال 1392 بود. نمونه­ی پژوهش شامل 3 زوج (6 نفر) از افراد مراجعه کننده به این کلینیک­ بود که با توجه به پرسش نامه­ی نتایج (پی­آمد) 45.2 (45.2-OQ) و مقیاس سازگاری زوجی(DAS) جزء زوج­های پریشان قرار گرفتند. روش نمونه­گیری در این پژوهش نمونه­گیری هدفمند بود، به این صورت که زوج­ها پس از احراز شرایط ورود و پر کردن پرسش­نامه­ها وارد دوره­ی درمانی می­شدند. در این پژوهش از طرح آزمایشی تک موردی از نوع خط پایه چندگانه ناهم­زمان استفاده شد. پروتکل درمان مبتنی بر پذیرش و تعهد در سه مرحله­ی خط پایه، مداخله­ی 12 جلسه­ای و پیگیری 1 ماهه اجرا گردید و آزمودنی­ها قبل از درمان، میانه­ی درمان، پایان درمان و 1 ماه پس از پایان درمان به پرسش نامه نتایج (برآمد) 45.2 (45.2-OQ) پاسخ داده­ها به روش ترسیم دیداری، شاخص تغییر پایا (RCI) و فرمول درصد بهبودی تحلیل شدند. نتایج نشان داد که: درمان مبتنی بر پذیرش و تعهد بر همه­ی متغیرهای مورد مطالعه تأثیر مطلوب دارد.

کلیدواژه‌ها


عنوان مقاله [English]

Effectiveness of Acceptance and Commitment Therapy (ACT) in the Treatment of Distressed Couples

چکیده [English]

Acceptance and Commitment Therapy (ACT) is a revolutionary new development in human psychology. Originally developed for treating anxiety and depression, the principles of ACT can be applied to a broad range of human concerns, including marriage and couple therapy.The aim of this study was to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) to reduce  psychological distress and interpersonal distress among couples of  Dezful. The population included all the couples that refered to the counseling center of the Education office. The sample consisted of 3 couples that were selected according to the results of the Outcome Questionnaire 45.2 (45.2-OQ) and the Dyadic Adjustment Scale (DAS). Non-congruent multiple baseline experimental single case study was used as the method of the present study. The Acceptance and Commitment Therapy protocol was carried out in three phases of the intervention (Baseline, 12 sessions, and a one- month follow-up). Participants completed the Outcome Questionnaire 45.2 (45.2-OQ). before the treatment, during the treatment, and one month after the treatment had ended.
Data were analyzed using visual inspection, the improvement percentage formula and the reliable change index (RCI) strategies. Results showed that the Acceptance and Commitment Therapy (ACT) has positive effects on all the variables of the study.
 
 
 

کلیدواژه‌ها [English]

  • Keywords: acceptance antherapy
  • distressed couples
  • interpersonal distressedd commitment
 
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal ofPersonality and Social Psychology, 84, 822–848.
Carson, J. W., Carson, K. M., Gil, K. M., & Baucom, D. H. (2004). Mindfulness-based relationship enhancement. Behavioral Therapy, 35, 471–494.
Cooper, M. L., Russell, M., Skinner, J. B., Frone, M. R., & Mudar, P. (1992). Stress and alcohol use: Moderating effects of gender, coping, and alcohol expectancies. Journal ofAbnormal Psychology, 101, 139–152.
DeGenova, M. K., Patton, D. M., Jurich, J. A., & MacDermid, S. M. (1994). Ways of coping among HIV-infected individuals. Journal of Social Psychology, 134, 655–663.
Fincham, F. D., Reis, H. T., & Rusbult, C. E. (2004). Attribution processes in distressed and nondistressed couples: Responsibility for marital problems. In H. T. Reis & C. E. Rusbult (Ed.), Close relationships: Key readings (pp. 427–434). Philadelphia, PA: Taylor & Francis.
Foa, E. B., & Riggs, D. S. (1995). Post-traumatic stress disorder following assault: Theoretical considerations and empirical findings. Current Directions in Psychological Science, 4, 61–z65.
Gurman, A. S., & Fraenkel, P. (2002). The history of couple therapy: Amillennial review. Family Process, 41, 199–260.
Hayes, S. C., & Wilson, K. G. (1994). Acceptance and commitment therapy: Altering the verbal support for experiential avoidance. Behavior Analyst, 17, 289–303.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes.Behaviour Research and Therapy, 44, 1–25.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance andcommitment therapy: An experiential approach to behavior change. New York: The Guilford Press.
Jacobson, N. S., & Christensen, A. (1996). Integrative couple therapy: Promoting acceptance and change. New York: Guilford Press.
Johnson, S.M. (1999). Emotionally focused couple therapy: Straight to the heart. In J.M. Donovan (Ed.), Short-term coupletherapy (pp. 1242). New York Guilford.
Johnson, S., & Lebow, J. (2000). The “coming of age” of couple therapy: A decade of review. Journal of Marital and Family Therapy,  26, 23–38.
Koster, E. H. W., Rassin, E., Crombez, G., & Naring, G. W. B. (2003). The paradoxical effects of suppressing anxious thoughts during imminent threat. Behaviour Research &Therapy, 41(9), 1113–1120.
Jacobson, N. S., Christensen, A., Prince, S. E., Cordova, J., & Eldridge, K. (2000). Integrative behavioral couple therapy: An acceptance based, promising new treatment for couple discord. Journal of Consulting and Clinical Psychology, 68, 351–355.
Lambert, M., Burlingame, G. M., Umphress, V., Hansen, N. B., V ermeersch, D. A., & Clouse, G. C., (1996). The reliabilityand validity of the outcome questionnaire. Clinical Psychology and Psychotherapy, 3, 249–258.
Leitenberg, H., Greenwald, E., & Cado, S. (1992). A retrospective study of longterm methods of coping with having been sexually abused during childhood. Child Abuse and Neglect, 16, 399–407.
Linehan, M. M. (1987). Dialectical behavior therapy for borderline personality disorder: Theory and method. Bulletin of the Menninger Clinic, 51, 261–276.
Moser, A. E., & Annis, H. M. (1996). The role of coping in relapse crisis outcome: A prospective study of treated alcoholics. Addiction, 91, 1101–1114.
Norton, R., (1983). Measuring marital quality–a critical look at the dependent variable. Journal of Marriage and the Family 45, 141–151.
Peterson, B. D., Eifert, G. H., Feingold, T., & Davidson, S. (2009). Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study With Two Couples. Cognitive and Behavioral Practice, 16, 430–442.
Polusny, M., & Follette, V. M. (1995). Long-term correlates of child sexual abuse: Theory and review of the empirical literature. Applied and Preventive Psychology, 4, 143–166.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. T. (2001). Mindfulness-based cognitive therapy for depression: A new approach to preventingrelapse. New York: Guilford Press.
Smari, J., & Holmsteinsson, H. E. (2001). Intrusive thoughts, responsibility attitudes, thought-action fusion, and chronic thought suppression in relation to obsessive-compulsive symptoms. Behavioural and Cognitive Psychotherapy, 29, 13–20.
Spanier GB, Thompson L. A. (1982) confirmatory analysis of the Dyadic Adjustment Scale.Journal of Marriage and the Family, 44:731–738.
Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal ofMarriage  and the Family, 38, 15–28.
Spanier, G. B., & Filsinger, E. E. (1983). The dyadic adjustment scale. In E. E. Filsinger (Ed.), Marriage and family assessment: A sourcebookforfamily therapy (pp. 155–168). Beverly Hills: Sage Publications.
Stuart, R. B. (1992). Review of the dyadic adjustment scale. In J. J. Kramer, & J. C. Conoley (Eds.), The eleventh mental measurementyearbook (pp. 297–298). Lincoln: University of Nebraska Press.
Teasdale, J. T. (2003). Mindfulness and the third wave of cognitive-behavioural therapies. Paper presented at the European Association for behavioural and cognitive therapies annual congresses, Prague, Czech Republic. therapy: What do we know? Where are we going. Journal of Consulting and Clinical Psychology, 61, 85–93.
Thomas, K. W. (1976). Conflict and conflict management. In M. D. Dunnette (Ed.), The handbook of organizational and industrial psychology (pp. 839-935). Chicago: Rand Mc Nally.
Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62, 615–640.
Wells, A. (2000). Emotional disorders and metacognition: Innovativecognitive therapy. Chichester, UK: Wiley.
Wheeler, J. G., Christensen, A., & Jacobson, N. S. (2001). In D. H. Barlow (Ed.). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual (3rd ed.) (pp. 609-630). New York: The Guilford Press.
Whisman, M. A., & Uebelacker, L. A. (2006). Impairment and distress associated with relationship discord in a national sample of married or cohabiting adults. Journal of Family Psychology, 20, 369–377.
Wilson, G. T. (1996). Acceptance and change in the treatment of eating disorders and obesity. Behavior Therapy, 27, 417–439.