Document Type : Research Paper

Authors

1 PhD Student in Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

2 Assosiate professor, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

Abstract

Abstract
The current study has been conducted to get the amount of effectiveness of the compassion-based approach on alexithymia and the sense of coherence in mothers with intellectually disabled children. It has been in progress for two months with a semi-experimental design using pre-test and post-test, accompanied by a control group. The whole population of the study involved 56 mothers having intellectually disabled children, who registered them in the Marand Well-being Organization Office from 2017 to 2022, of whom 30 had the required condition to get into the research. The study used a purposeful method for choosing the samples and put them randomly in two experimental and control groups. Compassion-based approach training was conducted in eight sessions for the experimental group while the control group received nothing. The data collected were analyzed and collected through alexithymia and the sense of coherence scales and were undergone the SPSS-22 software for the latter analysis and variance calculations. According to the results obtained compassion-based approach therapy for alexithymia and sense of coherence had a meaningful effect (p≤0/05). The follow-up stage has also demonstrated that the effect of compassion-based treatment on alexithymia and the sense of coherent sense of mothers with intellectually disabled children has been stable. Based on the results, psychology and counseling experts could use compassion-based training programs for alexithymia reduction and coherence sense enhancement of intellectually disabled children’s caregivers.
Keywords: Alexithymia, Compassion-Based Therapy, Intellectual Disability, Sense of Coherence.
 
 
Extended Abstract

Introduction

Mental intellectual (intellectual developmental disorder) is a disorder that begins during the development period and includes a person's lack of adaptive functioning and intelligence in the practical, social, and conceptual domains (American Psychiatric Association, 2022). The presence of a mentally retarded child can cause a change in the mental health and dynamics of the family system (Bahadori Khosrowshahi and Habibi-Kaleiber, 2015). When parents find out about their child's disability, they experience various forms of stress and psychological pressure, social isolation, and mental health problems (Popa, 2020). In the meantime, mothers, in the position of the main caretaker of the child, bear the biggest burden of the problem (Milani Far, 1400, p. 184). As most of the caretaking time for the child and interacting with him is usually taken by the mother, and due to the intellectual disability of the child, it has many problems in the intelligence, cognitive, emotional, and behavioral development field, there are major tensions in this regard directed at the mother (Gupta and Kaur, 2010).
One of the therapeutic interventions that seem to be effective in empowering mothers with mentally retarded children is self-compassion therapy (Rostampour-Brinjistanki, Abbasi, and Mirzaeian, 2019). Compassion therapy was founded by Gilbert (2005) as the main therapy and even complementary therapy (Lucre and Clapton, 2021). This treatment is a patient-centered behavior change strategy, and its purpose is to identify and reduce a person's doubts about changing their behavior, change in lifestyle and routine, and improve the person's perception of the importance of behavior change (Hacken and Taylor, 2021).
Research Question
Is compassion-based therapy effective in increasing the sense of coherence and reducing alexithymia of mothers with mentally retarded children?
Literature Review
The results of various studies show that compassion therapy increases self-coherence adaptability, reduces negative spontaneous thoughts (Ardashirzadeh, Bakhtiarpour, Homaei, Iftikhar Saadi, 2019), increases the sense of coherence (Ghaffari, Ismali, Atashgir, Hakim-abadi, 2017; Lloyd, 2017), improves the symptoms and quality of life (Nashi et al., 2019), reduces depression and anxiety (Safarinia, Mortezai Karhrodi, Alipur, 2022), increases the tolerance of distress and reduces of guilt in mothers with physically disabled children movement (Mahmoudpour, Dehghanpour, Ejadi and Mohammadi, 2021), improves of psychological flexibility in mothers with mentally retarded children (Rostampour Brijstanaki et al., 2016) and improves of alexithymia (Ahmadi Malairi, Rahmani, Pourasghar, 2021) Tajdin, Al-Yasin, Heydari, and Davoudi, 2019).
Methodology
The current research method was a semi-experimental pre-test post-test type with a control group with a 2-month follow-up. The statistical population of the present study was mothers with mentally disabled children who had a disability file for their children in Marand Welfare Department from 2017 to 2022 (N=56). In order to select the statistical sample of the research, by referring to the Marand Welfare Organization and using the purposeful sampling method, 30 mothers with mentally retarded children who have alexithymia (above 60) and sense of coherence (below 63) scales were selected and randomly replaced in the experimental and control groups.
Results
The results of multivariate tests showed that the interaction between time and group is significant for all variables. Therefore, compassion-based treatment training was effective on all variables and caused changes in alexithymia and sense of coherence (P<0.05). The obtained results showed that there is a significant difference between the pre-test and post-test scores in the two variables of emotional ataxia and sense of coherence (P<0.001). In other words, the effect of compassion-based intervention on research variables is confirmed. Also, there is a significant difference between pre-test and follow-up scores in both variables (P<0.001). In other words, the effect of time is confirmed. Meanwhile, no significant difference was observed between the post-test and follow-up scores in the two variables of alexithymia and the sense of coherence (P<0.05).
           
Table 1. Benferoni test to investigate the effectiveness of compassion-based therapy for research variables over time




Comparison


Alexithymia


sense of coherence




Mean difference


standard error


Significance level


mean difference


standard error


Significance level






Pre-test post-test


16.24


1.82


0.001


8.51


1.37


0.001




Post-test follow-up


0.97


1.26


0.07


0.48


1.18


0.69




Pre-test follow-up


6.42


2.11


0.001


8.93


1.42


0.001




Discussion
The present study was conducted with the aim of the effectiveness of the compassion-based approach on emotional ataxia and sense of coherence in mothers with intellectually disabled children. Based on the obtained results, compassion-based therapy reduced alexithymia in mothers with mentally retarded children, which is in agreement with the results of some studies (Ahmadi Malairi et al., 2021; Tajdin et al., 2019; Marsh, Chan, and McBeth, 2018; Kiel and Pidgon, 2017). Another finding of the research was that compassion-based therapy is effective in increasing the sense of coherence of mothers with mentally disabled children. The result obtained in accordance with the research results of Aghalar and Akrami (2021), Ardeshirzadeh et al. (2019), Narimani and Eyni (2019), Li, Liu, Han, Zhu, and Wang (2017), and Lloyd (2017).
Conclusion
The present study showed that the participants had clinically significant improvement in each scale and it seems that the intervention based on compassion was effective. The results of the follow-up test were not significantly different from the final test, and the therapeutic method based on compassion had a lasting effect on increasing the sense of coherence and reducing alexithymia.
Acknowledgments
We would like to thank all those who participated in this study.

Keywords

References
Ahmadi Malayeri, G., Rahmani, M., & Pourasghar, M. (2023). The Effectiveness of Compassion-based Therapy on Emotional Ataxia and Aggression in Women with Premenstrual Dysphoria. Islamic Life Style. 6(4),88-98URL: http://islamiclifej.com/article-1-1369-fa.html
Amjadiyan, F., Jafari, A., & Ghamari, M. (2022). The Comparison of Effectiveness of Self-Compassion and Emotion-Focused Therapy in Decreasing Psychophysical Vulnerability in Mothers of Children with Learning Disability. Psychology of Exceptional Individuals12(47), 115-149. doi: 10.22054/jpe.2023.65651.2409
Ardeshirzadeh, M., Bakhtiarpour, S., Homaei, R., & Eftekhar Saadi, Z. (2021). Effectiveness of Compassion Therapy on Self-coherence, Post-divorce Adjustment and Negative Automatic Thoughts in Divorced Women. IJPN, 8(6), 62-71. URL: http://ijpn.ir/article-1-1686-fa.html
Agha Yousefi, A. R., & Sharif, N. (2011). Correlation between psychological well-being and sense of coherence in the students of Islamic Azad University-Central Tehran Branch. Pajoohande, 15 (6), 273-279. URL: http://pajoohande.sbmu.ac.ir/article-1-1046-fa.html
Aghalar, S., & Akrami, L. (2022). The effectiveness of Compassion-Based Therapy for Depressive Symptoms, Rumination, and Self-Compassion in Mothers with Mild Intellectual Disability Child. Clinical Psychology and Personality, 20(1), 45-57. doi: 10.22070/cpap.2022.7261.0
Alipour, A., & Sharif, N. (2011). Studying the validity and reliability of the sense-cohesion questionnaire in college students, Researcher (Research Journal of Shahid Beheshti University of Medical Sciences). 17 (1) (Sequential 85): 50-56. file:///C:/Users/2022/Downloads/pajoohande-v17n1p50-en.pdf
Boersma K, Håkanson A, Salomonsson E, Johansson I. (2015). Compassion focused therapy to counteract shame, self- criticism and isolation. A replicated single case experimental study for individuals with social anxiety. Journal of Contemporary Psychotherapy. 1, 45(2):89-98.
Basharpoor, S., Almardani someeh, S., & Shahmohammadzadeh, Y. (2015). The Role of Alexithymia and Emotional Expressivity in Predicting Somatization Symptoms among Students of Mohaghegh Ardabili University during 2014-2015. JRUMS, 13 (10), 961-972. URL: http://journal.rums.ac.ir/article-1-2312-fa.html
Bahadori KhosroShahi, J., & Habibi Kalaibar, R. (2016). The Effectiveness of Acceptance and Commitment Based Training on the Meaningfulness of Life and Emotional Self-Disclosure among Mothers of Children with Intellectual Disability. Psychology of Exceptional Individuals, 6(23), 83-105. doi: 10.22054/jpe.2016.7368
Ghaffari, M., Esmaeli, A., Atashgir, A., & Hokmabadi, S. (2018). Evaluation of the Relationship between the Sense of Coherence and Compassion towards the Lives of Others with Nurses' Attitudes to Patient Education: The Mediating Role of Personal Intelligence. SJNMP, 4(2), 27-38. URL: http://sjnmp.muk.ac.ir/article-1-163-fa.html
Hasan Larijani, M., Hossein Sabet, F., & Borjali, A. (2020). Effects of Acceptance and Commitment Therapy on Alexithymia in Patients with Multiple Sclerosis. MEJDS, 10, 124-124. URL: http://jdisabilstud.org/article-1-1498-fa.html
Hosseini, M., Abdakhodaei, & M. S. (2015). The effect of Fordyce's cognitive-behavioral happiness training on the psychological coherence of type 2 diabetic patients, Neyshabur Faculty of Medical Sciences Journal. 4(4), 1-12. https://civilica.com/doc/643935
Mahmoudpour, A., Dehghanpour, S., Ejadi, S., & Mohamadi, S. (2021). The Effectiveness of Compassion-Focused Therapy on Distress Tolerance and Feeling of Guilt in Mothers of Children with Physical-Motor Disability. QJCR 2021; 20(79), 269-289. URL: http://irancounseling.ir/journal/article-1-1324-fa.html
Mahmoudi, M., Saberi, H., & Bashardoust, S. (2022). Predicting psychological distress based on childhood trauma with the mediating role of alexithymia. Advances in Cognitive Sciences, 24(3) :41-56. URL: http://icssjournal.ir/article-1-1443-fa.html
Mousavi, S. M., Khajevand Khoshli, A., Asadi, J., & Abdollahzadeh, H. (2021). Comparison of the effectiveness of compassion-focused therapy and acceptance and commitment therapy on distress tolerance in women with systemic lupus erythematosus. Journal of Psychological Science. 20(99), 453-460. URL: http://psychologicalscience.ir/article-1-860-fa.html
Mohammadzadeh, A. (1390). Examining the psychometric characteristics of the 13-question test of Antonovsky's sense of coherence. Master's thesis in psychology. Payam Noor university of Tehran.
Mirzaei, M., Rahnejat, A., Taheri, N., Moeeni, F., Roostaei, M., Nazemi, M. et al. (2020). Effectiveness of Group Compassion Therapy on Improving Symptoms and Quality of Life in Bulimia Nervosa. Paramedical Sciences and Military Health, 15(1), 35-42. URL: http://jps.ajaums.ac.ir/article-1-217-fa.html
Milani Far, B. (2022). Psychology of exceptional children and adolescents. Tehran: Qoms Publishing.
Narimani, M., & Eyni, S.. Relationship between Meaning of Life, Self- Compassion and sense of coherence with perceived stress in cancer patients. IJCA, 1(3), 1-10. URL: http://ijca.ir/article-1-94-fa.html
Nasrolahi, B., & Aghaee, V. (2022). Comparison of Alexithymia and cognitive emotion regulation strategies in individuals with symptoms of generalized anxiety disorder, social anxiety disorder and substance abuse with healthy individuals. Rooyesh, 11(4), 217-228. URL: http://frooyesh.ir/article-1-3602-fa.html
Niasati, N., Ghorban Shiroudi, S., Khalatbari, J., & Tizdast, T. (2022). The Effectiveness of an Education Package based on Compassion-Focused Therapy, Emotion-Focused Therapy, and Acceptance and Commitment-based Therapy on the Tolerance of Anxiety and Impulsivity of Adolescents with Aggressive Behaviors. Islamic Life Style, 5(4), 107-117. URL: http://islamiclifej.com/article-1-968-fa.html
Rostampour Brenjestanaki, M., Abbasi, G., & Mirzaian, B. (2020). Effectiveness of Compassion-focused Therapy on Psychological Flexibility recovery and Self-criticism decrease in Mothers with Mentally Retarded Children. Biannual Journal of Applied Counseling, 10(2), 1-18. doi: 10.22055/jac.2020.33836.1749
Sarlak, F., & Sajjadian, I. (2015). Comparison of emotional dyslexia, anxiety and depression communication skills in codependent and normal people. Journal of Social Psychology. 4(40), 75-88. https://psychology.ahvaz.iau.ir/article_530956_ad7de09ca7fe384fd9e2f74ec516bd0f.pdf
Saffarinia, M., Mortezaei, Z., & Alipour, A. (2022). Sexual dysfunction is one of the complications of infertility treatment and is often overlooked in the care of women with infertility. Journal of Applied Family Therapy, 3(3), 457-473. doi: 10.22034/aftj.2022.334734.1493.pdf
Tajdin, A., AleYasin, A., heydari, H., & davodi, H. (2020). Comparison of the effectiveness of compassion-focused therapy and reality therapy on alexithymia among male prisoner clients. Journal of Psychological Science. 19(95), 1519-1532. URL: http://psychologicalscience.ir/article-1-835-
taheri, M. (2012). Relationship between attachment style and life expectancy in mothers of sons with educable intellectually disability. Journal of Fundamentals of Mental Health, 14(53), 24-35. doi: 10.22038/jfmh.2012.930
Yousefi Afrashteh, M., & Rezaei, S. (2021). The Spirituality and Quality of Life in the Elderly: The Mediating Role of Self-Compassion and Sense of Cohesion. Aging Psychology, 7(2), 151-137. doi: 10.22126/jap.2021.6358.1526
Yousefi, Z., & sobhani, M. (2018). The Effectiveness of Quality of Life Therapy on Burnout and It's Dimensions among Female Workers. Career and Organizational Counseling, 10(37), 9-30. https://jcoc.sbu.ac.ir/article_99905_184abf9164b6eff7c44b57bbb640434a.pdf