Journal of Health And Care
Volume 26, Issue 4 (winter 2024)
JHC 2024, 26(4): 328-342 |
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Mirali Bidakhavidi Y, Jandaghi B, Smkhani Akbarinejhad H. Comparing the Effectiveness of Compassion-focused Therapy and Short-term Solution-focused Therapy on Self-esteem and Aggression in Female Adolescents with Self-injurious Behaviors. JHC 2024; 26 (4) :328-342
URL: http://hcjournal.arums.ac.ir/article-1-1571-en.html
URL: http://hcjournal.arums.ac.ir/article-1-1571-en.html
Department of Law, Hoda Faculty, Qom, Iran
Abstract: (476 Views)
Background: Self-injury is one of the problems that causes many psychological and social harms. Its prevalence in adolescents is very high and it has become a serious problem. The present study aimed to compare the effectiveness of Compassion-Focused Therapy (CFT) with Short-Term Solution-Focused Therapy (STSFT) on self-esteem and aggression in female adolescents with self-injurious behaviors.
Methods: This study was quasi-experimental with pre-test, post-test, and follow-up with a control group design. The study population included all female students with self-injurious behaviors attending the second high school level in the 1402-1403 (2024) academic year in Tabriz City. A total of 45 people were selected using a non-random purposeful sampling method and randomly divided into three groups (15 participants each). Members of the compassion-focused therapy group and the short-term solution-focused therapy group received their specific intervention in 8 and 6 sessions of 1.5 hours each. The control group received no treatment. Both groups completed the Cooper Smith (1976) 58-question self-esteem questionnaire and Buss and Perry (1992) 29-question aggression questionnaire, before, after, and 4 months after the intervention. Data were analyzed using repeated measures analysis of variance and Bonferroni post hoc tests using SPSS-26 software.
Results: There was no significant difference between the scores of self-esteem and aggression in the experimental and control groups at the pre-test (p<0.05). The results showed that CFT and STSFT increased self-esteem and decreased aggression in female adolescents with self-injurious behaviors at the post-test, compared with the control group (p<0.001). The effects of CFT and STSFT on self-esteem and aggression persisted at the follow-up (p<0.001). In addition, the effects of CFT and STSFT on self-esteem and aggression at post-test and follow-up were insignificant (p<0.05).
Conclusion: Based on the results of this study, compassion-focused therapy, and short-term solution-focused therapy may be effective in enhancing the self-esteem and reducing the aggression of female adolescents with self-injurious behaviors. Therefore, these two therapeutic approaches can be used to reduce the problems arising from self-injury among teenage females, including reducing aggression and improving their self-esteem
Methods: This study was quasi-experimental with pre-test, post-test, and follow-up with a control group design. The study population included all female students with self-injurious behaviors attending the second high school level in the 1402-1403 (2024) academic year in Tabriz City. A total of 45 people were selected using a non-random purposeful sampling method and randomly divided into three groups (15 participants each). Members of the compassion-focused therapy group and the short-term solution-focused therapy group received their specific intervention in 8 and 6 sessions of 1.5 hours each. The control group received no treatment. Both groups completed the Cooper Smith (1976) 58-question self-esteem questionnaire and Buss and Perry (1992) 29-question aggression questionnaire, before, after, and 4 months after the intervention. Data were analyzed using repeated measures analysis of variance and Bonferroni post hoc tests using SPSS-26 software.
Results: There was no significant difference between the scores of self-esteem and aggression in the experimental and control groups at the pre-test (p<0.05). The results showed that CFT and STSFT increased self-esteem and decreased aggression in female adolescents with self-injurious behaviors at the post-test, compared with the control group (p<0.001). The effects of CFT and STSFT on self-esteem and aggression persisted at the follow-up (p<0.001). In addition, the effects of CFT and STSFT on self-esteem and aggression at post-test and follow-up were insignificant (p<0.05).
Conclusion: Based on the results of this study, compassion-focused therapy, and short-term solution-focused therapy may be effective in enhancing the self-esteem and reducing the aggression of female adolescents with self-injurious behaviors. Therefore, these two therapeutic approaches can be used to reduce the problems arising from self-injury among teenage females, including reducing aggression and improving their self-esteem
Keywords: Compassion-focused Therapy, Short-term Solution-focused Therapy, Self-esteem, Aggression, Self- injurious Behaviors
Type of Study: quasi-experimental |
Subject:
Psychiatric Nursing
Received: 2024/07/2 | Accepted: 2024/12/10 | Published: 2024/12/30
Received: 2024/07/2 | Accepted: 2024/12/10 | Published: 2024/12/30
References
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10. Shechtman Z, Tutian R. Teachers treat aggressive children: an outcome study. Teaching and Teacher Education. 2016;58:28-34. [DOI:10.1016/j.tate.2016.04.005]
11. Vacher C, Romo L, Dereure M, Soler M, Picot MC, Purper-Ouakil D. Efficacy of cognitive behavioral therapy on aggressive behavior in children with attention deficit hyperactivity disorder and emotion dysregulation: study protocol of a randomized controlled trial. Trials. 2022;23(1):124. [DOI:10.1186/s13063-022-05996-5] [PMID] []
12. Healy SR, Valente J, Caetano S, Martins S, Sanchez Z. Worldwide school-based psychosocial interventions and their effect on aggression among elementary school children: a systematic review 2010-2019. Aggression and Violent Behavior. 2020;55:101486. [DOI:10.1016/j.avb.2020.101486]
13. Mahmoudinia S, Sepah-Mansour M, Emamipour S, Hosni F. Comparison of the effectiveness of the aggression alternative training program and the immunization against stress training program on adolescent impulsivity. Social Psychology Research. 2018;8(30):1-18. [persian]
14. Short MM, Mazmanian D, Oinonen K, Mushquash CJ. Executive function and self-regulation mediate dispositional mindfulness and well-being. Personality and Individual Differences. 2016;93:97-103. [DOI:10.1016/j.paid.2015.08.007]
15. Denoth F, Biagioni S, Baldini F, Baroni M, Franchini M, Molinaro S. Weight categories among male adolescents linked to risky behaviors: high or low BMI, which is worse? Adolescents. 2022;2(1):128-39. [DOI:10.3390/adolescents2010012]
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22. Derikvand F, Yazdanbakhsh K, Karami J. The effectiveness of compassion-focused therapy on externalized problems (aggression and delinquency) in bullying students. Knowledge & Research in Applied Psychology. 2022;23(2):40-51.
23. Aghaali Tari S, Haghani R, Nikkhah B. The effectiveness of the therapy based on self-compassion on the aggression and resilience of female student with ODD. Medical Journal of Mashhad University of Medical Sciences. 2021;63(6):2210-20. [persian]
24. Damavandian A, Golshani F, Saffarinia M, Baghdasarians A. Comparing the effectiveness of Compassion-Focused Therapy (CFT) and Dialectic Behavior Therapy (DBT) on aggression, self-harm behaviors and emotional self-regulation in Juvenile offenders of Tehran Juvenile Correction and Rehabilitation Center. Social Psychology Research. 2021;11(41):31-58. [persian]
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26. Asmkhani Akbarinejad H, Zolfalipour Maleki S. Postmodern/Poststructuralist Theories of Counseling and Psychotherapy. 1th ed. Tehran: Savalan; 2021. [persian]
27. Yasfard G, Abaspour Azar Z, Hosseini Almadani SA. Comparing the effectiveness of group dialectical behavior therapy and solution-focused brief therapy on self-esteem, cognitive-emotional regulation and non-suicidal self-injury in daughters. Iranian Journal of Health Education and Health Promotion. 2020;7(4):343-58. [persian] [DOI:10.29252/ijhehp.7.4.343]
28. Bakhshipoor B, Ramezanzadeh S. The effect of solution-focused brief therapy on aggression in children and adolescents. Journal of Psychological Studies. 2016;12(3):141-56.
29. Farhoodi F, Saeedmanesh M, Mirshahi F. Solution-focused brief group therapy on self-esteem and test anxiety first secondary school female students in Koshkoueeh City. Middle Eastern Journal of Disability Studies. 2019;9(1):20. [persian]
30. Erdoğan E, Demir S. The effect of solution focused group psychoeducation applied to schizophrenia patients on self-esteem, perception of subjective recovery and internalized stigmatization. Issues in Mental Health Nursing. 2022;43(10):944-54. [DOI:10.1080/01612840.2022.2083735] [PMID]
31. Akbaş E, Çamur Z, Kılınç E. The effect of the solution-focused approach intervention program on anger management and violent behavior in adolescents: a systematic examination. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi. 2022;41:147-66.
32. Hsu K-S, Eads R, Lee MY, Wen Z. Solution-focused brief therapy for behavior problems in children and adolescents: a meta-analysis of treatment effectiveness and family involvement. Children and Youth Services Review. 2021;120:105620. [DOI:10.1016/j.childyouth.2020.105620]
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36. Soheylizad M, Yahaghi Amjad E, Amini D, Gholamaliee B. Relationship between self-esteem, resilience and quality of life in patients with type 2 diabetes in Hamadan in 2015. Pajouhan Scientific Journal. 2016;15(1):1-8.
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38. Mosalman Z. The effect of cognitive therapy on irrational beliefs, ataxia, aggression of depressed people. Master's Thesis in General Psychology. Islamic Azad University of Mashhad; 2016. [persian]
39. Salamat A. The effectiveness of behavioral activation therapy on burnout and aggression in diabetic patients. Master's Thesis in General Psychology. Islamic Azad University of Tehran; 2017. [persian]
40. Gilbert P. The origins and nature of compassion focused therapy. British Journal of Clinical Psychology. 2014;53(1):6-41. [DOI:10.1111/bjc.12043] [PMID]
41. Baker DA, Caswell HL, Eccles FJ. Self-compassion and depression, anxiety, and resilience in adults with epilepsy. Epilepsy & Behavior. 2019;90:154-61. [DOI:10.1016/j.yebeh.2018.11.025] [PMID]
42. Morley RM, Terranova VA, Cunningham SN, Kraft G. Self-compassion and predictors of criminality. Journal of Aggression, Maltreatment & Trauma. 2016;25(5):503-17. [DOI:10.1080/10926771.2015.1107170]
43. Bluth K, Eisenlohr-Moul TA. Response to a mindful self-compassion intervention in teens: A within-person association of mindfulness, self-compassion, and emotional well-being outcomes. Journal of Adolescence. 2017;57:108-18. [DOI:10.1016/j.adolescence.2017.04.001] [PMID] []
44. Albertson ER, Neff KD, Dill-Shackleford KE. Self-compassion and body dissatisfaction in women: a randomized controlled trial of a brief meditation intervention. Mindfulness. 2015;6:444-54. [DOI:10.1007/s12671-014-0277-3]
45. Kim H. Client Growth and Alliance Development in Solution-Focused Brief Family Therapy. State University of New York at Buffalo; 2006.
46. Dick AS, Lopez DA, Watts AL, Heeringa S, Reuter C, Bartsch H, et al. Meaningful associations in the adolescent brain cognitive development study. Neuroimage. 2021;239:118262. [DOI:10.1016/j.neuroimage.2021.118262] [PMID] []
47. Gu H, Ma P, Xia T. Childhood emotional abuse and adolescent nonsuicidal self-injury: the mediating role of identity confusion and moderating role of rumination. Child Abuse Neglect. 2020;106:104474. [DOI:10.1016/j.chiabu.2020.104474] [PMID]
48. Wu R, Huang J, Ying J, Gao Q, Guo J, You J. Behavioral inhibition/approach systems and adolescent nonsuicidal self-injury: the chain mediating effects of difficulty in emotion regulation and depression. Personality and Individual Differences. 2021;175:110718. [DOI:10.1016/j.paid.2021.110718]
49. Bettis AH, Liu RT, Walsh BW, Klonsky ED. Treatments for self-njurious thoughts and behaviors in youth: progress and challenges. Evidence-Based Practice in Child and Adolescent Mental Health. 2020;5(3):354-64. [DOI:10.1080/23794925.2020.1806759] [PMID] []
50. Doğru H. Psychopathological differences between self-injurious behaviors and suicide Attempts in adolescents. The Eurasian Journal of Medicine. 2023;55(1):37-42. [DOI:10.5152/eurasianjmed.2023.21287] [PMID] []
51. Sfeir E, Geara C, Hallit S, Obeid S. Alexithymia, aggressive behavior and depression among Lebanese adolescents: a cross-sectional study. Child and Adolescent Psychiatry and Mental Health. 2020;14:32. [DOI:10.1186/s13034-020-00338-2] [PMID] []
52. Teo I, Fronczyk KM, Guindani M, Vannucci M, Ulfers SS, Hanasono MM, et al. Salient body image concerns of patients with cancer undergoing head and neck reconstruction. Head & Neck. 2016;38(7):1035-42. [DOI:10.1002/hed.24415] [PMID]
53. Ghorbani M, Alipour A, Aliakbari Dehkordi M. The effectiveness of interventions of positive approach on depression, selfesteem, life expectancy and body image of mastectomized women. Health Psychology. 2017;6(23):151-67. [persian]
54. Hu Y, Cai Y, Wang R, Gan Y, He N. The relationship between self-esteem and aggressive behavior among Chinese adolescents: a moderated chain mediation model. Frontiers in Psychology. 2023;14:1191134. [DOI:10.3389/fpsyg.2023.1191134] [PMID] []
55. Shechtman Z, Tutian R. Teachers treat aggressive children: an outcome study. Teaching and Teacher Education. 2016;58:28-34. [DOI:10.1016/j.tate.2016.04.005]
56. Vacher C, Romo L, Dereure M, Soler M, Picot MC, Purper-Ouakil D. Efficacy of cognitive behavioral therapy on aggressive behavior in children with attention deficit hyperactivity disorder and emotion dysregulation: study protocol of a randomized controlled trial. Trials. 2022;23(1):124. [DOI:10.1186/s13063-022-05996-5] [PMID] []
57. Healy SR, Valente J, Caetano S, Martins S, Sanchez Z. Worldwide school-based psychosocial interventions and their effect on aggression among elementary school children: a systematic review 2010-2019. Aggression and Violent Behavior. 2020;55:101486. [DOI:10.1016/j.avb.2020.101486]
58. Mahmoudinia S, Sepah-Mansour M, Emamipour S, Hosni F. Comparison of the effectiveness of the aggression alternative training program and the immunization against stress training program on adolescent impulsivity. Social Psychology Research. 2018;8(30):1-18. [persian]
59. Short MM, Mazmanian D, Oinonen K, Mushquash CJ. Executive function and self-regulation mediate dispositional mindfulness and well-being. Personality and Individual Differences. 2016;93:97-103. [DOI:10.1016/j.paid.2015.08.007]
60. Denoth F, Biagioni S, Baldini F, Baroni M, Franchini M, Molinaro S. Weight categories among male adolescents linked to risky behaviors: high or low BMI, which is worse? Adolescents. 2022;2(1):128-39. [DOI:10.3390/adolescents2010012]
61. Bježančević M, Groznica Hržić I, Dodig-Ćurković K. Self-injury in adolescents: a five-year study of characteristics and trends. Psychiatria Danubina. 2019;31(4):413-20. [DOI:10.24869/psyd.2019.413] [PMID]
62. Gilbert P, Simos G. Compassion Focused Therapy: Clinical Practice and Applications. Routledge; 2022. [DOI:10.4324/9781003035879]
63. Chen S. An online solution focused brief therapy for adolescent anxiety during the novel coronavirus disease (COVID-19) pandemic: a structured summary of a study protocol for a randomised controlled trial. Trials. 2020;21:1-2. [DOI:10.1186/s13063-020-04355-6] [PMID] []
64. Millard L, Wan MW, Smith D, Wittkowski A. The effectiveness of compassion focused therapy with clinical populations: a systematic review and meta-analysis. Journal of Affective Disorders. 2023;326:168-92. [DOI:10.1016/j.jad.2023.01.010] [PMID]
65. Fallah A, Heydari S, Emadian S. Comparing the effectiveness of mindfulness-based stress reduction and compassion-focused therapy on distress tolerance, high-risk behaviors and feelings of loneliness in students with self-njurious behaviors. Journal of Torbat Heydarieh University of Medical Sciences. 2023;11(2):99-113. [persian]
66. Kashanian F, Khodabakhshi-Koolaee A, Taghvaei D, Ahghar G. Comparing the effectiveness of two group therapies compassion-focused therapy and positive-oriented therapy on empathy and feelings of happiness in adolescent girls with a background of self-injury. Journal of Pediatric Nursing. 2023;9(3):40-51. [persian]
67. Derikvand F, Yazdanbakhsh K, Karami J. The effectiveness of compassion-focused therapy on externalized problems (aggression and delinquency) in bullying students. Knowledge & Research in Applied Psychology. 2022;23(2):40-51.
68. Aghaali Tari S, Haghani R, Nikkhah B. The effectiveness of the therapy based on self-compassion on the aggression and resilience of female student with ODD. Medical Journal of Mashhad University of Medical Sciences. 2021;63(6):2210-20. [persian]
69. Damavandian A, Golshani F, Saffarinia M, Baghdasarians A. Comparing the effectiveness of Compassion-Focused Therapy (CFT) and Dialectic Behavior Therapy (DBT) on aggression, self-harm behaviors and emotional self-regulation in Juvenile offenders of Tehran Juvenile Correction and Rehabilitation Center. Social Psychology Research. 2021;11(41):31-58. [persian]
70. Baratiyan A, Salimi A, Moghim F, Shakrami M, Davarniya R. Effect of short-term solution-based treatment on increasing self-esteem of female students. Journal of Nursing Research. 2015;11(4):64-57. [persian] [DOI:10.21859/ijnr-110407]
71. Asmkhani Akbarinejad H, Zolfalipour Maleki S. Postmodern/Poststructuralist Theories of Counseling and Psychotherapy. 1th ed. Tehran: Savalan; 2021. [persian]
72. Yasfard G, Abaspour Azar Z, Hosseini Almadani SA. Comparing the effectiveness of group dialectical behavior therapy and solution-focused brief therapy on self-esteem, cognitive-emotional regulation and non-suicidal self-injury in daughters. Iranian Journal of Health Education and Health Promotion. 2020;7(4):343-58. [persian] [DOI:10.29252/ijhehp.7.4.343]
73. Bakhshipoor B, Ramezanzadeh S. The effect of solution-focused brief therapy on aggression in children and adolescents. Journal of Psychological Studies. 2016;12(3):141-56.
74. Farhoodi F, Saeedmanesh M, Mirshahi F. Solution-focused brief group therapy on self-esteem and test anxiety first secondary school female students in Koshkoueeh City. Middle Eastern Journal of Disability Studies. 2019;9(1):20. [persian]
75. Erdoğan E, Demir S. The effect of solution focused group psychoeducation applied to schizophrenia patients on self-esteem, perception of subjective recovery and internalized stigmatization. Issues in Mental Health Nursing. 2022;43(10):944-54. [DOI:10.1080/01612840.2022.2083735] [PMID]
76. Akbaş E, Çamur Z, Kılınç E. The effect of the solution-focused approach intervention program on anger management and violent behavior in adolescents: a systematic examination. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi. 2022;41:147-66.
77. Hsu K-S, Eads R, Lee MY, Wen Z. Solution-focused brief therapy for behavior problems in children and adolescents: a meta-analysis of treatment effectiveness and family involvement. Children and Youth Services Review. 2021;120:105620. [DOI:10.1016/j.childyouth.2020.105620]
78. Cory G, Cory MS. Group Therapy. (Translated by Seifullah Bahari, Bayramali Ranjgar, Hamid reza Hosseinshahi Baravati, Malek Mirhashimi & Siamak Naghshbandi) Tehran: Ravan; 2017. [persian]
79. De Shazer S. Words Were Originally Magic. WW Norton & Co; 1994.
80. Pritchard M. Does self esteem moderate the relation between gender and weight preoccupation in undergraduates? Personality and Individual Differences. 2010;48(2):224-27. [DOI:10.1016/j.paid.2009.10.015]
81. Soheylizad M, Yahaghi Amjad E, Amini D, Gholamaliee B. Relationship between self-esteem, resilience and quality of life in patients with type 2 diabetes in Hamadan in 2015. Pajouhan Scientific Journal. 2016;15(1):1-8.
82. Buss AH, Perry M. The aggression questionnaire. Journal of Personality and Social Psychology. 1992;63(3):452-59. [DOI:10.1037/0022-3514.63.3.452] [PMID]
83. Mosalman Z. The effect of cognitive therapy on irrational beliefs, ataxia, aggression of depressed people. Master's Thesis in General Psychology. Islamic Azad University of Mashhad; 2016. [persian]
84. Salamat A. The effectiveness of behavioral activation therapy on burnout and aggression in diabetic patients. Master's Thesis in General Psychology. Islamic Azad University of Tehran; 2017. [persian]
85. Gilbert P. The origins and nature of compassion focused therapy. British Journal of Clinical Psychology. 2014;53(1):6-41. [DOI:10.1111/bjc.12043] [PMID]
86. Baker DA, Caswell HL, Eccles FJ. Self-compassion and depression, anxiety, and resilience in adults with epilepsy. Epilepsy & Behavior. 2019;90:154-61. [DOI:10.1016/j.yebeh.2018.11.025] [PMID]
87. Morley RM, Terranova VA, Cunningham SN, Kraft G. Self-compassion and predictors of criminality. Journal of Aggression, Maltreatment & Trauma. 2016;25(5):503-17. [DOI:10.1080/10926771.2015.1107170]
88. Bluth K, Eisenlohr-Moul TA. Response to a mindful self-compassion intervention in teens: A within-person association of mindfulness, self-compassion, and emotional well-being outcomes. Journal of Adolescence. 2017;57:108-18. [DOI:10.1016/j.adolescence.2017.04.001] [PMID] []
89. Albertson ER, Neff KD, Dill-Shackleford KE. Self-compassion and body dissatisfaction in women: a randomized controlled trial of a brief meditation intervention. Mindfulness. 2015;6:444-54. [DOI:10.1007/s12671-014-0277-3]
90. Kim H. Client Growth and Alliance Development in Solution-Focused Brief Family Therapy. State University of New York at Buffalo; 2006.
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