@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2018;24(2):125-131
ISSN: 2252-0805 The Horizon of Medical Sciences 2018;24(2):125-131
The Effectiveness of Compassion-Focused Therapy on Mental Health of Women with Multiple Sclerosis
ARTICLE INFO
Article Type
Original ResearchAuthors
Salimi A (1)Arsalandeh F (2)
Zahrakar K (1)
Davarniya R (*)
Shakarami M (3)
(*) Department of Counseling, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
(1) Department of Counseling, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
(2) Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
(3) Department of Counseling, Faculty of Psychology and Educational Sciences, University of Isfahan, Isfahan, Iran
Correspondence
Address: Counseling Department, Psychology & Educational Sciences Faculty, Kharazmi University, University Square, Shahid Beheshti Street, Karaj, IranPhone: +98 (26) 234579600
Fax: +98 (26) 234579600
rezadavarniya@yahoo.com
Article History
Received: December 2, 2017Accepted: May 2, 2018
ePublished: May 16, 2018
ABSTRACT
Aims
Multiple sclerosis (MS) is a progressive and chronic disease of central
nervous system with different symptoms and physical-psychological disabling
effects, which brings about various problems for the patient. The present study
was aimed to investigate the effectiveness of compassion-focused therapy (CFT) on
mental health of women with multiple sclerosis.
Materials & Methods The present research was a semi-empirical intervention conducted by pretest-posttest with control group design. The research population included all the women with active case file in MS association of Tehran in 2016. The sample was composed of 30 female patients which were selected by available sampling method and based on exclusion and inclusion criteria of the study and their scores in the questionnaire. The sample were assigned into experimental and control groups (15 individuals per group) by random assignment method. The study tool was general health questionnaire (GHQ) of Goldberg and Hiller (1979). After conducting the pretest for both groups, subjects of the experimental group received eight weekly 2-hour sessions of CFT in a group format. The control group was put in the waiting list. The data were analyzed through univariate covariance analysis (ANCOVA) in SPSS v18.
Findings Results indicated that, after the posttest, there was a significant difference between mean scores of mental health among experimental and control groups. In other words, CFT led to increased mental health in subjects of the intervention group compared to the control group (p<0.01, F=45.49).
Conclusion According to the results of the present study, the compassionfocused therapy reduces psychological problems and improves mental health of patients with multiple sclerosis through increasing their internal awareness, nonjudgmental acceptance, empathy, and consistent attention to internal emotions. It is recommended that MS associations across Iran would use this therapeutic method for enhancing psychological health of patients.
Materials & Methods The present research was a semi-empirical intervention conducted by pretest-posttest with control group design. The research population included all the women with active case file in MS association of Tehran in 2016. The sample was composed of 30 female patients which were selected by available sampling method and based on exclusion and inclusion criteria of the study and their scores in the questionnaire. The sample were assigned into experimental and control groups (15 individuals per group) by random assignment method. The study tool was general health questionnaire (GHQ) of Goldberg and Hiller (1979). After conducting the pretest for both groups, subjects of the experimental group received eight weekly 2-hour sessions of CFT in a group format. The control group was put in the waiting list. The data were analyzed through univariate covariance analysis (ANCOVA) in SPSS v18.
Findings Results indicated that, after the posttest, there was a significant difference between mean scores of mental health among experimental and control groups. In other words, CFT led to increased mental health in subjects of the intervention group compared to the control group (p<0.01, F=45.49).
Conclusion According to the results of the present study, the compassionfocused therapy reduces psychological problems and improves mental health of patients with multiple sclerosis through increasing their internal awareness, nonjudgmental acceptance, empathy, and consistent attention to internal emotions. It is recommended that MS associations across Iran would use this therapeutic method for enhancing psychological health of patients.
CITATION LINKS
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[3]Moss-Morris R, McCrone P, Yardley L, Van Kessel K, Wills G, Dennison L. A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue. Behav Res Ther. 2012;50(6):415-21.
[4]Masoudi R, Mohammadi I, Ahmadi F, Hasanpour Dehkordi A. The effect of self-care program education based on Orem's theory on mental aspect of quality of life in multiple sclerosis patients. Iran J Nurs. 2009;22(60):53-64. [Persian]
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[7]Attar Sayyah AE, Hoseini Kakhk SAR, Hamedinia MR, Mehrjoo M. Effect of 8-week combined training (resistance and proprioceptive neuromuscular facilitation) on fatigue and quality of life in multiple sclerosis patients. Horiz Med Sci. 2016;22(1):43-50. [Persian]
[8]Jahan bakhsian N, Zahrakar K, Davarniya R. A study on the effectiveness of caregivers’ group supportive-training intervention on the mental health of MS patients. Razi J Med Sci. 2016;23(144):19-29. [Persian]
[9]Milo R, Osherov M. Daclizumab and its use in multiple sclerosis treatment. Drugs Today (Barc). 2017;53(1):7-18.
[10]Siegert RJ, Abernethy DA. Depression in multiple sclerosis: A review. J Neurol Neurosurg Psychiatry. 2005;76(4):469-75.
[11]Jean VM, Beatty WW, Paul RH, Mullins L. Coping with general and disease-related stressors by patients with multiple sclerosis: Relationships to psychological distress. Mult Scler. 1997;3(3):191-6.
[12]Schubert DS, Foliart RH. Increased depression in multiple sclerosis: A Meta-analysis. Psychosomatics. 1993;34(2):124-30.
[13]Riether AM. Anxiety in patients with multiple sclerosis. Semin Clin Neuropsychiatry. 1999;4(2):103-13.
[14]Maurelli M, Marchioni E, Cerretano R, Bosone D, Bergamaschi R, Citterio A, et al. Neuropsychological assessment in MS: Clinical, neurophysiological and neuroradiological relationships. Acta Neurol Scand. 1992;86(2):124-8.
[15]Stenager E, Knudsen L, Jensen K. Multiple sclerosis: Correlation of anxiety, physical impairment and cognitive dysfunction. Ital J Neurol Sci. 1994;15(2):97-101.
[16]Stenager EN, Stenager E. Suicide and patients with neurologic diseases, methodologic problems. Arch Neurol. 1992;49(12):1296-303.
[17]Stenager EN, Stenager E, Koch-Henriksen N, Brønnum-Hansen H, Hyllested K, Jensen K, et al. Suicide and multiple sclerosis: An epidemiological investigation. J Neurol Neurosurg Psychiatry. 1992;55(7):542-5.
[18]Ashworth F, Gracey F, Gilbert P. Compassion focused therapy after traumatic brain injury: Theoretical foundations and a case illustration. Brain Impair. 2011;12(2):128-39.
[19]Depue RA, Morrone-Strupinsky JV. A neurobehavioral model of affiliative bonding: Implications for conceptualizing a human trait of affiliation. Behav Brain Sci. 2005;28(3):313-50.
[20]Gilbert P. Introducing compassion-focused therapy. Adv Psychiatr Treat. 2009;15(3):199-208.
[21]Lincoln TM, Hohenhaus F, Hartmann M. Can paranoid thoughts be reduced by targeting negative emotions and self-esteem? An experimental investigation of a brief compassion-focused intervention. Cogn Ther Res. 2013;37(2):390-402.
[22]Heriot-Maitland C, Vidal JB, Ball S, Irons C. Acompassionate-focused therapy group approach for acute inpatients: Feasibility, initial pilot outcome data, and recommendations. Br J Clin Psychol. 2014;53(1):78-94.
[23]Boersma K, Håkanson A, Salomonsson E, Johansson I. Compassion focused therapy to counteract shame, self-criticism and isolation, a replicated single case experimental study for individuals with social anxiety. J Contemp Psychother. 2015;45(2):89-98.
[24]Gale C, Gilbert P, Read N, Goss K. An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clin Psychol Psychother. 2014;21(1):1-12.
[25]Lucre KM, Corten N. An exploration of group compassion-focused therapy for personality disorder. Psychol Psychother. 2013;86(4):387-400.
[26]Braehler C, Gumley A, Harper J, Wallace S, Norrie J, Gilbert P. Exploring change processes in compassion focused therapy in psychosis: Results of a feasibility randomized controlled trial. Br J Clin Psychol. 2013;52(2):199-214.
[27]World Medical Association. World Medical Association declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4.
[28]Rezaei F, Kajbaf, MB, Vakili Zarch N, Dehghani F. Effectiveness of cognitive behavioral stress management therapy in general health of asthmatic patients. Knowl Health. 2011;6(3):9-15. [Persian]
[29]Hoseyni M, Abdkhodai MS, Aghamohammadian Sherbaf HR. Role of mediating sense of coherence in relationship between duration and number of physical complications of diabetes with mental health in patients with type 2 diabetes mellitus. Horiz Med Sci. 2017;23(4):311-7. [Persian]
[30]Raes F. The effect of self-compassion on the development of depression symptoms in a nonclinical sample. Mindfulness. 2011;2(1):33-6.
[31]Leaviss J, Uttley L. Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychol Med. 2015;45(5):927-45.
[32]Imrie S, Troop NA. A pilot study on the effects and feasibility of compassion-focused expressive writing in day hospice patients. Palliat Support Care. 2012;10(2):115-22.
[33]Noorbala F, Borjali A, Ahmadian-Attari MM, Noorbala AA. Effectiveness of compassionate mind training on depression, anxiety, and self-criticism in a group of Iranian depressed patients. Iran J Psychiatry. 2013;8(3):113-7.
[34]Judge L, Cleghorn A, McEwan K, Gilbert P. An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. Int J Cogn Ther. 2012;5(4):420-9.
[35]Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self-compassion program. J Clin Psychol. 2013;69(1):28-44.
[36]Neff KD, McGehee P. Self-compassion and psychological resilience among adolescents and young adults. Self Identity. 2010;9(3):225-40.
[2]Solari A, Radice D. Health status of people with multiple sclerosis: A community mail survey. Neurol Sci. 2001;22(4):307-15.
[3]Moss-Morris R, McCrone P, Yardley L, Van Kessel K, Wills G, Dennison L. A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue. Behav Res Ther. 2012;50(6):415-21.
[4]Masoudi R, Mohammadi I, Ahmadi F, Hasanpour Dehkordi A. The effect of self-care program education based on Orem's theory on mental aspect of quality of life in multiple sclerosis patients. Iran J Nurs. 2009;22(60):53-64. [Persian]
[5]Sharifi Neyestanak ND, Ghodoosi Boroojeni M, Seyedfatemi N, Heydari M, Hoseini AF. Selfesteem and its associated factors in patients with multiple sclerosis. Iran J Nurs. 2012;25(78):14-22. [Persian]
[6]Sadri Damirchi E, Aghazadehasl M. Effectiveness of cognitive-behavioral group therapy on coping styles in multiple sclerosis patients. Horiz Med Sci. 2017;23(2):117-22. [Persian]
[7]Attar Sayyah AE, Hoseini Kakhk SAR, Hamedinia MR, Mehrjoo M. Effect of 8-week combined training (resistance and proprioceptive neuromuscular facilitation) on fatigue and quality of life in multiple sclerosis patients. Horiz Med Sci. 2016;22(1):43-50. [Persian]
[8]Jahan bakhsian N, Zahrakar K, Davarniya R. A study on the effectiveness of caregivers’ group supportive-training intervention on the mental health of MS patients. Razi J Med Sci. 2016;23(144):19-29. [Persian]
[9]Milo R, Osherov M. Daclizumab and its use in multiple sclerosis treatment. Drugs Today (Barc). 2017;53(1):7-18.
[10]Siegert RJ, Abernethy DA. Depression in multiple sclerosis: A review. J Neurol Neurosurg Psychiatry. 2005;76(4):469-75.
[11]Jean VM, Beatty WW, Paul RH, Mullins L. Coping with general and disease-related stressors by patients with multiple sclerosis: Relationships to psychological distress. Mult Scler. 1997;3(3):191-6.
[12]Schubert DS, Foliart RH. Increased depression in multiple sclerosis: A Meta-analysis. Psychosomatics. 1993;34(2):124-30.
[13]Riether AM. Anxiety in patients with multiple sclerosis. Semin Clin Neuropsychiatry. 1999;4(2):103-13.
[14]Maurelli M, Marchioni E, Cerretano R, Bosone D, Bergamaschi R, Citterio A, et al. Neuropsychological assessment in MS: Clinical, neurophysiological and neuroradiological relationships. Acta Neurol Scand. 1992;86(2):124-8.
[15]Stenager E, Knudsen L, Jensen K. Multiple sclerosis: Correlation of anxiety, physical impairment and cognitive dysfunction. Ital J Neurol Sci. 1994;15(2):97-101.
[16]Stenager EN, Stenager E. Suicide and patients with neurologic diseases, methodologic problems. Arch Neurol. 1992;49(12):1296-303.
[17]Stenager EN, Stenager E, Koch-Henriksen N, Brønnum-Hansen H, Hyllested K, Jensen K, et al. Suicide and multiple sclerosis: An epidemiological investigation. J Neurol Neurosurg Psychiatry. 1992;55(7):542-5.
[18]Ashworth F, Gracey F, Gilbert P. Compassion focused therapy after traumatic brain injury: Theoretical foundations and a case illustration. Brain Impair. 2011;12(2):128-39.
[19]Depue RA, Morrone-Strupinsky JV. A neurobehavioral model of affiliative bonding: Implications for conceptualizing a human trait of affiliation. Behav Brain Sci. 2005;28(3):313-50.
[20]Gilbert P. Introducing compassion-focused therapy. Adv Psychiatr Treat. 2009;15(3):199-208.
[21]Lincoln TM, Hohenhaus F, Hartmann M. Can paranoid thoughts be reduced by targeting negative emotions and self-esteem? An experimental investigation of a brief compassion-focused intervention. Cogn Ther Res. 2013;37(2):390-402.
[22]Heriot-Maitland C, Vidal JB, Ball S, Irons C. Acompassionate-focused therapy group approach for acute inpatients: Feasibility, initial pilot outcome data, and recommendations. Br J Clin Psychol. 2014;53(1):78-94.
[23]Boersma K, Håkanson A, Salomonsson E, Johansson I. Compassion focused therapy to counteract shame, self-criticism and isolation, a replicated single case experimental study for individuals with social anxiety. J Contemp Psychother. 2015;45(2):89-98.
[24]Gale C, Gilbert P, Read N, Goss K. An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clin Psychol Psychother. 2014;21(1):1-12.
[25]Lucre KM, Corten N. An exploration of group compassion-focused therapy for personality disorder. Psychol Psychother. 2013;86(4):387-400.
[26]Braehler C, Gumley A, Harper J, Wallace S, Norrie J, Gilbert P. Exploring change processes in compassion focused therapy in psychosis: Results of a feasibility randomized controlled trial. Br J Clin Psychol. 2013;52(2):199-214.
[27]World Medical Association. World Medical Association declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4.
[28]Rezaei F, Kajbaf, MB, Vakili Zarch N, Dehghani F. Effectiveness of cognitive behavioral stress management therapy in general health of asthmatic patients. Knowl Health. 2011;6(3):9-15. [Persian]
[29]Hoseyni M, Abdkhodai MS, Aghamohammadian Sherbaf HR. Role of mediating sense of coherence in relationship between duration and number of physical complications of diabetes with mental health in patients with type 2 diabetes mellitus. Horiz Med Sci. 2017;23(4):311-7. [Persian]
[30]Raes F. The effect of self-compassion on the development of depression symptoms in a nonclinical sample. Mindfulness. 2011;2(1):33-6.
[31]Leaviss J, Uttley L. Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychol Med. 2015;45(5):927-45.
[32]Imrie S, Troop NA. A pilot study on the effects and feasibility of compassion-focused expressive writing in day hospice patients. Palliat Support Care. 2012;10(2):115-22.
[33]Noorbala F, Borjali A, Ahmadian-Attari MM, Noorbala AA. Effectiveness of compassionate mind training on depression, anxiety, and self-criticism in a group of Iranian depressed patients. Iran J Psychiatry. 2013;8(3):113-7.
[34]Judge L, Cleghorn A, McEwan K, Gilbert P. An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. Int J Cogn Ther. 2012;5(4):420-9.
[35]Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self-compassion program. J Clin Psychol. 2013;69(1):28-44.
[36]Neff KD, McGehee P. Self-compassion and psychological resilience among adolescents and young adults. Self Identity. 2010;9(3):225-40.