Determining the Effectiveness of Group Well-Being Therapy on Depression and Sense of Psychological Coherence of Students With Social Anxiety

Social anxiety disorder is one of the most common and debilitating anxiety disorders. Most people with social anxiety disorder also experience depressive symptoms due to their inability and, of course, their unwillingness to be in public, seen, and evaluated. Also, one of the factors affecting anxiety is the level of emotional coherence. This issue refers to the personal focus on life. It is an internal source with a positive effect on physical and mental health. Studies show that different approaches and therapies have been proposed to treat anxiety and depression. A new treatment approach is the well–being therapy approach. This therapy is a short–term organized, helpful, and problem–solving treatment program based on the cognitive pattern of Ryff's psychological well–being. This therapy uses self–care, organized memory, writing, and therapist–patient interaction to enhance a person's mental health. Therefore, the present study aimed to determine the effectiveness of group well–being on depression and a sense of psychological coherence in students with social anxiety.

The research is a quasi–experimental study with a pretest–posttest design and a control group. The statistical population consisted of all female adolescents with social anxiety disorder studying in the fall of 2020 in girls' public senior schools in Birjand City, Iran. The study sample consisted of 30 female students with social anxiety aged 15 to 18 years selected from eligible volunteers by multi–stage cluster sampling method. They were then randomly assigned to the experimental and the control groups. The inclusion criteria were obtaining the desired score based on the cut–off point score and obtaining the diagnosis of social anxiety disorder based on the clinical interview, being at least 15 years old, participating in group intervention sessions, not participating in other educational and medical classes at the same time, and having the necessary physical and mental readiness to answer questions. The exclusion criteria included having a concomitant psychological disorder, conscious dissatisfaction, and absence from more than two training sessions. Social Anxiety Scale (Connor et al., 2000), Structured Clinical Interview for DSM–IV (First et al., 2007), Beck Depression Inventory–II (Beck et al., 1996), and Sense of Coherence Questionnaire (Flensborg–Madsen et al., 2006) were used in the pretest and posttest. The experimental group was treated for 10 sessions of group well–being therapy, but the control group received no treatment. Statistical analysis of data was performed in SPSS software version 24 on two levels of descriptive statistics and inferential statistics. Regarding descriptive statistics, mean and standard deviation, and the inferential statistics, the Chi–square test and multivariate analysis of covariance were used at the significance level of α = 0.05.

The results showed that group well–being therapy significantly reduced depression (p = 0.008) and increased psychological cohesion (p = 0.002) of students with social anxiety in the experimental group compared to the control group. The effect size also showed that group well–being therapy had a 24.4% effect on reducing depression and a 31.3% on increasing psychological coherence.

Based on the present study findings, group well–being therapy improves the psychological status of students with social anxiety.