مجله پژوهش های روان شناسی بالینی و مشاوره
سال سیزدهم شماره 1 (بهار و تابستان 1402)

Family as a dynamic system embraces a number of subsystems, the most important of which is spouse subsystem. Couple’s ability in marital self-regulation is a significant factor determining the quality of their interactions. Marital self-regulation refers to the ability of couples to change their beliefs, emotions, and behaviors. It has two dimensions: communication regulation and communication effort. The ability of adapting needs, preferences, and expectations to spouse determines the ability of couples in marital self-regulation. Another determining factor governing couples’ relationship is emotional distress tolerance. According to Simons and Gaher (2005), distress tolerance consists of four aspects of tolerance, appraisal, absorption, and regulation. Distress tolerance is defined as the ability of experiencing and tolerating negative and stressful internal and environmental discomforts. Tavares and Aassve (2013) showed that low distress tolerance is related to poor marital relationship and is a factor of failure in marriage. Solution-focused approach has been taken by some therapists for a variety of family therapies, people with mental disabilities, domestic violence, people with substance abuse disorders, marital intimacy, and sexual disorders. This approach has been proved to be effective.  Since couples’ inability to tolerate marital distress and self-regulation causes disturbed marital interactions, this study was conducted to answer the following question: Does the effect of short-term solution-focused couples therapy on couples’ increasing marital self-regulation and emotional distress tolerance and its components last to the one-month follow-up stage?

This semi-experimental study used a pre-test, post-test, follow-up design. The statistical population includes all couples who visited private and government counseling centers in Ilam city in 2021. Purposive sampling method was used and participants were randomly divided into experimental and control groups. Considering the inclusion and exclusion criteria, from among 25 volunteered couples (50 people), 12 couples (6 couples for experimental group and 6 couples for the control group, totally 24 people) were selected. Moreover, the treatment was conducted in 36 sessions, 90 minutes every session (6 sessions for each couple).Marital Self-regulation Questionnaire and Distress Tolerance Scale were used as the instruments of the study.  Marital self-regulation questionnaire (behavioral self-regulation for effective relationships scale) was developed by Wilson et al. (2005). This questionnaire consists of 16 items that evaluate communication regulation and communication effort. The Distress Tolerance Scale is a 15-item self-report measure of emotional distress tolerance developed by Simons and Gaher (2005). This questionnaire consists of four subscales of tolerance, appraisal, absorption, and regulation. Data were analyzed using descriptive and inferential statistics (ANCOVA).

The results of univariate covariance analysis for the post-test scores of marital self-regulation components showed that F for communication regulation is 381.374 (p<0.001) and communication effort is 248.74 (p<0.001). These results show that there is a significant difference between experimental and control groups regarding communication effort and communication regulation among couples in the post-test stage, and short-term solution-focused treatment improves couples’ communication effort and communication regulation. Moreover, F ratio of univariate covariance analysis for communication self-regulation (F=442.521 and p<0.001) and communication effort (F=779.855 and p<0.001) indicates the persistence of the effectiveness of this treatment until follow-up stage. The results of univariate covariance analysis on post-test scores of distress tolerance components for couples show that F ratio for tolerance is 8.262 (p<0.001), for absorption is 280.05 (p<0.001), for appraisal is 230.37 (p<0.001), and for regulation is 0.800 (p=0.383). The results of univariate covariance analysis on follow-up scores of distress tolerance components show that F ratio for tolerance is 622.403 (p<0.001), for absorption is 753.943 (p<0.001), for appraisal is 237.887 (p<0.001), and for regulation is 0.047 (p=0.831), which show the persistence of the effectiveness of the treatment until the follow-up stage.

This study aimed to investigate the impact of short-term solution-focused couple therapy on improving couples’ marital self-regulation and distress tolerance and their components. The results showed that this treatment had a significant impact on improving the aspects of couples’ marital self-regulation and tolerating general distress, and this impact lasts until the follow-up stage. But the effectiveness of this treatment was not confirmed for couples’ emotion regulation regarding distress tolerance. One can say that, through adopting a positive position and focusing on the present and future, solution-focused treatment can creates hope in couples. This therapy endeavors to guide couples towards a more compatible life by focusing on and identifying couples’ internal and external capabilities.

Divorce and destructive conflicts between couples are major endangering issues that cause mental disorders and harms in the family and endanger communities’ psychological health. So, many social institutions try to take preventive measures in this regard. Conflict is an inevitable phenomenon of marital relationships, the result of which could be couples’ aroused negative feelings. Couples may think differently about each other, and the difference would result in stress or tension among them. The decision for living together as a couple creates diverse expectations and various hopes, some of which will probably remain unfulfilled. Failing to manage different challenges or expectation of married life may lead to destructive behaviors. Destructive behaviors make worse the situation, make couples dissatisfied, and even in some cases may result in such behaviors as insulting, shouting, and criticizing the other one. If one of the couples face the negative behaviors, probably shows similar or worse behaviors. Several therapeutic methods have been proposed for helping couples to solve their conflicts, among of which is acceptance and commitment couples therapy. Acceptance and commitment couples therapy is a psychological method that aims helping those who experience a long-lasting problem or pain. Some studies have shown that acceptance and commitment couples therapy can positively impact on such marital variables as the quality of life, compatibility between couples, intimacy, marital satisfaction, interpersonal conflicts, and psychological distresses. Many scholars have paid attention to marital conflicts, since more examining feelings, behaviors, and cognition can help find more solutions for marital challenges. This research, then, tried to investigate the impact of acceptance and devotion couples therapy on marital conflict among those who have applied for divorce. The study tries to answer the following questions:Does acceptance and commitment couples therapy decrease the marital conflicts among the couples applying for divorce?Do the impacts of acceptance and commitment couples therapy on decreasing the marital conflicts last to the follow-up phase?

This semi-experimental research used a pre-test, post-test, and a follow-up design. The statistical population consisted of all couples applying for divorce and referring to Andisheh Counseling Center of Tabriz, Iran, from May to December 2021. According Cohen’s table, 30 couples were selected as members of the sample. The couples were divided randomly into experimental and control groups (15 couples in each group). The experimental groups were trained using acceptance and commitment couples therapy over 10 sessions of 90 minutes, twice a week (and a follow-up session), and the control group did not receive any treatmen and were told that they were on the waiting list. Barati and Sanaei’s (2000) revised Marital Conflicts Questionnaire that includes 54 items was used to measure the type and extent of conflicts in marital relationships. The questionnaire has content validity. Its reliability coefficient of the questionnaire in was calculated using Cronbach's alpha to be 0.91. The collected data were analyzed at descriptive and inferential levels. Mean and standard deviation were used for the descriptive part and mixed model ANOVA was used for the inferential part of data analysis.

The average age of the participants was 34.34 and their marriage duration was 3 to 24 years. Most participants had been married for 3 to 6 years. Of 30 couples, 26.56% had no children, 26.55% had one child, 33.44% had two children, 9% had three children, and 3.35% had four children. Regarding degrees, of the 30 male participants, 3.4% had PhD, 20% had a MA/MSc degree, 26.5% had a BA/Bsc degree, 13.6% had an associate degree, and 36.7% had diploma. Of the 30 female participants, 16.6% had a MA/MSc degree, 46.6% had a Ba/Bsc degree, 3.4% had an associate degree, and 33.4% had a diploma. Descriptive statistics showed that the average score for the subscales and the overall marital conflict have decreased in the experimental group in post-test and follow-up tests, but no changes can be seen in the control group. Moreover, the significance of the difference between the groups regarding the scores was evaluated through mixed ANOVA, the normal distribution of the data was tested through Mauchly’s Test of Sphericity, and the interaction effect was measured through Wilk’s lambda test. Since both were insignificant, the data are normally distributed and the homogeneity of variances is valid. The analysis of the variance of intergroup and intragroup effects regarding marital conflicts in different situations showed the reduction of conflicts between couples in the experimental group (F=108.110, p=0.0001) and the stability of the results in the follow-up phase (F=39.40, p=0.001). Therefore, regarding Question 1 of the study, it can be said that acceptance and commitment couples therapy had reduced the marital conflict between couples in the experimental group over time. Regarding Question 2 of the study, the stability of the effectiveness of the intervention over time was approved.

The results showed that acceptance and commitment couples therapy reduces marital conflicts. The difference between marital conflicts in the experimental and control groups after the intervention is significant; that is, the average score of marital conflicts was lower at the post-test of the experimental group. According to Cohen, the effect size of 40% is medium. The effect size of this study was 49%, meaning that the effect is valid after three months. Accordingly, implementing each of the six stages of acceptance and commitment couples therapy (experiential avoidance, acceptance, cognitive dissonance, being present, self-monitoring, and values) improves the damage caused to different dimensions of the couples’ behavior, cognition, emotion, and relationship. This therapy increases couples’ intimacy, reduces their marital conflicts, improves the quality of their communication, and enhances their marital satisfaction.

One of the most important developmental stages of every human being is childhood, because during this period personality is formed. Children in the family learn to respect others’ rights, to pay attention to people, and to recognize social values and norms. Many studies have shown the adverse impacts of child abuse and the cognitive and emotional misbehavior on the child. Among the long-term psychological effects of physical abuse are major behavioral and psychological problems in adolescence and adulthood. Adults who recall maltreatment are significantly at risk of developing psychological trauma. Retrospective reports of maltreatment experiences up to age 12 have shown that at the age 18, these individuals have several psychiatric problems, including depression, anxiety, self-mutilation, alcohol dependence and conduct disorder. These results show a strong connection between childhood maltreatment and suffering from the mentioned disorders. Research has proven that early maladaptive schemas mediate the relationship between childhood maltreatment and adulthood psychological trauma. Although the tissue damage of physical abuse heals over time, its psychological effects often continue throughout a person's life and leave disastrous results. Some studies have shown that mental and physical abuse during childhood can lead to a decrease in mental well-being in adulthood. As a result, one of the things that needs to be considered is psychological well-being.Reef and Case (2002) presented the theory of psychological well-being or positive mental health. According to the theory, psychological well-being consists of six factors: self-acceptance (having a positive attitude towards oneself), having a positive relationship with others (empathy and intimate relationship with others), autonomy (feel of independence and ability to resist social pressures), purposeful life (having purpose and meaning in life), personal growth (feel of continuous growth), and mastering the environment (ability to manage the environment). The theory has been widely used over the world. One of the most important methods that can be used for improving the various psychological aspects of adults is therapeutic forgiveness approach. Forgiveness therapy can be effectively used alone or combined with other approaches for changing an individual’s view towards others and managing emotions correctly in communication. Examining the Quranic verses and traditions in Islam also shows the emphasis on forgiveness and forgiving others’ mistakes. Forgiveness is a process in which a person moves past the wrong done to him and gives up his right to be angry about the hurtful act committed. The aim of forgiveness can be improving relationships, achieving inner peace, empathizing with the wronged person, or performing a valuable behavior. This study, then, sought to explore the impacts of implementing forgiveness therapy on the mental well-being of mothers experiencing abuse in childhood.

This quasi-experimental study used a pre-test-post-test design with a control group. Available sampling and random assignment were used for this study. The statistical population consisted of mothers visiting Ferdowsi University of Mashhad Counseling Center in the second quarter of 2018, who were subjected to behavioral, linguistic and psychological abuse during their childhood. The people were recruited through invitation to participate in the research project and after screening by means of mental well-being questionnaire (score less than 168), 30 of them were selected and randomly assigned to two groups of 15 people for the experiment and 15 people for the control group. Data were collected through Reef's psychological well-being questionnaire (Reef, 1989). The data collected from the pre-test and post-test questionnaires were analyzed using SPSS. The data were analyzed using the analysis of covariance (ANCOVA) was used to infer the data to control the pre-test effect.

Descriptive results show that the average psychological well-being of the experimental group increased by 20.87 in the post-test phase, while no noticeable changes were observed in the control group from the pre-test to post-test phases. The results in the inferential statistics section, using covariance analysis, showed that the averages of the experimental group due to therapeutic forgiveness are significantly higher than the averages of the control group, which means that therapeutic forgiveness increases the psychological well-being of mothers who have been abused in childhood.

Data analysis showed that therapeutic forgiveness increased the mental well-being of mothers abused in childhood. Forgiveness includes six psychological components: the absence of emotion, judgment, and negative behavior towards the wrongdoer, and the presence of emotion, judgment, and positive behavior towards the same mistake. Therapeutic forgiveness emphasizes the importance of the injured person not allowing the traumatic incident to continuously affect the his/her sense of self or ruin his personal relationships and go beyond the natural response to the injury. This is necessary for self-development and as well as for the emotional and moral development of the injured person. When forgiveness takes place completely, the person psychologically feels being healed. Forgiveness is considered an individual characteristic that is done to show a positive and socially friendly reaction to human and environmental errors. To increase mental health and improve resentment, which is necessary for a people’s communication and their emotional, spiritual and physical growth. In other words, forgiveness is an emotional transformation that is freely chosen, during which the desire to take revenge and avoid the wrongdoer decreases, and as a result, improves physical and mental health.

The outbreak of Covid-19 and prevalence of death all over the world not only affects the physical health, but also the mental health of people. People experience various mental problems such as depression, anxiety, and stress. The negative impact of the virus on humans is so great that some scholars see it impossible to estimate the psychological impact of Covid-19 on people (Burke & Arslan, 2020). Therefore, the way dealing with the consequences of the virus is difficult (Xiang et al., 2020). Examining people’s psychological characteristics may be helpful for understanding the impact of preventive behaviors on psychological health, especially in patients who recovered from Covid-19. According to Arslan (2016), considering psychological well-being of these patients and the the factors affecting it can lead to improving their psychological health, especially those who have recovered from the illness. In this regard, Armour et al. (2021) reports the decrease of psychological well-being of patients with Covid-19. According to Dubey et al. (2020), one of the most widely used treatments during Covid-19 pandemic for reducing stress and improving positive psychological characteristics is mindfulness-based stress reduction group exercises. The exercise helps patients concentrate on correct and preventive behaviors without being worried about re-infection (Saricali et al., 2022). Emotion-focused group therapy is also one of the most effective treatments for people who have recovered from Covid-19 (Koren et al., 2021). Based on this method, the therapist encourages patients to use strategies that enhance thier awareness, acceptance, expression, regulation, and change of emotions. The aim of this inetervention is strengthening effective self-regulation and making a new meaning for life (Beasley & Ager, 2019). Emotion-focused group therapy may reduce stress and improve emotional control in people who recovered from Covid-19. Thompson-de Benoit and Kramer (2021) approved the impact of emotional therapy on psychotherapy in the time of Covid-19. However, few research has focused on the effectiveness of interventions that may improve psychological well-being of critically ill patients who have recovered from Covid-19. Since the virus has adverse impacts on the psychological well-being of critically ill patients who recover from Covid-19, such a study seems to be necessary. This study aims to compare the impacts of mindfulness-based stress reduction group exercises with the impacts of emotion-focused group therapy on psychological well-being of hospitalized and recovered patients from Covid-19.

The semi-experimental research included pre-test, post-test, and follow-up stages. The statistical population included all patients who were admitted to Imam Reza Hospital in Mashhad in between June and August 2021 for being infected with Covid-19, recovered, and discharged. The sample included 45 patients (15 patients for each group), who were selected using convenience sampling method and randomly divided into three groups. The first experimental group received eight 45-minute sessions of emotion-focused group therapy, the second experimental group received eight 120-minute sessions of mindfulness-based stress reduction group therapy, and the control group did not receive any intervention. For all the groups, a pre-test, a post-test, and a follow-up test two months after the end of the treatmen were conducted. The short version of Ryff’s psychological well-being scale was used for collecting data.

The results of mixed model for repeated measures showed that both mindfulness-based stress reduction exercises and emotion-focused group therapy have an impact on psychological well-being and its components in pre-test, post-test, and follow-up stages, as they improved the psychological well-being of the patients. Bonferroni test, however, showed that the treatments differ only in the purposefulness component, since the average score of purposefulness in the group treated with emotion-focused group therapy is significantly higher than the average score of purposefulness in group treated with mindfulness-based stress reduction group exercises.

Mindfulness-based exercises activate patients’ parasympathetic system, create a sense of relaxation, and reduce stress in body’s defense system. Moreover, created mental peace allows the recovered people to concentrate on preventive behaviors without being worried about the possibility of re-infection (Saricali et al., 2022). Arguably, through making people clearly aware of the current experiences as well as through experiencing and allowing all thoughts and feelings without judging, avoiding, or suppressing them (Bishop, 2004), mindfulness prevents people from being obsessively attracted to negative feelings and emotions and suppressing them. Instead, it makes patients accept the emotions. Mindfulness exercises help the patient become totally aware of his thoughts, feelings, and physical states at all moments and see calmly what is happening in the surrounding environment. Moreover, mindfulness exercises help the patient avoid drowning in his negative feelings and emotions, caused by acute illness in the past, and stop thinking and predicting about becoming sick again in the future. The results also showed that emotion-focused group therapy impacts on the psychological well-being. During the theraputic sessions, patients speak about their feelings and emotions and experience new emotions. Patients are helped to identify, experience, discover, change, and manage their emotions in a better way.

About 2 to 16 percent of children and adolescents suffer from oppositional defiant disorder (Nazario, 2020), which is associated with symptoms such as frequent and ongoing pattern of anger, arguing and defiance toward others, conflict, nervous mood, irritability, rebelliousness, and malice. The mentioned symptoms must exist in four ways to confirm the diagnosis of this disorder: 1) at least it has occurred to a person other than a sibling; 2) causes significant problems at work, school, or home, 3) is accompanied by other behavioral disorders such as substance abuse, depression or bipolar disorder; 4) lasts at least once a week for 6 months (Payne, 2022).One of the psychological mechanisms used by adolescents with oppositional defiant disorder is avoidance. Avoidance occurs in cognitive-behavioral dimensions and causes failure in finding an appropriate response to emotional stimuli and weakens emotion management. Persistence of problems such as malice, harmful and antisocial behaviors, drug abuse, suicide, depression, anxiety, and so on aramong the disadvantages of using cognitive behavioral avoidance. Therefore, it is crucial to find effective coping methods to reduce this psychological mechanism in adolescents with oppositional defiant disorder.Some methods of psychotherapies have been used to treat oppositional defiant disorder, individually or in groups (Shahmardi, 2021). For example, Muratori et al. (2021) investigated the effectiveness of mindfulness-based group therapy in people with confrontational disobedience, however; they examined the effectiveness on a non-adolecent sample suffering from hyperactivity symptoms. Considering related studies and research gaps, the aim of this study is examining the effectiveness of mindfulness-based stress reduction group therapy on reducing cognitive-behavioral avoidance components in adolescents with oppositional defiant disorder.

The statistical population of this semi-experimental research consisted of all male students with oppositional defiant disorder. The sample consisted of 40 male students who, based on the diagnosis of regional counseling center specialists, showed cognitive avoidance syndrome. The criteria for being included in this research were: not having any other physical or neurological disease, not being under any medication or psychotherapy, and agreeing to participate in the research. These participants were purposefully selected and then randomly divided into experimental and control groups (20 people in each group). Mindfulness-based stress reduction group therapy was performed for the experimental group over 8 weeks, once a week, 40 minutes each time. However, the control group did not receive any intervention. Participants were asked to complete the Cognitive Behavioral Avoidance Questionnaire of Sexton and Dugas (2008) in the pre-test and post-test phases. The data were analyzed through multivariate analysis of covariance method (MANCOVA).

The results showed that compared to the control group, participants in the experimental group showed lower scores in the subscales of replacing disturbing thinking with positive thinking, returning attention to interrupt the process of worry (distraction), and changing mental images to verbal thinking in the post-test measurment. These results indicate that mindfulness-based stress reduction group therapy is an effective intervention in reducing cognitive behavioral avoidance components including replacing disturbing thinking with positive thinking, returning attention to interrupt the process of worry (distraction), and changing mental images to verbal thinking.

The combination of techniques and skills used in the method of reducing stress based on mindfulness with the advantages of group therapy resulted in the finding that this therapeutic method can reduce cognitive behavioral avoidance and its components in adolescents with oppositional defiant disorder. Therefore, the mindfulness-based stress reduction group therapy can be used as a suitable method for adolescents to enjoy the benefits of reducing the components of cognitive behavioral avoidance such as appropriate response to emotions, managing emotions, reducing stress, anxiety and other negative psychological effects caused by confrontational disobedience.

Chronic renal failure is defined as the presence of at least three months of glomerular filtration rate less than 60 ml/min/1.73 m2 or structural/functional abnormalities of the kidney for more than three months (Lameire et al., 2021). Research showed that dialysis women suffer from a more negative body image than normal women (Dąbrowska-Bender et al., 2018). Body image is defined as individuals perception and attitudes towards their physical characteristics (Griffiths et al., 2018). Some studies have shown that body image dissatisfaction is directly related to a lack of self-confidence and self-esteem in sexual relations, more especially in women (Gillen & Markey, 2019). Sexual self-esteem is defined as individuals' overall desire to positively evaluate their capacity for participating in healthy sexual behaviors and experiences in a pleasurable and satisfying manner. Sexual self-esteem affects sexual behavior and includes emotional responses to thoughts and feelings (Akbari, 2017).Schema therapy and acceptance and commitment therapy are two different approaches, each of which looks at pathology with a different perspective. It seems that a combination of the two theraputic models can be a good complement to cover the shortcomings of each of them (Grecucci, 2018). Since no research has specifically compared the impacts of these approaches on psychological status of dialysis patients, it is important to investigate and compare the effectiveness of the acceptance and commitment therapy and schema therapy based on acceptance and commitment (AC-based schema therapy) on body image and sexual self-esteem of dialysis women.

This study was a semi-experimental research with a pretest-posttest and follow-up ‎control group design. The statistical population consisted of all married dialysis women who referred to Khorasan Razavi Dialysis Patients Support Association between January 2021 and June 2022. The sample included 45 married women undergoing dialysis. The participants were selected using convenience sampling method and were randomly assigned to three groups. The first group (15 people) received the therapeutic intervention based on acceptance and commitment, the second group (15 people) received the AC-based schema therapy intervention, and the third group (15 people) were placed on the waiting list to receive psychological treatment. The tools included the Body Image Concern Inventory (BICI) and Sexual Self-Esteem ‎Index for Woman-Short Form (SSEI-W-SF). The AC-based therapy sessions were held based on the treatment protocol of Gustafson (2020) during ten 120-minute weekly sessions. The AC-based schema therapy sessions were held according to the treatment protocol of McKay et al. (2012) for ten 120-minute weekly sessions. The data were analyzed using repeated measures analysis of variance and Bonferroni test.

The results of chi-square test demonstrated that the groups were homogeneous in terms of age (p=0.979, χ2=8.00), duration of marriage (p=1.000, χ2=5.267), and duration of dialysis (p=0.628, χ2=9.867). After checking that the assumptions were fulfilled, repeated measures analysis of variance was used. The results showed that body image scores in the within-group section (P=0.001, F=57.908), the interaction effect of group and repetition (P=0.001, F=23.243) and the between-group effect (P=0.035, F=3.640) are significant in the studied groups in three phases of measurement. Moreover, sexual self-esteem scores in the within-group section (P=0.001, F=25.429), the interaction effect of group and repetition (P=0.001, F=6.575), and the between-group effect (P=0.037, F=3.251) are significant in the studied groups in three phases of measurement (P<0.05). Considering the significance of F statistic, it seems necessary to make post-experience comparisons. Hence, Bonferroni post hoc test was used to compare the therapy groups with the control group.The results of Bonferroni post hoc test revealed that in the posttest and follow-up phases, there is no significant difference between the studied groups (AC-based therapy and AC-based schema therapy and the control group) in the variables of body image (P=0.98) and sexual self-esteem (P=0.85), but in the posttest and follow-up phases, a significant difference was found between the AC-based therapy group and AC-based schema therapy with the control group (P<0.05). AC-based schema therapy caused more changes in the components of body image and sexual self-esteem in dialysis women.

The results indicating the greater impact of AC-based schema therapy compared to acceptance and commitment therapy are consistent with the findings of  Aalami (2020). Paying special attention to the factors causing ineffective behaviors adopted in order to reduce the emotional pain of the schema is one of the strengths of AC-based schema therapy compared to acceptance and commitment therapy (Nikpour, 2021). Showing the difficult situation of frequent dialysis as the only factor provoking uncomfortable feelings and thoughts formed from childhood experiences causes patients to know the root of their problems instead of considering the disease as the cause of dissatisfaction with appearance and lack of self-esteem in sexual relations. As a result, it will make them more motivated and hopeful to overcome and adjust their maladaptive schemas. The other strength of AC-based schema therapy compared to acceptance and commitment therapy is that clients more easily identify their values that are beyond their maladaptive schemas, and as a result, are more motivated to follow values (McKay, 2012). Another advantage of AC-based schema therapy is dedicating some of the group therapy sessions to teach communication skills, including self-expression, overcoming feelings of anger and hatred, assertiveness and marital skills (Lev & McKay, 2017), which increases intimacy and emotional interest of women in the marital relationship. Learning these skills, in addition to providing the apportunity for experiencing more sexual pleasure and the desire to have sexual relationships, can prevent the recurrence of dialysis women’s problems, since better satisfaction of the unsatisfied basic needs make people able to prevent the activation of maladaptive schemas.

Physical disabilities make people disable to use their body parts effectively for at least six months, disrupting the efficiency of body and challenging the physical abilities (Lucas-Carrasco et al., 2011). One of the variables affecting the mental well-being of physically disabled people is emotion. Emotion regulation involves managing emotions arising from a wide range of stressful and non-stressful situations, positively or negatively (Miranda et al., 2012). Another issue that can affect the life of physically disabled people is rumination, defined as a response to a negative mood (Calvete et al., 2021). Emotion dysregulation is common in many mental disorders and emotion regulation forms the basis of dialectical behavior therapy (Asarnow et al., 2021). Some of the issues used in this kind of treatment are behaviorchange, emotion regulation, mindfulness, and acceptance (Rizvi & Thomas, 2016). The statistics show that physically disabled people constitute a significant part of Iran’s population. These people are facing many problems in various areas, therefore; research is needed to improve their mental health and quality of life. This study aimed to investigate the impacts of dialectical behavior therapy on emotion regulation and rumination in physically disabled people in the Welfare Organization of Mashhad, Iran.

This quasi-experimental study used a pre-test, post-test, and follow-up with a control group design. The statistical population consisted of all physically disabled people in the Welfare Organization of Mashhad in 2019, from which 30 were selected through convenience sampling. The participants were then randomly assigned to experimental and control groups. For this study cognitive emotion regulation questionnaire and Nolen-Hoeksema and Morrow’s rumination scale were used as to measure the study variables. The cognitive emotion regulation questionnaire has been designed by Garnefski et al. (2002) to measure cognitive emotion regulation. It includes 36 items, evaluating nine different emotion regulation strategies. Nolen-Hoeksema and Morrow’s Rumination Scale developed by Nolen-Hoeksema and Morrow (1991), consists of two subscales of ruminative responses and distracting responses. It should be noted that only the subscale of ruminative responses was used in the present study. The ruminative responses subscale has 22 items. Dialectical behavior therapy method was performed on the experimental group for eleven weekly sessions.

The data were analyzed using SPSS-25. The results showed that Mauchly’s Test of Sphericity is significant for adaptive and non-adaptive strategies and rumination (p<0.05). Thus, the greenhouse-geyser epsilon index was used for correction. Moreover, the results of Pillai's trace test for adaptive and non-adaptive strategies and rumination are significant (p<0.05).The results showed that there is a significant difference between the scores of emotion regulation variables (adaptive strategies) and rumination in the pre-test, post-test and follow-up (p<0.05). The results related to the interaction impact between time and group show that this impact was significant for the emotion regulation variables (adaptive and non-adaptive strategies) and rumination. Therefore, there is an interaction between different levels of the groups, which indicates that 47%, 15%, and 32% of the intra-group variations can be explained by the interaction between time and group, respectively. Furthermore, the results related to intergroup impacts show that there is no significant difference between the scores of emotional regulation variables (adaptive strategies and non-adaptive strategies) and rumination in the experimental and control groups (p>0.05).

This study aimed to explore the impact of dialectical behavior therapy on emotion regulation and rumination in physically disabled people in the Welfare Organization of Mashhad. The results showed that dialectical behavior therapy led to the improvement of adaptive strategies and the reduction of non-adaptive behaviors. It is clear that physically disabled people experience all kinds of negative emotions due to their physical and motor difficulties and their resulting limitations. Moreover, dialectical behavioral therapy techniques focus on emotional dysregulation. Dialectical behavior therapy presupposes that improving skills and using them result from better emotion regulation. The goal of dialectical behavior therapy is modifying emotions towards emotional efficiency in a way that negative emotions are driven towards adaptation. Hence, the participants learned to use such dialectical behavioral therapy techniques as mindfulness and disturbance tolerance in dealing with suffering and stress. They learned not to be oversensitive to their emotions and not to use resistance and avoidance instead of positive emotion regulation strategies.In explaining the impact of dialectical behavior therapy on rumination, it can be said that in this therapy, the participants were taught not to be afraid of change and not to resist changing their negative thoughts. They were taught to pay attention to learning new skills like mindfulness to deal with their negative thoughts. Acceptance and non-judgment in dialectical behavior therapy sessions make people stop excessive conflict with their negative emotions and rumination and experience their emotions in a real way.Finally, due to the limited research sample and the selection based on the severity of the disability, intervening variables such as family and economic status were not under the control of the therapist. Looking forward, it will be important that counselors and therapists use the dialectical behavior therapy to improve emotion regulation and rumination in other societies.

Parents’ divorce is one of the most common stressors for children and has severe consequences for children of divorce (Quchani et al., 2021). A meta-analysis of 92 studies published in the 1980s (Amato & Keith, 1991) and 67 studies in the 1990s (Amato, 2001) showed that children of divorce experience more behavioral, internalizing, social, and academic problems than other children. Adolescents from divorced families are more likely to be involved in drug and alcohol abuse (Hoffmann & Johnson, 1998). They are also two or three times more likely to have significant mental health problems and use mental health services (Hetherington et al., 1992). Moreover, excessive aggression, stress, low self-esteem, and poor relationships with peers are more common in these children (Wolchik et al., 2009). Parents play a central role in facilitating the optimal adjustment of children after divorce. Besides, the skills and resources required to successfully resolve early developmental tasks after divorce are important tools for overcoming future challenges (Patterson & Fisher, 2002).Mothers are more affected by the consequences of divorce than fathers (Wickrama et al., 2022). They are more affected by psycho-emotional issues than men, and are more concerned about their children and their fate than fathers (Akhavan Tafti, 2003). The New Beginnings Program (Wolchik et al., 2009) is an experimental program to help divorced mothers improve their ability for adapting to their children’s conditions. The program is an experimentally evaluated program for children of divorced parents, in which custodial mothers act as mediators of change. This study examines whether the New Beginnings Program affects the parenting self-efficacy of divorced mothers and the adjustment of children of divorce.

This quasi-experimental study was conducted using a pre-test post-test design with a control group. The research population consisted of divorced mothers in Ahvaz who were the custodians of their children aged 5 to 13 and who applied to participate in the New Beginnings Program. The participants were 30 divorced mothers who were selected through purposive sampling and were randomly placed into the intervention and control groups each with 15 members. The data were collected through the Parental Self-Efficacy Questionnaire and the Child Adjustment Scale. The New Beginnings Program was conducted for 10 sessions, once a week and for 90 minutes only for the participants in the intervention group. The data gathered from the two groups were compared using univariate and multivariate analysis of covariance (ANCOVA).

The results of one-way ANCOVA for parenting self-efficacy (F=307.05) and children’s social adjustment (F=192.57) showed significant differences between the intervention and control groups. The mean scores of parenting self-efficacy for the participants in the intervention and control groups were 55.53 and 29.33, respectively, after the intervention, showing a significant increase in parenting self-efficacy for the participants in the intervention group compared to the control group after the intervention. Moreover, the mean scores of the children’s social adjustment for the participants in the intervention and control groups were 78.80 and 33.87, respectively, after the intervention, confirming a significant increase in the children’s social adjustment for the participants in the intervention group compared to the control group after the intervention.

Some divorced mothers feel incompetent and ineffective in parenting after divorce. Thus, the main goal of the New Beginnings Program is to teach correct parenting and childrearing skills to mothers to help them establish a correct relationship with their children. This program also empowers mothers to develop a sense of efficiency, self-worth, and parenting self-efficacy. Mothers can also develop effective listening and problem-solving skills, helping them to spend adequate time responding correctly to their children. The program also helps mothers develop effective childrearing and anger management skills. Thus, the New Beginnings Program can positively affect the self-efficacy of divorced mothers and their children’s social adjustment. The program also contributes to fostering warm behavior, acceptance, and support in these women to become more effective mothers for their children and teach them skills to prevent future problems. The mothers participating in this study were able to create a safe and welcoming environment for themselves and their children and develop a more positive attitude towards themselves. Moreover, it seems that changing some childrearing misconceptions in mothers can help to improve social adjustment in children of divorce. Providing training for mothers to establish effective communication with the child, turning negative cycles of dialogue into positive cycles, paying attention to good behavior, encouraging children to behave well and speak well using favorable outcomes, removing obstacles to father-child visits, and protecting the child from parents’ problems during training sessions are some strengths of the New Beginnings Program, which enhanced the children’s social adjustment in the post-intervention phase.

A mental damage that can be observed in the users of methamphetamine is bipolar disorder, which happens because of high consumption of the drug. Another psychological problem observed among methamphetamine abusers is borderline personality disorder. People with bipolar disorder and borderline personality disorder need appropriate interventions, and acceptance and commitment treatment (ACT) can be a good choice. This study aimed to explore the impact of commitment and acceptance treatment on extravagant and methamphetamine abuse in people with bipolar disorder and borderline personality disorder.

This quasi-experimental research used a pre-test and post-test and a control group design, including four groups (two experimental groups and two control groups). The inclusion criteria were: at least four months had passed since the participants had been hospitalized for withdrawal methamphetamine, they had been diagnosed as people with bipolar disorder or borderline personality disorder, they did not take psychiatric drugs during the treatment, and they did not participate in other therapeutic interventions at the same time. The exclusion criteria were: the participant did not want to continue the therapy, the participant with bipolar disorder and borderline personality disorder have other disorders, and the participant age is over 55. The aims of the study were explained to the participants and their written consent was obtained. They were explained that all information of the participants will remain confidential and will be used only for research purposes.The statistical population of this research included all people with bipolar and borderline personality disorder admitted to Karamat Camp in Mobarakeh city of Isfahan in 2021. The population includes those who both used methamphetamine and suffered extravagance. From among the people with bipolar disorder and borderline personality disorder, 60 people (30 people for each group) were selected using available sampling and they were randomly divided into experimental and control groups. They were selected after performing Millon Clinical Multiaxial Inventory questionnaire and diagnosed by a psychiatrist and a psychologist of the camp. The participants were evaluated both in pre-test and post-test phases.The experimental groups participated in therapeutic commitment and acceptance interventions for 9 sessions, one and a half hours, three sessions per week. The control groups did not participate in any type of intervention. During the sessions, there was no drop in the number of participants. SPSS 23 was used for analysis of covariance.The measuring instruments were: a) Millon Inventory 3, designed by Millon (1994). The most recent version of this questionnaire consists of 175 items, scored under 28 separate scales; b) Personal Control Scale, known as PCS (Shua Kazemi, 2010). This test consists of 15 items and evaluates the degree of personal control over drug abuse (in past and now). This test includes two sets of questions. The person’s conditions over the past 90 days is examined in the first part and his conditions when starting drug abuse is examined in the second part; C) Clarke and Mortimer’s Extravagance Questionnaire (Clarke & Mortimer, 2013). This questionnaire consists of 19 items. The sum of scores will be between 19 and 95. The range 9-44 shows appropriate management of life expenditures, 45-68 shows medium expenditures, and 69-95 indicates extravagance and being thoughtfulness after the expenditure.

The results showed that ACT was effective for metaphemtamine abuse treatment in the experimental group with bipolar disorder (p<0.05), but it was not effective for extravagance treatment (P>0.05). Moreover, ACT impacts the metamphetmaine abuse and extravagance control in the experimental group with borderline personality disorder (P<0.05), while there was no change in the control groups.

The results confirm the effectiveness of Acceptance and Commitment Treatment (ACT) for the treatment of methamphetamine abuse in people with bipolar and the treatment of methamphetamine abuse and extravagance in people with borderline personality disorder. It is suggested that ACT-based therapeutic interventions be used in addiction treatment centers. Moreover, it is suggested that researchers try to find the best model for methamphetamine abuse treatment by comparing ACT method with other treatment methods. This study focused on people with bipolar and borderline personality disorder and it is suggested that future studies explore the relationship between methamphetamine abuse and ten types of personality disorder.

The maternity process is one of the evolutionary and delightful events in women’s lives. Intended pregnancy is generally viewed as a pleasant issue for families, while unintended pregnancy is usually mentioned as an unpleasant and stressful process for the whole family, especially the mother. Unintended pregnancy refers to a pregnancy occurred without couple’s intention for having a baby. When mothers encounter with an unintended pregnancy, it can disturb her and cause psychological consequences such as depression and anxiety. Some studies have shown that there is a mutual relationship between mother’s anxiety and attachment to the fetus. That is, mothers having unintended pregnancy experience higher levels of depression and anxiety, therefore they cannot make proper bonding with their fetus. Maternal-fetal attachment is defined as a continuous, intimate, and close relationship between the mother and her fetus which is satisfactory for both of them and makes easy the mother-infant relationship after delivery. Mother’s attachment to her fetus improves satisfaction and quality of life in mothers. Studies have showed that there is a positive relationship between the dimensions of attachment and subjective well-being. Subjective well-being explores how people evaluate their lives and it includes life satisfaction, marital life satisfaction, mood, positive emotions, lack of depression and anxiety in two cognitive and affective components. Considering the above-mentioned issues, it is expected that when the subjective well-being of mothers improves, the level of their attachment to their fetus increases as well. One way to increase the mother's attachment to the fetus in such a condition is training, and among the relatively new and effective trainings is self-compassion training. This study tried to examine the impacts of self-compassion training on the subjective well-being and maternal-fetal attachment in women experiencing unintended pregnancy.

This study was conducted using a pre-test, post-test, follow-up design and a semi-experimental control group of 80 pregnant women who had an unintended pregnancy and visited Kermanshah health centers. The inclusion criteria for the study are: being in the first or second trimester of pregnancy, not having severe midwifery problems in the recent pregnancy such as uterine bleeding or abnormal results in fetal health screening, the age between 18 and 45, not taking psychoactive drugs or neuroleptics, and being consent to participate in this research. The exclusion criteria are: Failure to participate in two or more counseling sessions, pregnancy loss during the study, and unwillingness to participate in or continue the process of this study. Participants were selected through cluster and convenient sampling methods. They were divided randomly into control and experimental groups. For collecting data, the demographic characteristics, subjective well-being, and maternal-fetal attachment questionnaires were used. For the experimental group, eight group sessions, each in 90 minutes, once a week were held to train self-compassion. During this time, the control group was placed on the waiting list. The evaluation of the participants was done in the pre-test stage before the start of the intervention, in the post-test stage immediately after the final session of training, and in the follow-up stage, four weeks after the end of the last training session. The data was analyzed using SPSS version 25. Frequency, frequency percentage, and mean were used to check the descriptive indicators, Fisher's exact test, Chi square, and Mann-Whitney test were used to check the homogeneity of demographic variables, and non-parametric Friedman and Mann-Whitney tests were applied to check the findings.

The results of Friedman test showed that the mean score of subjective well-being and maternal-fetal attachment in the experimental group increased after the intervention (post test), and four weeks after the end of training. These changes were statistically significant (p<0.001). However, in the control group, this trend was decreasing. Therefore, we conclude that there was a significant impact during the intervention in the experimental group. Moreover, the results of the Mann-Whitney test showed that there is a significant difference between the experimental and control groups in the second and third rounds of measurement.

The results showed seemingly self-compassion training can lead to the improvement of the subjective well-being and improvement of maternal-fetal attachment in women experiencing unintended pregnancy. It is suggested, therefore, that an independent midwifery counseling unit be stablished that provides counselling and self-compassion based training services for women who are experiencing unintended pregnancy. Providing counseling and support services by midwives and health care workers can lead to the women's adaptive behaviors in this period and increase their ability to face the challenges caused by unintended pregnancy. It also can help them deal with this phenomenon better, be able to cope with this, show a more appropriate reaction, and even have more ability to get pregnant again.