مقايسه اثربخشي درمان شناختي- رفتاري و روان‌ نمايشگري بر نشانه‌هاي اختلال‌هاي بروني ‌سازي شده‌ كودكان

Comparison of the effectiveness of cognitive-behavioral and Psychodrama therapy on symptoms of externalized disorders in children

زﻣﯿﻨﻪ و ﻫﺪف: روان ﻧﻤﺎﯾﺸﮕﺮي ﻧﻮﻋﯽ ﺗﺨﻠﯿﻪ ﻫﯿﺠﺎﻧﯽ اﺳﺖ ﮐﻪ ﺑﻪ ﺑﺎزﮔﺸﺎﯾﯽ ﻣﺸﮑﻞ ﺷﺨﺼﯿﺘﯽ ﯾﮏ ﻓﺮد ﻣﺸﺨﺺ و اراﺋﻪ ﺟﻨﺒﻪ ﻫﺎﯾﯽ از زﻧﺪﮔﯽ او ﻣﯽ ﭘﺮدازد و ﻣﻘﺎﯾﺴﻪ آن ﺑﺎ درﻣﺎن ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري ﻣﯽ ﺗﻮاﻧﺪ ﺗﻌﯿﯿﻦ ﮐﻨﻨﺪه ﻣﯿﺰان اﺛﺮﺑﺨﺸﯽ آن ﻫﺎ ﺑﺎﺷﺪ؛ ﺑﻨﺎﺑﺮاﯾﻦ ﻫﺪف از ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﻣﻘﺎﯾﺴﻪ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﺷﻨﺎﺧﺘﯽ- رﻓﺘﺎري و روان ﻧﻤﺎﯾﺸﮕﺮي ﺑﺮ ﻧﺸﺎﻧﻪ ﻫﺎي اﺧﺘﻼل ﻫﺎي ﺑﺮوﻧﯽ ﺳﺎزي ﺷﺪه ﮐﻮدﮐﺎن 7 ﺗﺎ 12 ﺳﺎل ﻣﯽ ﺑﺎﺷﺪ. ﻣﻮاد و روش ﻫﺎ: روش ﭘﮋوﻫﺶ از ﻧﻮع ﻣﻄﺎﻟﻌﺎت ﻧﯿﻤﻪ ﺗﺠﺮﺑﯽ )ﺷﺒﻪ آزﻣﺎﯾﺸﯽ( اﺳﺖ ﮐﻪ ﺑﺎ ﻃﺮح ﭘﯿﺶ آزﻣﻮن، ﭘﺲ آزﻣﻮن و ﭘﯿﮕﯿﺮي ﺑﻪ ﻫﻤـﺮاه ﮔـﺮوه ﮐﻨﺘـﺮل ﺻﻮرت ﭘﺬﯾﺮﻓﺖ. ﮔﺮوه ﻧﻤﻮﻧﻪ ﺑﻪ ﺻﻮرت در دﺳﺘﺮس از ﺑﯿﻦ ﮐﻮدﮐﺎﻧﯽ ﮐﻪ در ﻣﺮاﺟﻌﻪ ﺑﻪ ﻣﺮﮐﺰ ﻣﺸـﺎوره آواي ﻣﻬـﺮ ﭘﺎﺳـﺎرﮔﺎد، ﺗﺸـﺨﯿﺺ ﻧﺸـﺎﻧﻪ ﻫـﺎي اﺧـﺘﻼل ﺑﺮوﻧﯽ ﺳﺎزي ﺷﺪه ﺑﺮاي آﻧﺎن ﺛﺒﺖ ﺷﺪه ﺑﻮد و واﺟﺪ ﻣﻼك ﻫﺎي ﻻزم ﺟﻬﺖ ﺷﺮﮐﺖ در ﭘﮋوﻫﺶ ﺑﻮدﻧﺪ، ﺗﻌﺪاد 24 ﻧﻔﺮ ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه آزﻣـﺎﯾﺶ و ﯾﮏ ﮔﺮوه ﮐﻨﺘﺮل ﻗﺮار ﮔﺮﻓﺘﻨﺪ. درﻣﺎن ﺷﻨﺎﺧﺘﯽ- رﻓﺘﺎري و روان ﻧﻤﺎﯾﺸﮕﺮي ﺑﺮاي ﮔﺮوه ﻫﺎي آزﻣﺎﯾﺸﯽ اﺟﺮا ﮔﺮدﯾﺪ، اﻣـﺎ ﮔـﺮوه ﮐﻨﺘـﺮل ﻫـﯿﭻ ﻣﺪاﺧﻠـﻪ ﺧﺎﺻـﯽ درﯾﺎﻓﺖ ﻧﮑﺮد. اﺑﺰارﻫﺎي ﭘﮋوﻫﺶ ﺷﺎﻣﻞ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺳﯿﺎﻫﻪ ي رﻓﺘﺎري ﮐﻮدك آﺧﻨﺒﺎخ )ﻧﺴﺨﻪ واﻟﺪﯾﻦ( ﺑﻮد. ﺑﺮاي ﺗﺠﺰﯾﻪ وﺗﺤﻠﯿﻞ داده ﻫـ ﺎ و ﺑﺮرﺳـﯽ رواﺑـﻂ ﺑـﯿﻦ ﻣﺘﻐﯿﺮﻫﺎ از ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ و آزﻣﻮن ﺗﻌﻘﯿﺒﯽ ﺗﻮﮐﯽ و آزﻣﻮن t ﻣﺴﺘﻘﻞ اﺳﺘﻔﺎده ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻧﺘﺎﯾﺞ ﺗﺤﻘﯿﻖ ﻧﺸﺎن داد ﮐﻪ ﺑﯿﻦ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري و درﻣﺎن روان ﻧﻤﺎﯾﺸﮕﺮي در ﻣﺘﻐﯿﺮﻫﺎي رﻓﺘﺎر ﭘﺮﺧﺎﺷﮕﺮي و رﻓﺘﺎر ﻗﺎﻧﻮن ﺷﮑﻨﺎﻧﻪ در ﻣﺮﺣﻠﻪ ﭘﺲ آزﻣﻮن ﺗﻔﺎوت ﻣﻌﻨﺎداري وﺟﻮد ﻧﺪارد )0.001≥(P وﻟﯽ در ﻣﺮﺣﻠﻪ ﭘﯿﮕﯿـﺮي در ﻣﺘﻐﯿـﺮ رﻓﺘـﺎر ﻗـﺎﻧﻮن ﺷـﮑﻨﺎﻧﻪ ﺗﻔـﺎوت ﻣﻌﻨـﯽ داري وﺟـﻮد دارد )0.001≤P(. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻣﻘﺎدﯾﺮ اﻧﺪازه اﺛﺮ ﺑﺮاي ﻣﺘﻐﯿﺮﻫﺎي رﻓﺘﺎر ﭘﺮﺧﺎﺷﮕﺮي و رﻓﺘﺎر ﻗﺎﻧﻮن ﺷﮑﻨﺎﻧﻪ در درﻣﺎن ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري و روان ﻧﻤﺎﯾﺸﮕﺮي ﻣﺸﺨﺺ ﮔﺮدﯾﺪ اﺛﺮﺑﺨﺸﯽ درﻣﺎن روان ﻧﻤﺎﯾﺸﮕﺮي ﺑﯿﺸﺘﺮ از درﻣﺎن ﺷﻨﺎﺧﺘﯽ رﻓﺘﺎري ﻣﯽ ﺑﺎﺷﺪ )0.001≤P(. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﺑﻪ ﻧﻈﺮ ﻣﯽ رﺳﺪ ﮐﻪ روش درﻣﺎن روان ﻧﻤﺎﯾﺸﮕﺮي ﻧﺴﺒﺖ ﺑﻪ درﻣﺎن ﺷـﻨﺎﺧﺘﯽ -رﻓﺘـﺎري در ﺑﻬﺒـﻮد رﻓﺘﺎرﻫـﺎي ﭘﺮﺧﺎﺷـﮕﺮاﻧﻪ و ﻗـﺎﻧﻮن ﺷـﮑﻨﺎﻧﻪ ﺳﻮدﻣﻨﺪﺗﺮ ﻣﯽ ﺑﺎﺷﺪ.

Aim and Background: Psychodrama is a type of emotional discharge that reopens a specific person's personality problem and presents aspects of his life and its comparison with cognitive-behavioral therapy can determine their effectiveness; Therefore, the aim of the present study was to compare the effectiveness of cognitive-behavioral and Psychodrama therapy on the symptoms of externalized disorders in children aged 7 to 12 years. Methods and Materials: The research method is quasi-experimental (quasi-experimental) studies with pre-test, post-test and follow-up with a control group. The sample group was available among 24 children who were registered at Ava Mehr Pasargad Counseling Center to diagnose the symptoms of externalized disorder and met the necessary criteria to participate in the study, 24 people were randomly selected. They were divided into two experimental groups and one control group. Cognitive-behavioral and Psychodrama were performed for the experimental groups, but the control group did not receive any special intervention. The research instruments included the Achenbach Child Behavior Inventory Questionnaire (parents' version). Analysis of covariance and Tukey post hoc test were used to analyze the data and examine the relationships between variables. Findings: The results showed that there was no significant difference between the effectiveness of cognitive-behavioral therapy and psychodrama therapy in the variables of aggressive behavior and law-breaking behavior in the post-test stage (P≥0.001) but there was a significant difference in the follow-up stage in the law-breaking behavior variable. .000.001) According to the effect size values for the variables of aggressive behavior and law-breaking behavior in cognitive-behavioral therapy and psychodrama, it was found that the effectiveness of psychodrama is more than cognitive-behavioral therapy (P≤0.001). Conclusions: It seems that cognitive-behavioral therapy is more useful than psychodrama in improving aggressive behaviors.