مقایسه کارایی بالینی ماتریکس درمان پذیرش و تعهد با درمان پذیرش و تعهد متمرکز بر شفقت و درمان شناختی- رفتاری هافمن بر اختلال اضطراب اجتماعی

نوع مقاله : علمی- پژوهشی

نویسندگان

1 دانشجوی دکتری روان‌شناسی بالینی، گروه روان‌شناسی بالینی، دانشکده اقتصاد و مدیریت، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.

2 استادیار، گروه روان‌شناسی بالینی، دانشکده اقتصاد و مدیریت، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.

چکیده

هدف: شواهد تجربی و نظری نشان می­دهد که مداخله­ های­ شناختی- رفتاری، کارایی پایداری ندارند. پژوهش حاضر با هدف مقایسة کارایی بالینی ماتریکس درمان­ پذیرش ­و تعهد با درمان ­­پذیرش ­و تعهد متمرکز بر شفقت و درمان­شناختی- رفتاری هافمن بر اختلال اضطراب اجتماعی انجام شد. روش­: این پژوهش از نوع کارآزمایی ­بالینی یک­سر کور با طرح آزمایشی تک­آزمودنی با خط پایة ­چندگانه ناهمزمان بود که به­روش ­نمونه­ گیری هدفمند در طی 12­جلسۀ 60 ­دقیقه­ ای با پیگیری 2 ­ماهه بر روی 9­ دانشجو با اختلال اضطراب اجتماعی اجرا شد. برای مقایسة نتایج این سه الگوی ­مداخله­ ای، از مقیاس اضطراب­­ اجتماعی ­لیبویتز (هیمبرگ و همکاران، 1999)، فرم کوتاه مقیاس خود­ شفقت­ورزی (ریس و همکاران، 2011)، نسخۀ دوم پرسشنامۀ ­پذیرش ­و عمل (باند و همکاران، 2011) و پرسشنامۀ زندگی ­ارزشمند (ویلسون و همکاران، 2010) استفاده شد. داده­ها به روش ترسیم­دیداری، درصد بهبودی، شاخص ­تغییر پایا و شاخص­ های شش­گانه کارایی بالینی تحلیل شدند. یافته­ ها: نتایج نشان داد که­ هر سه روش مداخله ­ای در کاهش اضطراب ­اجتماعی (2.58->Z) و افزایش انعطاف ­پذیری­ موثر و از لحاظ بالینی معنادار است (2.58Z>). با ­این ­وجود، درمان­شناختی- رفتاری هافمن در افزایش خود شفقت ­ورزی و زندگی­ ارزشمند از لحاظ بالینی موثر و معنادار نبود (1.96>Z)، و این نتایج نیز در پایان دورۀ پیگیری 2­ماهه حفظ شد. نتیجه ­گیری: بنابراین ماتریکس درمان ­پذیرش ­و تعهد و درمان ­پذیرش و تعهد متمرکز بر شفقت از نظر اندازه ­­تغییر، ثبات، کلیت ­تغییر و ایمنی در مقایسه با درمان­شناختی- رفتاری هافمن، کارایی بالینی موثرتری دارند، اما هر سه روش مداخله در میزان ­پذیرش و عمومیت تغییر مشابه بودند.

کلیدواژه‌ها

عنوان مقاله [English]

Comparing of Clinical Efficacy of ACT Matrix with ACT Focused on Compassion and Hofmann's CBT on Social Anxiety Disorder

نویسندگان [English]

  • Hamid Asadi 1
  • Masoud Mohammadi 2
  • Ghasem Naziri 2
  • Azam Davoodi 2
1 Ph.D. Student Clinical Psychology, Department of Clinical Psychology, College of Economy & Management, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
2 Assistant Professor, Department of Clinical psychology, College of Economy & Management, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
چکیده [English]

Aim: The empirical and theoretical evidence suggest that Cognitive-Behavioral Interventions lack stable efficacy. This study aimed to compare the clinical efficacy of ACT Matrix, ACT Focused on Compassion, and Hofmann's CBT in treating social anxiety disorder.
 
Method: A single-blinded clinical trial with a single-case experimental design, employing a non-concurrent multiple baseline approach, was conducted on 9 students with social anxiety disorder, selected through purposive random sampling. The treatment comprised 12 sessions (60 minutes each) with a two-month follow-up. Liebowitz Social Anxiety Scale (Heimberg & et al., 1999), Self-Compassion Scale-Short Form (Raes & et al., 2011), Acceptance and Action Questionnaire (Second Version, Bond & et al., 2011), and the Valued Living Questionnaire (Wilson & et al., 2010) were used for outcome assessment. Data analysis involved visual drawing, recovery percentage, stable change index, and six indicators of clinical efficiency.
 
Results: All three intervention methods significantly reduced social anxiety (Z<-2.58) and enhanced flexibility (Z>2.58). However, Hofmann's CBT exhibited limited clinical effectiveness in increasing self-compassion and valued living (Z<1.96). These results were sustained at the 2-month follow-up.
 
Conclusion: The ACT Matrix and ACT focused on compassion demonstrated superior clinical efficacy in terms of magnitude of change, stability, total change, and safety compared to Hoffmann's CBT. Nevertheless, all three interventions exhibited similarities in acceptance and generality of change.

کلیدواژه‌ها [English]

  • Social Anxiety
  • Flexibility
  • Cognitive-Behavioral Therapy
  • ACT focused on Compassion
  • ACT Matrix

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