Procedia Social and Behavioral Sciences
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Procedia - Social and Behavioral Sciences 00 (2011) 000–000 Procedia - Social and Behavioral Sciences 30 (2011) 2173 – 2179
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The Effectiveness of Cognitive Group Therapy Decreasing the Symptoms of Depression Shahram Vaziri a *, Zahra Jamshidifar b, Seyyed Ali Darbani c a
Islamic Azad University, Roudehen branch, 189, Iran Islamic Azad University, Roudehen branch, 189, Iran c Islamic Azad University, Roudehen branch, 189, Iran
b
Abstract The purpose of this investigation is to study the effectiveness of cognitive group therapy on decreasing the symptoms of depression among students.therefore, twelve students were randomly selected and under went cognitive therapy for twelve sessions. The results of the study indicated that cognitive therapy is effective in reducing the symptoms of depression. Keywords: depression symptoms, cognitive group therapy
1. Introduction Depression, is one of the most common & important disorders in our century. Researches show that, approximately 75% of people who are admitted in therapeutic institudes, are affected with depression. [Brown & Harris 1987 & Beck 1993]. In old days, years ago it was assumed that depression is only the disorder of adults. [Hammen, 1997], but when researchers investigate about that they found out that children can suffer from depression, too. [Harrington 1994] and after that, the American psychiatric Association used the diagnostic criteria of adult depression for children with some changes. In addition to hereditary (genetic) factors, the role of cognitive patterns [Beck 1967]. Hopelessness [Abramson Metalsky& Alloy 1989 &Kaslow& Brown &Mees 1994].Negative self-estimation [Kenolal, cantwell&Kazdin 1989]. Difficulty in data analysis [Garber, Bracfladt&Zeman 1991] & resistance to revise the depressed mood [Garber 1991] are shown in this disorder because, mood disorders are explained based on the same (Biologic, psycho logic, social & cultural) attitudes. But the interesting point is that Anti-depressant drugs are not effective in all of the children. [summers Flanagan 1996]. Whereas, the results of psycho logic interventions, especially cognitive behavioral therapy presented glad tidings (hopeful) frame work. Beck’s cognitive model (1976, 1967) is shown in image 1 (diagram). As you see, it says that: Experience in people leads to form assumptions or images about the world & themselves. When these assumptions enter to the understanding organization, These cognitive subjects are used in assessment & central of the behavior. Whenever these assumptions get inflexible & resistant or go to extremes they will transform to a non-effective structure that will make him Brittle & prone (susceptible) to depression.
* Shahram Vaziri. Tel.: +9802215726164; fax: +9802215726164 E-mail address:
[email protected] 1877-0428 © 2011 Published by Elsevier Ltd. Open access under CC BY-NC-ND license. Selection and/or peer-review under responsibility of the 2nd World Conference on Psychology, Counselling and Guidance. doi:10.1016/j.sbspro.2011.10.422
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"Diagram 1": Cognitive Model of depression The primitive experience Formation of non-effective assumptions Sensitive event Activation of assumptions Automatic negative thoughts Behavioural depression signs Body Motivational
emotional
cognitive
After primitive studies, growing collection of cognitive behavioural therapeutic methods came to an existence. Evidences indicate that the use of interventional methods for the reason of reduction of depressant thought's Amplitude or severity has good effect. The study about therapeutic follow ups also shows that cognitive behavioural therapy at least has the same effect of three cyclic drugs in reduction of depression. Equality in rate and ratio of depression in teenagers & adults [cooper & Good gear 1993] with increase in cognitive capabilities of teenagers let us use methods based on group cognitive therapy. In according to what we said, in this research we are going to investigate the effect of group cognitive therapy in reduction of depression symptoms. 2.Method Community and statistical sample: the research's statistical community. Is the second & third class (grade) in guide school in Tehran city. Two schools (one for girls & the other for boys) has been selected and one second grade and one third grade from each school is chosen randomly among the students of 4 classes (n=131), 12 people (students) that have gotten the most score in Beck's test has been selected (chosen) & classified in 2 groups for therapy. 3.Instruments Beck's depression questioner: This test, not only in diagnosis of patients, but also is used in normal people & in terms of (reliability & occurrence) has a high positive correlation with other clinical scales.
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This questioner was formed in 1961 by Beck and reexamined in 1974 & it's reliability & occurrence has been proven. (SCL-90-R) questioner: The check list of disorder's symptoms has been introduced by derogates (1994). These check list was a good instrument for assessment of the present level of disorder's symptoms. That will occur in an one-week interval. This questioner measures the symptoms in 9 different aspects & 3 general indexes. In this study (research) the depression index of this questioner is used. High scores in these scale shows that (the) person is experiencing more symptoms than the total depression symptoms reliability & accuracy of this questioner is admitted by internal & external studies. 4.Therapeutic pattern In this study we used this frame work: this program (schedule) generally is based on Beck's emotional-logical therapy & Mack muslin's approach & the frame work at therapy through the sessions is like this: Pre-session: Preparing the participants, understanding of guidelines& subjects of cognitive therapy. First session: Welcoming, explanation about the rules of group, acquaintance practice, holy thought and emotion, standards that are disposed (enacted) by ourselves& others & allegory (citing) (proverb) of suitcase for stages of cognitive therapy, guided imaging relaxation, home assignments. Second session: review and examine the assignments explanation of cognitive depression theory, practice for classification of abnormal stress & anger, practice for automatic thoughts, explain about resistance to therapy, Diagnosis of preventive resistances, home assignment. Third session: review of assignments; explain about thought induction, practice of thought induction, teaching the down ward arrow method, home assignment. Forth session: examine the home assignments, review & examine down ward arrow practice of progressing of the advance down ward arrow, explain about different Beliefs, classification of home assignments. Fifth session: review of home assignments, preparing list of believes, explain about cognitive maps & preparing them & grading the mental sadness units, home assignments. Sixth session: review of assignments, “Do you believe in Amoo Norooz?, showing the ability of changing their believes, testing the believes, practical analysis, standard analysis, home assignments. Seventh session: examine home assignments, effectiveness analysis, practice the effectiveness analysis, explain concordance, home assignments. 8th session: examine the assignments, explain logical analysis, teaching the logical analysis, practice logical analysis home assignments. 9th session: review of assignments, teaching the structure of hierarchy, practice of making at list one hierarchy of opposition, making the oppositional, home assignment.
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10th session: review of assignments, teaching the changes of understanding, filling the change of understanding forms, voluntary prevention of cortex, practice voluntary prevention of cortex, home assignments. 11th session: review & examine home assignments teaching self-punishing self-rewording, practice self-punishing & self-rewording's, teach techniques of maintaining the practices, home assignment. 12th session: review and examine home assignments overview on schedule, (appointments) for follow up, finishing ceremony, giving the evidence of training. As you see the structure of session is designed in a way that 2 subjects are learned& practiced. The therapeutic sessions are 90- 120 minutes once a week. 5. Results As we said: for screening the subjects first of all, Back’s depression test, has done on 4 classes (2 boy classes& 2 girls classes)& then among this group 12 people that took the highest scores have been selected& examined. Table 1 is showings the statistical factors of depression. Scores of subjects: Table 1: statistical factors of depression
Boys
Total
Girls
Numbers
64
131
67
Mean
15
15/74
16/4478
Standard deviation from mean
1/44
1/03
1/4933
Middle
11/5
12
13
Mode
3
3
33
11/595 134/4444
11/5321 141/5321
12/223 149/4025
Kurtosis
0/601
0/485
0/388
Error of Kurtosis
0/299
0/212
0/293
skewness
-0/907
-1/178
-1/380
Error of skewness
0/590
0/420
0/578
39
39
39
Standard deviation variance
range
For investigations the meaningfulness of the differences, we compared the mean of depression among boys & girls in both groups. As you see, the difference in the rate of depression between boys & girls is not a meaningful difference.
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Table 2: Comparison between depressionMean between boys & girls
After classifying the 12 people who took the highest scores in depression to two groups, we compared the again from the aspect of depression differences (table 3, 4). As you see there is no meaningful difference between them. 95% confidence interval of the Difference Assumptions
F
Variance equality Variance inequality
sig
0/831
0/364
t
df
0/695 0/696
Sig 2tailed
Mean difference
std
lower
upper
129
0/488
1/448
2/0835
-2/6746
5/5701
129
0/488
1/448
2/081
-2/6696
5/5651
Table 3: statistical factors of depressionScores of subjects after selecting the therapeutic group number
mean
standard deviation
Standard deviation From mean error
First group
6
36/1667
2/3166
0/9458
Second group
6
36/8333
2/4833
1/0138
Table 4: Comparison of depression between 2 therapeutic groups
Assumptions
Lon test for Equality Variances
F Variance Equality
0/604
sig
t
0/286
Variance inequality
df
Sig
Mean difference
-0/481
10
-0/641
-0/6667
-0/481
9/952
-0/641
-0/6667
After the therapeutic sessions we examined the scores of every session (table 5).
Table 5: Comparison between depression symptom meansIn every therapeutic session Before session mean
After session mean 2/750
sig 0/000
29
1/167
0/019
29
28/5
0/5
0/645
4th to 5th
28/5
26/5
2
0/134
5th to 6th
26/5
26/08
0/417
0/756
1st to 2nd
32/92
2nd to 3rd
30/167
3rd to 4th
30/167
Difference of means
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6th to 7th
26/08
25/67
0/417
0/737
7th to 8th
25/67
22/5
3/167
0/012
22/5
21/08
1/417
0/03
9 to 10
21/08
19/08
2
0/002
10th to 11th
19/08
16/5
2/583
0/000
11th to 12th
16/5
12
3/383
0/001
8th to 9th th
th
As it's shown in table 5, in some sessions although, there's no meaningful change before & after the sessions, But: the pace of depression symptoms in all of the sessions is reductive (reducing). As you see after the 8th session, in all of the therapeutic sessions, getting better (recovery) can be seen in comparison to previous stages. The analysis of variance scores in each session is explaining the meaningful changes in the sessions (table 6). Table 6: Comparison between means of scores during the therapeutic sessions Changes
Total square
df
F
sig
Inter groups Intra group
4673/57 1024/92
11 132
424/871 7/765
0/000
total
5698/49
143
6. Conclusion & discussion Cognitive therapy is one of the most important approaches during several years ago. Many researches have been done about it. In this study our effort was to use a Defined (definite) framework & a clear cognitive therapeutic package. The clearance of this package introduced by Michel Ferry showed that cognitive method can have an important role in reduction of depression symptoms. Lead to illogical behaviors and such believes usually comes from Essential reference Errors that people enact (dispose) for themselves. We can resist against depression symptoms with preparing a training framework (structure). In this therapy teenagers learn how to change their Automatic thoughts, negative believes& emotions, obsessive thoughts, habits. How to have insight about them& over view their thoughts& emotions& how to experience the ways of changing them. References Abramson, L., Metaisky, C., & Alloy, L.B. (1989). Hopelessness depression: A theory subtype of depression. Psychological Review, 96, 358372. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. Beck, A. T. (1991). Cognitive therapy: A 30-year retrospective. American Psychologist, 46(4), 368-375. Beck, A.T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row. Beck, A. T. (1976). cognitive theory and the emotional disorders. New York: International University Press. 6
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