تدوين بسته درماني مبتني بر تجارب زيسته والدين داراي فرزندان مبتلا به اختلال نافرماني‌مقابله‌اي و مقايسه اثربخشي آن با بازي درماني مبتني بر رابطه والد-كودك (فيليال¬تراپي) بر كيفيت تعامل والد-كودك، شناخت اجتماعي، مشكلات هيجاني رفتاري و كاهش علائم در اين كودكان

Developing a Therapeutic Package Based on the Lived Experiences of Parents with Children Diagnosed of Oppositional Defiant Disorder an‎d Comparison of Its Effectiveness with Parent-Child Relationship-Based Play Therapy on the Quality of Parent-Child Interactions, Social Cognition, Mental Health, an‎d Reduction of Symptoms in These Children

روان شناسي

This research was conducted with the aim of developing a therapeutic package based on the lived experiences of parents of children with Oppositional Defiant Disorder (ODD) an‎d comparing its effectiveness with Filial Therapy on parent-child interaction quality, social cognition, behavioral-emotional problems, an‎d symptom reduction in these children. The study was conducted using a mixed-methods (qualitative an‎d quantitative) approach with a sequential exploratory design. The statistical population consisted of parents an‎d their children with ODD who referred to counseling centers in the city of Aran va Bidgol in the second half of the Persian year 1399 (2020-2021). In the qualitative phase, using semi-structured interviews with 20 parents an‎d specialists, the lived experiences of parents were investigated, an‎d the data were analyzed using phenomenological an‎d thematic analysis methods. In the quantitative phase, using a multiple-baseline single-case design (A-B-A), 8 children with ODD were assigned to two groups (therapy based on lived experiences an‎d Filial Therapy) an‎d the effectiveness was investigated. The research instruments included the ODDRS questionnaire, CSI-4, the Pianta Parent-Child Relationship Scale, an‎d the Hutchins Theory of Mind questionnaire, which were measured using SPSS-26. The content validity of the therapeutic package was assessed using the Content Validity Ratio (CVR) method by 10 child psychology specialists with at least 5 years of clinical experience. The specialists reviewed all 9 sessions based on a stan‎dard three-point scale. Qualitative findings revealed that parental experiences were categorized into four main themes: the childʹs behavioral problems including deficits in life skills, negative an‎d positive consequences of the disorder, factors contributing to the development of ODD (family conflicts an‎d parenting style), an‎d parental coping strategies (emotional reactions an‎d relationship management). Based on this, a 9-session therapeutic package was designed an‎d validated, which included child-centered interventions (emotion regulation training, impulse control, social cognition) an‎d parent-centered interventions (relationship management, conflict reduction, parent training). Results indicated that the therapeutic package had desirable content validity (CVR = 0.80). Among the sessions, 6 sessions were confirmed without needing modification, an‎d 3 sessions were confirmed after implementing the specialistsʹ suggestions. The Content Validity Index (CVI = 0.89) an‎d inter-rater reliability (r = 0.92) were also at an excellent level. The results of the quantitative phase also showed that both interventions were effective in improving the dependent variables; however, therapy based on lived experiences, compared to Filial Therapy, had more stable an‎d stronger effectiveness in improving parent-child interaction, social cognition, an‎d reducing behavioral problems. Furthermore, this method showed better treatment stability during the follow-up stage. In conclusion, while both therapeutic approaches proved effective, the lived-experience-based intervention demonstrated greater efficacy in improving the target components. These findings suggest that incorporating parental experiential knowledge into therapeutic frameworks can provide a comprehensive treatment model that complements existing ODD intervention protocols.

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