Volume 30, Issue 4 (7-2023)
RJMS 2023, 30(4): 62-73 |
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Ethics code: IR.IAU.SHK.REC.1400.010
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Izadi Firoozabadi N, Ghazanfari A, Mashhadizadeh S, Sharifi T. The Effectiveness of Mentalization-based Treatment and Mindfulness-Based Art Therapy on Components of Infertility Stigma. RJMS 2023; 30 (4) :62-73
URL: http://rjms.iums.ac.ir/article-1-7484-en.html
URL: http://rjms.iums.ac.ir/article-1-7484-en.html
Associate Professor, Department of Psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran , Aghazan5@yahoo.com
Abstract: (528 Views)
Background & Aims: Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse .Infertility affects millions of people of reproductive age worldwide – and has an impact on their families and communities. Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods.Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable (1). Worldwide, 48/5million of couples experience fertility problems (2). In Iran, around 20/2 percent are estimated to have difficulty conceiving or staying pregnant (3). Infertility stigma includes the components of personal worthlessness,social withdrawal,public stigma and family stigma,along with secrecy ,which distinguishes the infertile person from her environment and considers her an awkward patch. Infertility stigma puts strain on relationships, may lead individuals to hide their diagnoses from friends or family and delay or avoid treatment (5-7). In turn, this could lead to worse prognoses for these patients (8-11)(Kaya and Oskay 2020). The MBAT, mindfulness-based art therapy, as a new intervention method which combines art therapy and psychotherapy. MBAT integrates mindfulness practices and with making art therapeutically.The therapist creates a supportive container which includes: mindfulness teachings, guided meditations, and sensitive exploration of the art images created. Mindfulness-based art therapy takes place in either group or individual sessions .MBAT invites kindness and care and encourages a non - judgmental responses in mindfulness and art-making practices and orientates towards having patience to allow change to occur. Rather than focusing on how we want to be, we open to how we are in this moment, and then change can occur .The benefits of mindfulness-based art therapy include: reduced stress and anxiety, improved mood and self-esteem, more fulfilling personal relationships, deeper insight and ways to develop compassion for yourself and others .Mindfulness practice involves self-exploration and awareness of our minds, bodies, feelings and thoughts. Art making is a way to express ourselves beyond words. It encourages us to be in our present moment experiences, through noticing the sensations we are experiencing. This includes the sensate qualities of using art materials, involving touch, movement and play, which supports presence and awareness (12, 15). Mentalization -based therapy (MBT) is a type of long-term psychotherapy. Mentalization is the ability to think about thinking. Mentalization is a normal capacity that we all use in everyday life.MBT is an integrative treatment approach for borderline and other severe personality disorders. It combines ideas from both psychoanalysis and modern research and is based on the unique human capacity to mentalize , or understand mental states underlying one's own actions as well as those of others .Anthony Bateman and peter Fonagy applied the concept of mentalization to treating people with borderline personality, creating Mentalization-Based Therapy. They believe people with borderline personality (BPD) have a limited ability to mentalize, due either to genetic predisposition or early exposure to neglect.MBT can be an effective intervention for depression and eating disorders but the evidence is currently limited. Professionals supporting mothers of children at risk may benefit from receiving training in the principles of MBT. Mentalization refers to the ability to reflect upon, and to understand one's state of mind; to have insight into what one is feeling, and why.Poor mentalizing of our own thoughts and emotions means that we do not have a good understanding of our own reasons for acting the way we do (16-19). The aim of this research was to study Comparison of the effectiveness of Mindfulness-Based Art Therapy and Mentalization-based treatment on infertility stigma of infertile women In Isfahan.
Methods: The present study used a pretest-posttest design with 3 groups: 2 experimental groups and 1 control group. Code of ethics was IR.IAU.SHK.REC.1400.010. The study population consisted of all woman with primary infertility referring to the forensic medicine organization of isfahan, Iran, in winter and spring 2021. The sample group consisted of 45 individuals selected by the available sampling method. The inclusion criteria included interest in participating in the study . The exclusion criteria included diagnosis without psychological disorders, severe physical diseases and don’t absent more than two sessions. The participants were randomly divided into 3 groups each with 15 members. The experimental groups underwent therapeutic interventions. The first experimental group received (MBAT), mindfulness-based art therapy and the second one received (MBT), Mentalization-based therapy. The experimental group attended in ten sessions MBAT protocol and 20 sessions MBT protocol .Two month after the intervention, three groups were assessed again using the same tool(follow up). The control group received no intervention. The data were collected by (ISS), infertility stigma scale ,by Fu et al. (29) The questionnaire was introduced by Rajabi etal. It includes 27 statements .The statements are designed based on 5- Likert spectrum scale (30). The participants filled out the tool before and after the intervention. The data were analyzed by SPSS V.23. Data were evaluated by ANOVA with repeated measure.
Results: The effectiveness of mindfulness-based art therapy and Mentalization-based treatment on components of infertility stigma in woman with primary infertility was examined. In terms of the components of infertility stigma, the findings indicated differences among the mean scores at pretest and posttest stages in all groups. The results of ANOVA with repeated measures supported the effect of both treatments and decrease all of components of infertility stigma,except family stigma .The mindfulness-based art therapy and Mentalization-based treatment had significant effect on infertility stigma. Mentalization-based treatment was more effective than mindfulness-based art therapy . Jalambadani et al. showed that of mindfulness-based art therapy was effective in the quality of life in woman with breast cancer (20). Markin, McCarthy argued that Mentalization-based treatment was effective in pregnancy after loss (25). These findings are consistent with (20-23).
Conclusion: Mindfulness-based art therapy, as a new intervention method which combines art therapy and psychotherapy, seems to decrease infertility stigma of infertile women and helps the individual to concentrate on the moment rather than the future so that it increases awareness about one’s body by improving self-supervision. Such intervention leads to a notable decrease in psychological symptoms and higher self-care. On the other hand, people feel less motivated to control their environment, following the unexpected diagnosis of infertility. And also, Mentalization-based treatment decrease infertility stigma of infertile women . It helps to make sense of our thoughts, beliefs, wishes and feelings and to link these to our actions and behaviours .Using MBAT and specially MBT, is recommended in large scale in the population of infertile women. Through learning coping skills in the face of stressful events, people learn to deal with such situations with self-confidence and optimistically.
Methods: The present study used a pretest-posttest design with 3 groups: 2 experimental groups and 1 control group. Code of ethics was IR.IAU.SHK.REC.1400.010. The study population consisted of all woman with primary infertility referring to the forensic medicine organization of isfahan, Iran, in winter and spring 2021. The sample group consisted of 45 individuals selected by the available sampling method. The inclusion criteria included interest in participating in the study . The exclusion criteria included diagnosis without psychological disorders, severe physical diseases and don’t absent more than two sessions. The participants were randomly divided into 3 groups each with 15 members. The experimental groups underwent therapeutic interventions. The first experimental group received (MBAT), mindfulness-based art therapy and the second one received (MBT), Mentalization-based therapy. The experimental group attended in ten sessions MBAT protocol and 20 sessions MBT protocol .Two month after the intervention, three groups were assessed again using the same tool(follow up). The control group received no intervention. The data were collected by (ISS), infertility stigma scale ,by Fu et al. (29) The questionnaire was introduced by Rajabi etal. It includes 27 statements .The statements are designed based on 5- Likert spectrum scale (30). The participants filled out the tool before and after the intervention. The data were analyzed by SPSS V.23. Data were evaluated by ANOVA with repeated measure.
Results: The effectiveness of mindfulness-based art therapy and Mentalization-based treatment on components of infertility stigma in woman with primary infertility was examined. In terms of the components of infertility stigma, the findings indicated differences among the mean scores at pretest and posttest stages in all groups. The results of ANOVA with repeated measures supported the effect of both treatments and decrease all of components of infertility stigma,except family stigma .The mindfulness-based art therapy and Mentalization-based treatment had significant effect on infertility stigma. Mentalization-based treatment was more effective than mindfulness-based art therapy . Jalambadani et al. showed that of mindfulness-based art therapy was effective in the quality of life in woman with breast cancer (20). Markin, McCarthy argued that Mentalization-based treatment was effective in pregnancy after loss (25). These findings are consistent with (20-23).
Conclusion: Mindfulness-based art therapy, as a new intervention method which combines art therapy and psychotherapy, seems to decrease infertility stigma of infertile women and helps the individual to concentrate on the moment rather than the future so that it increases awareness about one’s body by improving self-supervision. Such intervention leads to a notable decrease in psychological symptoms and higher self-care. On the other hand, people feel less motivated to control their environment, following the unexpected diagnosis of infertility. And also, Mentalization-based treatment decrease infertility stigma of infertile women . It helps to make sense of our thoughts, beliefs, wishes and feelings and to link these to our actions and behaviours .Using MBAT and specially MBT, is recommended in large scale in the population of infertile women. Through learning coping skills in the face of stressful events, people learn to deal with such situations with self-confidence and optimistically.
Keywords: Infertility, I, Nfertility stigma, Mindfulness-based art therapy, Mentalization-based treatment
Type of Study: Research |
Subject:
Clinical Psychiatry
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