Razi Journal of Medical Sciences

fa اثربخشی واقعیت‌درمانی گروهی بر انزوای اجتماعی بیماران مبتلا به اختلال هویت جنسی Effectiveness of Reality-Group Therapy on Social Isolation of Patients with Gender Identity Disorder روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: اختلال هویتجنسی یک وضعیت نادر است که در آن افراد هویتجنسی خود را با آنچه ظاهر آن نشان میدهد نامتجانس احساس میکنند و موجب پریشانی یا اختلال اساسی در کارکرد اجتماعی، شغلی و سایر زمینههای مهم میشود. پژوهش حاضر  به هدف  اثربخشی واقعیتدرمانی بر انزوای اجتماعی بیماران اختلال هویتجنسی انجام گرفت. روش کار: این مطالعه به صورت نیمهآزمایشی با طرح پیشآزمون- پسآزمون و پیگیری با گروه کنترل انجام شد. جامعه پژوهش همه افراد دارای اختلال هویتجنسی مراجعهکننده به مرکز پزشک قانونی شهر شیراز در سال 1400-1399 که اختلال آن‌ها از طریق پزشک قانونی محرز شده بود و به دلیل عدم امکان دسترسی به همه آنها به صورت هدفمند از بین 195 نفر تعداد 30 نفر به روش نمونهگیری در دسترس انتخاب شدند و در دو گروه آزمایش (15 نفر) و کنترل (15 نفر) قرار گرفتند. ابتدا پرسشنامه انزوای اجتماعی راسل و همکاران (1980) از هر دو گروه گرفته شد، سپس گروه آزمایش به مدت 8 جلسه تحت آموزش واقعیتدرمانی قرار گرفت و گروه کنترل آموزشی دریافت نکرد. مجدداً پرسشنامه انزوای اجتماعی پس از آموزش واقعیتدرمانی انجام شد و در پیگیری  3 ماهه نیز تکرار شد و دادهها توسط تحلیل آماری توصیفی و استنباطی بررسی شد. یافته ها: در مولفه کاهش تنهایی  گروه کنترل  با گروه مداخله واقعیتدرمانی در سطح معنیداری ۰1/  تفاوت معنیدار دیده شد  لذا رویکرد واقعیتدرمانی تاثیرگذار بوده است. نتیجه گیری: نتایج نشان داد واقعیتدرمانی میتواند به این افراد کمک کند به خودشان به عنوان منشاء اعمال و کردار توجه کنند و با تاکید بر انگیزش درونی و احساس مسئولیت برای انجام رفتار باعث بالا بردن احساس ارزشمندی و کاهش احساس تنهایی شوند. Background & Aims: Sex, as the most fundamental element of identity, accompanies a person from the beginning to the end of life. During the socialization process, the members of the society internalize and internalize cognitive, emotional, and behavioral patterns related to their gender. They learn to behave in different social situations as expected from the members of a particular sexual group. Successfully going through this process leads to the formation of a sexual identity compatible with society. But sometimes there are disturbances in this way. In the sense that a person may have the characteristics of a certain gender from a biological point of view, but he does not consider himself to belong to that group spiritually and psychologically. Such a person feels and behaves like a member of the opposite sex. It is obvious that this dual situation causes mental disorders and weakens the individual's performance. This phenomenon is called Transsexuality. Reality therapy is one of the approaches that has provided coherent therapy with a holistic view. And its use is possible for all people who have problems. Not denying reality, taking responsibility, and accordingly planning to achieve goals, are one of the main human needs in the life process, which is given importance in this therapeutic approach. Humans can create a better situation for themselves by choosing more effective and suitable ways to achieve a fun, power, freedom, love, and belonging. Social isolation during some rapid and sudden changes is considered normal and is not interpreted as maladjustment, but when it chronically hinders success and progress in normal tasks and functions of life, it can It has very harmful emotional, social, and even physical consequences. Social isolation is a threat to the mental health and psycho-social functioning of a person. In view of the mentioned materials and considering the effect that social isolation has on the personality, and considering that there is little research in the field of human sexual behavior, as well as the lack of research on reality therapy training for patients with gender identity disorder, the research Presented with the aim of the effectiveness of reality therapy on social isolation of patients with a gender identity disorder. Methods: This study was conducted as a semi-experimental design with a pre-test-post-test and follow-up with a control group. The research population is all people with gender identity disorder who were referred to the Shiraz forensic center in 2020-2021, whose disorder was diagnosed by a forensic doctor, and due to the impossibility of accessing all of them in a targeted manner, out of 195 A total of 30 people were selected by convenience sampling and were divided into two experimental (15 people) and control (15 people) groups. First, Russell et al.'s social isolation questionnaire (1980) was taken from both groups, then the experimental group was given reality therapy training for 8 sessions, and the control group did not receive training. Again, the social isolation questionnaire was administered after the reality therapy training and was repeated in the 3-month follow-up, and the data were analyzed by descriptive and inferential statistical analysis. Results: A significant difference was seen in the loneliness reduction component between the control group and the reality therapy intervention group at a significance level of 0.1, therefore, the reality therapy approach has been effective. Conclusion: Since transgender people are often on the sidelines of social activities, many of their capabilities have not been developed. Efforts to make them capable of social relations can be effective in this direction. At the same time, heterosexual people must develop their social skills with people by developing their capacities and by avoiding committing deviant behaviors. The application of reality therapy techniques could help them in this field. Reality therapy is based on the basic assumption that people are motivated to change when they are convinced that their current behavior will not get them what they want. The goal of reality therapy is to foster acceptance of responsibility in the individual and create a successful identity. A person identifies the behavior he is trying to correct, devotes his whole being to it, and does not make excuses to deny his responsibility. In this approach, an effort was made to make the person know the short-term and long-term goals of his life. Define them clearly. Evaluate the ways to achieve the goal. Choose the methods that will lead to more favorable results and experience a more positive feeling towards yourself. It should be noted that this research has limitations that reduce its generalizability. Among these cases, we can mention the small size of the sample, the non-randomness of the sampling, and the fact that the samples are limited to one place, which is due to financial, human, time, etc. limitations, and shows the need for further extensive research.   واقعیت درمانی, انزوای اجتماعی, اختلال هویت جنسیتی Reality Therapy, Social Isolation, Gender Identity Disorder 328 335 http://rjms.iums.ac.ir/browse.php?a_code=A-10-6651-1&slc_lang=fa&sid=1 Zahra Shiri زهرا شیری 3900319475328460085469 3900319475328460085469 No PhD student, Department of General Psychology, Yasuj Branch, Islamic Azad University, Yasuj, Iran. دانشجوی دکتری، گروه روان شناسی عمومی، واحد یاسوج، دانشگاه آزاد اسلامی، یاسوج، ایران. Seyed Soleiman Hosseininik سلیمان حسینی نیک hosseininik51@gmail.com 3900319475328460085470 3900319475328460085470 Yes Assistant Professor, Department of Psychology, Azadiasuj University, Kohkilouyeh and Boyerahmad, Iran استادیار، دکترای تخصصی روانشناسی، گروه روانشناسی، دانشگاه آزاد یاسوج، کهکیلویه و بویراحمد، ایران Armin Mahmoodi آرمین محمودی 3900319475328460085471 3900319475328460085471 No Assistant Professor, Department of General Psychology, Yasuj Branch, Islamic Azad University, Yasuj, Iran. استادیار دانشگاه، گروه روان شناسی عمومی، واحد یاسوج، دانشگاه آزاد اسلامی، یاسوج، ایران.