Razi Journal of Medical Sciences

fa مقایسه اثربخشی دو رویکرد واقعیت درمانی و شفقت ورزی بر هراس از مرگ در پایان دوره درمان و پیگیری در سوء‌مصرف کنندگان مواد Comparing the Effectiveness of Two Approaches Reality Therapy and Compassion Therapy on the Fear of Death at the End of the Treatment and Follow-Up Period in Drug Abusers روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: در افراد سوءمصرف کننده مواد، سطح هراس از مرگ تحت تأثیر قرار می‌گیرد؛ از این رو استفاده از روش‌های درمانی برای هراس از مرگ در معتادان ضروری است. حال با توجه اهمیت موضوع و شیوع اعتیاد در جامعه، هدف مطالعه مقایسه اثربخشی دو رویکرد واقعیت درمانی و شفقت ورزی بر هراس از مرگ در معتادان بود. روش کار: جامعه آماری این پژوهش نیمه آزمایشی شامل کلیه معتادان مراجعه کننده به شش کلینیک ترک اعتیاد شهرستان گلوگاه بود که در سال 1401-1400 به کلینیک‌های این شهرستان جهت ترک اعتیاد مراجعه داشتند. نمونه پژوهش حاضر شامل 45 نفر (15 نفر گروه واقعیت درمانی، 15 نفر گروه شفقت ورزی، 15 نفر گروه کنترل) بود. ابزار پژوهش، پرسشنامه هراس از مرگ تمپلر (1970) و پروتکل‌های درمانی واقعیت درمانی گلاسر (2010) (هر جلسه شصت دقیقه) و درمان شفقت ورزی گیلبرت (2014) (هر جلسه نود دقیقه) بود. برای تحلیل داده‌ها از تحلیل واریانس اندازه مکرر استفاده شد. یافته‌ها: نشان می‌دهد که بطور متوسط میزان متغیر اضطراب مرگ در دو گروه مداخله درمانی (واقعیت‌درمانی و خودشفقت‌ورزی) نسبت به گروه کنترل در پس‌آزمون کاهش یافت. در آزمون پیگیری میزان اضطراب مرگ در دو گروه مداخله آموزشی نسبت به پس آزمون اندکی افزایش یافته و در گروه کنترل اندکی کاهش یافته است. از طرفی مشخص شد که واقعیت درمانی نسبت به شفق ورزی مؤثرتر بود. نتیجه‌گیری: به طور کلی می‌توان بیان داشت که با استفاده از شیوه درمانی واقعیت درمانی و شفقت ورزی میتوان هراس از مرگ را در  سو مصرف کنندگان مواد را بهبود بخشید.   <div style="text-align: justify;">Background & Aims: Today, there are few countries in the world where the most important and one of the major problems is not the issue of drugs and addiction. The World Health Organization has considered the issue of drugs, including production, transfer, distribution, and consumption, along with three other global issues, namely, the accumulation of weapons of mass destruction, environmental pollution, poverty, and class divisions among the basic issues that affect human life in social dimensions. , economic, cultural, and political threats and challenges in the global arena. Drug addiction is a neurological-psychiatric disorder that is associated with unpleasant habits and a strong desire to consume among its users, and over the years, it has caused many sufferings and tragedies due to the emergence of health problems for its abusers. Substance abuse disorder can make many substance-dependent patients suffer from psychological conditions such as stress, anxiety, and depression. Among the many psychological problems that arise in these people, we can mention a lack of attachment to life, depression, and despair, etc. Also, one of the essential components in addicts and even in depressed patients is problems related to mental health. Among the important factors affecting mental health is the category of death. Facing death and anxiety caused by it is considered as one of the most important components of people's mental health. Death anxiety means constant, abnormal, and morbid fear of death or dying. According to the definition of the British National Health Service, death anxiety is a kind of feeling of panic, fear, or worry when thinking about the process of dying or disconnecting from the world or what happens after death. Considering the importance of addiction disease and its complications, many methods are used to treat it, which can be referred to as self-compassion and reality therapy. Reality therapy is a strategic approach to behavior change; therefore, to explain it, we must first describe the selection theory. In psychology, various approaches such as behavioral therapy, cognitive therapy, psychoanalysis, etc. Therapeutic reality is an approach like other psychological approaches to change the behavior of mental patients in the first place and then to help change the behavior of clients in the process of self-development. Self-compassion training is one of the new interventions in the field of therapy that can increase a person's social support by applying kindness to oneself and others and improving social adjustment. In addition, this approach is effective on people's stress and psychological health. This approach can lead to improvement of distress tolerance and reduction of psychological distress of people. Self-compassion includes three components: self-love vs. self-judgment, human commonality vs. isolation, and mindfulness vs. extreme assimilation. The combination of these three components characterizes a person who has self-compassion. Therefore, it is necessary to use treatment methods for the fear of death in addicts. Now, according to what was said and also the importance of the subject, in this research we intend to investigate the effectiveness of two approaches reality therapy and compassion therapy on the fear of death in drug addicts and compare the effects of these two record therapies. Therefore, the main question of the research is: Is there a significant difference between the effectiveness of the two approaches of reality therapy and self-compassion on the fear of death in drug addicts and the two-month follow-up of the treatment?</div> Methods: The statistical population of this semi-experimental study included all addicts who were referred to six addiction treatment clinics in Galougah city in 1400-1401. The sample of the present study included 45 people (15 people in the reality therapy group, 15 people in the compassion group, and 15 people in the control group). The research tools were Templer's fear of death questionnaire (1970) and Glaser's (2010) reality therapy protocols (60 minutes each session) and Gilbert's (2014) compassion therapy (90 minutes each session). Repeated measure variance analysis was used to analyze the data. Results: It shows that, on average, the death anxiety variable in the two therapeutic intervention groups (reality therapy and self-compassion) decreased compared to the control group in the post-test. In the follow-up test, the level of death anxiety in the two educational intervention groups increased slightly compared to the post-test and decreased slightly in the control group. On the other hand, it was found that reality therapy was more effective than compassion. <div style="text-align: justify;">Conclusion: In general, it can be said that the fear of death in drug users can be improved by using reality therapy and compassion. In the current research, there were some limitations as follows: the available research sample cannot represent all addicts. The results of the present study can be generalized to the third group of drug users with demographic characteristics related to this research, and caution should be observed if the results are generalized to other women suffering from other types of addiction. In this research, it was not possible to control some variables such as family problems. Also, several questionnaires were completed at home, and the existing conditions may affect the way of answering. Considering the effectiveness of the two approaches of reality therapy and compassion therapy, it is suggested that these two approaches be used by therapists during the treatment and withdrawal of addiction so that the patients have more spirit in dealing with the withdrawal of the disease. Considering the effectiveness of these two psychotherapy approaches on mental disorders caused by addiction, it is suggested that therapists and mental health professionals, by holding reality therapy and compassion therapy, should take steps to change the level of mental health and follow-up treatment so that basic steps can be taken in to improve the process of leaving this disease and speeding up the recovery process of patients, it was harvested.</div> واقعیت درمانی, شفقت ورزی, هراس از مرگ, اعتیاد Reality Therapy, Compassion, Fear of Death, Addiction 392 402 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7227-1&slc_lang=fa&sid=1 Shahin Rezaei Shahri شهین رضایی شهری 3900319475328460073239 3900319475328460073239 No PhD Student of Health Psychology, Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran دانشجوی دکتری روانشناسی سلامت، گروه روانشناسی، واحد تنکابن، دانشگاه آزاد اسلامی، تنکابن، ایران Shahnam Abolghasemi شهنام ابوالقاسمی sh.abolghasemi@toniau.ac.ir 3900319475328460073240 3900319475328460073240 Yes Associate Prof. in Psychology, Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonkabon, Iran دانشیار، گروه روانشناسی، واحد تنکابن، دانشگاه آزاد اسلامی، تنکابن، ایران Fatemeh Eslahi farshami فاطمه اصلاحی فرشمی 3900319475328460073241 3900319475328460073241 No Assistant Professor, Department of Psychology, Chalus Branch, Islamic Azad University, Chalus, Iran استادیار، گروه روانشناسی، واحد چالوس، دانشگاه آزاد اسلامی، چالوس، ایران