Razi Journal of Medical Sciences

fa اثربخشی واقعیت درمانی بر اختلال وسواس فکری – عملی (OCD) زنان شاغل مراجعه کننده به مرکز مشاوره وفور The Effectiveness of Reality Therapy on Obsessive-Compulsive Disorder (OCD) of Working Women Referring to Vofoor Counseling Center روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: اختلال وسواس فکری – عملی (OCD)، اختلالات ناتوان کننده است که عملکرد فرد را تحت تأثیر قرار می‌دهد. هدف از انجام پژوهش حاضر بررسی اثربخش تئوری انتخاب برکاهش علائم اختلال وسواس فکری –عملی زنان خانه دار مراجعه کننده به مرکز مشاوره وفور بود. روش کار: پژوهش حاضر از نظر هدف کاربردی و  بصورت میدانی النجام شد. برای انجام پژوهش حاضر از روش  نیمه آزمایشی با طرح پیش آزمون - پس آزمون استفاده شد و از بین زنان شاغل دارای وسواس فکری - عملی مراجعه کننده به مرکز مشاوره وفور شهرستان تهران به روش نمونه گیری در دسترس 3 نفر از زنان دارای وسواس فکری- عملی، انتخاب شدند، و بصورت تصادفی در دو گروه آزمایش و کنترل گماشته شدند. ابتدا برای هر گروه پیش آزمون  وسواس - فکری عملی  با استفاده از از پرسشنامه ییل براون (BOCS– Y) انجام شد، سپس طرح مداخله‌ای هشت جلسه‌ای واقعیت درمانی برای گروه آزمایش و پیگیر انجام شد، سپس برای هر گروه پس آزمون، وسواس فکری -عملی، اجرا شد. در نهایت با استفاده از آزمون تحلیل کوواریانس تک متغیره به تحلیل یافته‌ها پرداخته شد. یافته‌ها: براسـاس نتـایج حاصل از پژوهش، طبق ارزیابی پرسشنامه‌ها در مراحل پیش آزمون و پس آزمـون که بر اساس مقایسه نتایج حاصـل از پاسـخگویی بـه هریک از سوالات پرسشنامه ییل براون به دست آمده،  مشخص شد مقدار آماره از میزان سطح معناداری 05/0 کمتر است. بنابراین میانگین متغیر وسواس فکری -عملی زنان در آزمودنی‌های گواه آزمایش پس از درمان واقعیت درمانی گلسر کاهش معناداری داشته است، به عبارت دیگر واقعیت درمانی گلسر تأثیر معناداری بر کاهش وسواس فکری -عملی زنان دارد و  هر سه یبمار در مقایسه با خط پایـه کـه همـان پیش آزمون می‌باشد، در کاهش نشانه‌هـای وسواسی بهبود داشـته‌انـد. نتیجه‌گیری: اثربخشـــی روش درمـــانی واقعیت درمانی در کـاهش شناختی نشانه‌های وسواس فکری –عملی در افراد مبتلا به اخـتلال وسـواس فکری-عملی  موثر بوده و مـی‌تـوان از ایـن یافته‌ها به منظور درمان بیماران مبتلا بـه ایـن اخـتلال استفاده کرد، هم چنین زمینه را برای بهبود اثربخشـی روش‌هــای درمــانی موجــود در ایــن حــوزه فــراهم خواهد آورد. واقعیت درمانی بـا قـرار دادن مسـئولیت انتخاب رفتار، بر دوش بیمار، وی را در قبال رفتاری که دارد صاحب اختیار و انتخـاب مـی‌دانـد و وی را از اعتقاد به کنترل بیرونی بـه کنتـرل درونـی و نـوعی از خـودپیروی رهنمـون مـی‌شـود و نهایتـا بیمـار را بـه خود رهبری  می‌رساند. </div> <div style="text-align: justify;">Bakcground & Aims: Obsessive-compulsive disorder (OCD) is a disabling disorder that affects an individual's performance. The aim of the present study was to investigate the effectiveness of the theory of choice in reducing the symptoms of obsessive-compulsive disorder in housewives who referred to the Wafar Counseling Center. The present study was applied in terms of its purpose and fieldwork. Among the employed women with obsessive-compulsive disorder who referred to the Wafar Counseling Center in Tehran, 3 people were selected as a sample using the available sampling method and were randomly assigned to the experimental and control groups. The inclusion criteria included being female and having insight into the disease and obtaining a significant score on the Yale-Brown Questionnaire, and being between 25 and 37 years old, having a high school diploma or higher, and university education, who were employed, and also willing to participate in the study. The exclusion criteria included not answering all the research questions, being male, and not having a connection to the disease. In order to maintain confidentiality, each client was assigned a code. Methods: To conduct the present study, a semi-experimental method with a pre-test-post-test design was used. Among the employed women with obsessive-compulsive disorder referring to the Wafur Counseling Center in Tehran, 3 women with obsessive-compulsive disorder were selected using a convenience sampling method and randomly assigned to two experimental and control groups. First, a pre-test of obsessive-compulsive disorder was conducted for each group using the Yale-Brown Questionnaire (BOCS-Y), then an eight-session reality therapy intervention plan was conducted for the experimental and follow-up groups, then a post-test of obsessive-compulsive disorder was implemented for each group. Finally, the findings were analyzed using a univariate analysis of covariance test. Results: Based on the results of the research, according to the evaluation of the questionnaires in the pre-test and post-test stages, which were obtained based on the comparison of the results obtained from answering each question of the Yale-Brown questionnaire, it was determined that the statistical value was less than the significance level of 0.05. Therefore, the average of the obsessive-compulsive variable in women in the control subjects of the experiment had a significant decrease after Glaser reality therapy treatment. In other words, Glaser reality therapy has a significant effect on reducing obsessive-compulsive symptoms in women. And all three patients improved in reducing obsessive-compulsive symptoms compared to the baseline, which is the pre-test. Conclusion: According to the results of the study, it can be concluded that the effectiveness of reality therapy in cognitively reducing the symptoms of obsessive-compulsive disorder in people with obsessive-compulsive disorder is effective, and these findings can be used to treat patients with this disorder. It will also provide a basis for improving the effectiveness of existing treatment methods in this field. Reality therapy, by placing the responsibility for choosing behavior on the shoulders of the patient, considers him to have authority and choice over his behavior, and guides him from believing in external control to internal control and a type of self-following, and ultimately leads the patient to self-leadership. The results of the study showed that at a significance level of 0.05, Glaser's reality therapy had a significant effect on reducing obsessive-compulsive disorder in working women in the experimental group. The results of the present study were consistent with the results of previous studies. In explaining the results, it can be said that obsessive-compulsive disorder is an anxiety disorder that has different forms and intensities. It is the presence of unpleasant, repetitive thoughts called obsessions about frightening things that are difficult to get out of the mind. Following these thoughts, a person performs physical or mental actions to reduce their unpleasant anxiety-provoking feelings. These actions are called practical compulsions, because the person feels compelled to perform these actions to relieve their anxiety. According to the results of this study, improvement in obsessive-compulsive symptoms was observed in patients with obsessive-compulsive disorder. During the eight treatment sessions that were conducted, obsessive symptoms and increased ability to reduce negative emotions such as anxiety when faced with the stimuli of obsessive behaviors were observed, as well as a greater sense of control through the perception of having the right to choose, in obsessive behaviors and greater responsibility for actions, thoughts and feelings (general behavior). According to research, people with obsessive-compulsive disorder have specific emotional schemas that are experienced as automatic and negative thoughts such as cognitive avoidance, rumination, and persistent worry. In a study, the effectiveness of cognitive therapy and reality therapy on rumination in women with obsessive-compulsive disorder was examined, and the effectiveness of reality therapy was confirmed. Overall, the present study provides evidence supporting the effectiveness of reality therapy in cognitively reducing obsessive-compulsive symptoms in individuals with obsessive-compulsive disorder. These findings can be used to treat patients with this disorder, and will also provide a basis for improving the effectiveness of existing treatment methods in this field. Reality therapy, by placing the responsibility for choosing behavior on the shoulders of the patient, recognizes him as the owner of authority and choice over his behavior, and guides him from believing in external control to internal control and a type of self-following, and ultimately leads the patient to self-leadership.  </div> واقعیت درمانی, اختلال وسواس فکری – عملی, زنان شاغل Reality Therapy, Obsessive-Compulsive Disorder, Working Women 1 11 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7639-3&slc_lang=fa&sid=1 Mahin Norouzi مهین نوروزی 3900319475328460090203 0009-0000-4898-3470 No PhD student, Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran دانشجوی دکتری، گروه روانشناسی، واحد تنکابن، دانشگاه آزاد اسلامی، تنکابن، ایران Parinaz Benisi پریناز بنیسی parenazbanisi2017@gmail.com 3900319475328460090204 3900319475328460090204 Yes Associate Professor, Department of Educational Management, West Tehran Branch, Islamic Azad University, Tehran, Iran دانشیار، گروه مدیریت آموزشی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران Ghanbar Ali Delfan Azari قنبرعلی دلفان اذری 3900319475328460090205 3900319475328460090205 No Assistant Professor, Department of Educational Sciences, West Tehran Branch, Islamic Azad University, Tehran, Iran استادیار، گروه علوم تربیتی، واحد تهران غرب، دانشگاه آزاد اسلامی، تهران، ایران