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| ORIGINAL ARTICLE |
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| Year : 2015 | Volume
: 1
| Issue : 4 | Page : 266-271 |
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Effectiveness of narrative therapy on mental health of addicts' wives treated in the addiction treatment centers in Khomeini Shahr
Elham Zamani Foroushani, Elham Foruzandeh
Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| Date of Web Publication | 31-Aug-2015 |
Correspondence Address:
Asst. Prof. Elham Foruzandeh
Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan
Iran
 Source of Support: Nil., Conflict of Interest: There are no conflicts of interest.  | Check |
DOI: 10.4103/2395-2296.163941
Aim: The purpose of this study was to evaluate the efficacy of narrative therapy on mental health of addicts' wives treated in the addiction treatment centers in Khomeini Shahr. Methodology: This study was conducted based on the quasi-experimental method with pretest, posttest, and control group. The population of this study was included all the wives of the addicts who were under the therapy of the addiction treatment centers in Khomeini Shahr, Isfahan, Iran. In this study, the addicts' wives were aware that their husbands were under the therapy in addiction treatment centers and were randomly put into the experimental group (15 individuals) and control group (15 individuals). The instrument of the research was General Health Questionnaire of Goldberg (1987). First, a pretest was taken from the experimental group and control group. Then, four sessions, which were 1 h were held for the experimental group. Finally, a posttest was taken from these two groups. Data were analyzed with the analysis of covariance. Result: Findings showed that narrative therapy had a statistically significant effect on the mental health of addicts' wives treated in the addiction treatment centers in Khomeini Shahr and increased their mental health (F = 8.96, P < 0.05). Conclusion: As a result, the narrative therapy approach is a change in their mental health for addressing consumers' wives tales about their position, family, and wife. Keywords: Addiction treatment centers, addicts' wives, mental health, narrative therapy
How to cite this article:
Foroushani EZ, Foruzandeh E. Effectiveness of narrative therapy on mental health of addicts' wives treated in the addiction treatment centers in Khomeini Shahr. Int J Educ Psychol Res 2015;1:266-71 |
How to cite this URL:
Foroushani EZ, Foruzandeh E. Effectiveness of narrative therapy on mental health of addicts' wives treated in the addiction treatment centers in Khomeini Shahr. Int J Educ Psychol Res [serial online] 2015 [cited 2023 Jun 5];1:266-71. Available from: https://www.ijeprjournal.org/text.asp?2015/1/4/266/163941 |
| Introduction | |  |
In recent years, substance abuse is one of the most serious humanitarian problems and one of the most complex human phenomena that destroy the basis and foundation of human society and its prevention requires the application of theory to analyze several different scientific disciplines and a variety of techniques. The damaging effects of substance abuse are important because addition to the addict, family and friends will be exposed to its destructive effects. Substance abuse in Iran is one of the most important issues in health, social, and culture so that more than 90% of people about substance abuse in the community have expressed serious concerns. Incompatibility of marital and family breakdown is the serious consequences of substance abuse. Financial pressures, domestic violence, changing roles and responsibilities, unacceptable social behavior such as extramarital all leads to a family breakdown.[1] Statistical evidence suggests that 34% of divorces caused by addiction and drug-related problems and 60% of the divorce demand from women is due to the addiction of their husbands and not receiving the alimony.[2] Women who themselves do not use addictive drugs but are living in a family that their husbands and sons are drug abusers are affected by abuse this drug abuse. From the perspective of some family therapists, substance abuse is often a problem in multi-generational families. Accordingly, a full assessment of the consumer and his family is necessary for this disorder in determining the range of biological, psychosocial, and most of all family separation, however, family therapy as a therapeutic approach for the treatment of drug dependence cannot be stated enough, but as an additional intervention can be valuable even requirements are met. In the treatment of substance dependence disorders, involving the family, would be a better therapeutic results, even in cases where working families are required to treat this disorder.[3]
Addicts' wives in the symptoms of depression, somatic, anxiety, insomnia, social functioning, and general health problems are more common than others, particularly this difference was significant in depression, anxiety and insomnia, somatic.[4] Research shows that women more than men are diagnosed with mental health problems, especially depression and anxiety, and they also use more psychiatric drugs than men.[5] Surveys show that agony and depression are significantly more in addicts' wives than other people and the women who are stricken to drug abuse become depressed more than other family members.[4] In spite of the fact that substance abuse can be as a result of people's genetic background that have mental disorder background in their family, they are actually the disruptive factors of their mental health families.[6]
Based on the narrative therapy, environment, and people impact on each other. Altogether, this approach to study the problem, whatever it is, and it will be handled externally and destruction. It means that we can separate a person from his or her problem. The problem will be considered as a nature, which a person can control it as a result of this kind of separation. In a traditional way, therapists were trained in a way that they only focused on the normal and pathological features of the clients. Narrative therapy is involved of the ways of understanding the people's lives and the ways of rewriting these kinds of stories in a collaborative task of a therapist and an individual which their life is under the discussion.[7] Narrative therapy had positive impacts on improving the discussions in depressed people, criminals, violence against women, multicultural consultants, survivors, and couples with different cultures.[8] Since the family is the first social organization in which the individual lives, so that the focus can reduce the stress incurred by its members. Narrative therapy as a fast method can have a positive impact on the mental health of women in the society. Researchers used metaphor as a sign of change and improvement in depression treatment, and significant changes were observed in patients.[9] Furthermore, the efficacy of narrative therapy was reported on the depressed women.[10],[11],[12] Researchers such as Jefferson, Singer Bruce, Singer, and Meredith reported the efficacy of narrative therapy approach and mindfulness on an alcohol woman.[13]
Narrative therapy involves a process of helping people to overcome their problems through talk therapy such as telling, listening, and hearing and saying again and again these stories. Furthermore, narrative therapy is an approach which sees people as their major experts in their life and sees problems as separate parts of people and thinks people have a lot of skills, beliefs, values, and capabilities, which help them to reduce the impacts of problems on their lives. Narrative therapy is attempted to be a flexible, respectful, gentle, and out of blame way for advice, communicative work, curiosity, interest, and asking questions that the therapist do not know their answers exactly. Studies show that couples who speak with each other and get along with their past experiences in their life, they face the current phenomena better.[14] According to research conducted in the field of family therapy and individual treatment, the aim of this study was to survey the efficacy of narrative therapy sessions on the mental health of addicts' wives.
| Methodology | | |
This study was conducted based on the quasi-experimental method with a pretest, posttest, and control group.
Participants
The population of this study was included all the wives of the addicts who were under the therapy of the addiction treatment centers in Khomeini Shahr, Isfahan, Iran. Sampling was done based on cluster method in this study. In cluster sampling, researchers first selected three centers of 12 centers of Khomeini Shahr County. Then, they selected the women who were aware of their husbands addiction from these three centers of Khomeini Shahr County. At the end, researchers selected randomly 30 individuals as an experimental group and 15 individuals as a control group. Since some of the members of the experimental group could not cooperate, researchers surveyed on 15 individuals in the experimental group and removed other 15 individuals from the process of research.
Based on the topic of the study, data were collected with the general health questionnaire (GHQ). Goldberg believes that the GHQ is a screening tool, which is based on the self-report method in clinical sets out to trace those people who have a mental disorder.[15] GHQ was built by Goldberg in 1987 and used widely for detecting mental minor disorders. This questionnaire was in the forms of 28, 30, 60, and 12 questions. The 28-point GHQ has the advantage that is designed for all members of the society. This kind of questionnaire is mainly used for identifying the mental disorders and surveying the mental health of the members of the society. This questionnaire has four subscales, which are physical symptoms, anxiety, depression, and insufficient interaction of social productivity. The total score of this questionnaire was obtained with the sum of scores. The four subscales of the GHQ were proved with statistical analysis (factor analysis). The total score of any individuals was obtained with the sum of the four subscale scores. Each subscale of this questionnaire has seven questions. Every individual can get a score between zero to 84 based on the selected items in each subscale.[16] In the present study, Cronbach's alpha was reported respectively, 0.88 for all the scales and 0.76, 0.80, 0.58, 0.85 for the subscales. The pretest was conducted on the experimental group and control group in a self-report form. Then, narrative therapy sessions were set individually for the experimental group in four sessions. After that, a posttest was performed in a self-report form. In the first session, researchers listened to the present narration of participants and externalized their problems. The purpose of the first session was to externalize the problem. Also, the problem is not related to the person, and the problem itself is very complicated. In continuous, researchers survey the impact of problems on the lives of participants and their relationships. Furthermore, the obstacles of the participants problems were surveyed. In the second session, researchers examined other things. Researchers surveyed problems separate from the participants and talked about the things that could overcome the problems. Then, they investigated the outcomes of the second session. In the third session, the client chooses a new story. The purpose of the third session was to seek and investigate individuals unique experiences. The purpose of seeking and investigating the individuals new experiences was to consider the impacts of separating problems from individuals and the ways of overcoming on these problems. In the fourth session, researchers surveyed other things. In this session, researchers studied the participants beliefs about the effectiveness of three previous sessions. Sometimes, clients in this step give a new name to their story because they understand there are problems with the second story.[17]
Findings
The obtained data with the covariance analysis were analyzed for the purpose of surveying the research assumptions. Due to the exit from the cycle of treatment and lack of access to them and their families despite many efforts, conducted follow-up sessions for the group was not possible.
As the results in [Table 1] shows, the mean and standard deviation of physical symptoms in pretest are 9.87 and 3.06 for experimental group and 10.53 and 4.1 for control group. Furthermore, the mean and the standard deviation of the physical symptoms in posttest are 6.47 and 2.26 for experimental group and 11.4 and 3.26 for control group. Also, researchers used Leven test as a preassumption of the covariance analysis for the purpose of the variance homogeneity, which its results showed the variance equality (P < 0.05).
We could conclude that the narrative therapy had a significant impact on the physical symptoms of the addicts' wives based on F, which was obtained from the statistical data of [Table 2].
As you can see, the results of [Table 3] show that the mean and the standard deviation of the anxiety in pretest are 11.2 and 4.34 for experimental group and 11 and 4.44 for control group. Furthermore, the mean and the standard deviation of the anxiety in posttest are 5.33 and 3.2 for experimental group and 11.73 and 4.13 for control group. Also, researchers used Leven test as a preassumption of the covariance analysis for the purpose of the variance homogeneity, which its results showed the variance equality (P < 0.05).
We could conclude that the narrative therapy had a significant impact on the anxiety of the addicts' wives based on F, which was obtained from the statistical data of [Table 4] (P < 0.05).
As you can see, the results of [Table 5] show that the mean and the standard deviation of the insufficient interaction of social productivity in pretest are 13.53 and 3.04 for experimental group and 12.67 and 3.24 for control group. Furthermore, the mean and the standard deviation of the insufficient interaction of social productivity in posttest are 9.4 and 3.24 for experimental group and 14.2 and 1.85 for control group. Also, researchers used Leven test as a preassumption of the covariance analysis for the purpose of the variance homogeneity, which its results showed the variance equality (P < 0.05). | Table 5: The descriptive statistics of the insufficient interaction of social productivity
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We could conclude that the narrative therapy had a significant impact on the insufficient interaction of social productivity of the addicts' wives based on F, which was obtained from the statistical data of [Table 6] (P < 0.05). | Table 6: The effects of the insufficient interaction of social productivity among the groups
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As you can see, the results of [Table 7] show that the mean and the standard deviation of the depression in pretest are 9.13 and 6.51 for experimental group and 7.6 and 6.65 for control group. Furthermore, the mean and the standard deviation of the depression in posttest are 2.66 and 3.354 for experimental group and 6.66 and 5.75 for control group. Also, researchers used Leven test as a preassumption of the covariance analysis for the purpose of the variance homogeneity, which its results showed the variance equality (P < 0.05).
We could conclude that the narrative therapy had a significant impact on the depression of the addicts' wives based on F, which was obtained from the statistical data of [Table 8] (P < 0.05).
| Conclusion | | |
The results showed that the performance of narrative therapy approach has a significant effect on mental health (P < 0.05). In other words, narrative therapy approach will lead to the increase in the mental health of addicts' wives. The researcher did not find any studies in relation to the efficacy of narrative therapy approach on the mental health of addict's wives. The results of present research are incompatible with the Levitt, Korman, and Angus findings in the use of metaphor in the treatment of group depression; Mim Weber, Davis Kierrynn, Lisa Mcphie, and Sarah Gibbs findings in the use of narrative therapy in the decrease of the amount of women depression; and Jefferson, Singer Bruce, Singer, and Meredith Berry findings in the use of narrative therapy approach and mindfulness in treating one alcohol woman.[9],[10],[11],[13] Furthermore, some researchers such as Naziri, Ghaderi, and Zarea showed that group narrative therapy approach would lead to the decrease in depression, negative automatic thoughts, and inefficient attitudes in depressed women.[12]
Getting help from family in the treatment process is one of the appropriate approaches in the treatment of addiction. In families affected by addiction, involvement of multiple, frequent criticism, taking refuge in silence, feeling the lack of companionship and eventually fatigue, and frustration leads to mental and physical health of couples affected and according to them, the more work, less gain. Often families are aware of the effects of substance abuse that addiction is shown. According to the statistical community in the present study, it can be expected that the marital problems and psychological damage is more addicted wives. Years of struggling with an addiction spouses but did not result in confusion and fragmentation of the family. It means that, years of trying to deal with addiction wife, no results have been found. Over that addiction is causing confusion in relationships spouses, life partners of couples understanding of addiction lead to turbulence. What spouses who are unaware of the abuse of his wife and lived happily together. However, as soon as they become aware of spouse abuse suddenly everything changes. Different therapeutic approaches to the disease of addiction have their perspective but what distinguishes the approach of narrative therapy is that in this approach, as much as the individual shape the environment, the environment too. A man rather than a reaction to the events of the story that makes the various issues creates a world that reacts to it in the future. Narrative therapy addressed the extrapolating the problem. This is the problem, and the problem is not the problem. Narrative therapy provides the opportunity for a fresh perspective on the problem and describes themselves and their relationships. With the adoption of this new approach can discover the truth about her. While a lot of difficult justification for his life when he could not understand them.
The narrations and the stories, which people express about their own life, are important because they enable people to give order to their life phenomena and build their past, present, and future experiences based on the logic. Narrations not only organized the time but also gave meaning to the temporal experiences in a way that peoples past memories were treated with the narrative therapy, their tolerance was increased, and they built a new dreamy future for themselves.[18] In narrative therapy, participants and the therapist are actually the editors of participant's private biography. In other words, editing participant's private biography has an active role in treating them. In this way, a person learns to help him or herself in removing his or her mental issues and tries it a lot. Since people think about their life stories through writing them, they select some of them and take apart the unimportant parts. Hence, people are the editors of their life stories, and this is a thing, which is emphasized in this approach. It means that people should edit their life stories. Among the limitations of this study include severe psychological problems and mood swings high in some patients and also the patients exit from the addiction treatment centers and not accessing to them in performing the pursuing sessions and also not cooperating with the researchers in letting their wives to attend the sessions. The results of the research suggest people to research with different samples with regard to the level of the culture and consider other control variables. Furthermore, narrative therapy sessions for patients and their spouses are done simultaneously.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]
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