The Effect of Logotherapy Group Training on Changes of ... ; Golshan, et al Archive of SID Iranian Journal of Health Psychology Received: 09/22/2019 Vol. 2, No. 2, Serial Number 4, p. 101-112, Autumn 2019-Winter 2020 Accepted: 02/20/2020 The Effect of Logotherapy Group Training on Changes of Depression, Self-Esteem and Intimacy Attitudes in Physically Disabled Women Andisheh Golshan1, Majid Zargham Hajebi2,* & Naser Sobhi-Gharamaleki3 Abstract Objective: This study was conducted to determine the effects of logotherapy group training on changing self-esteem and intimacy attitudes and depression of physically disabled women. Method: The research was performed in semi-experimental method with two groups (logotherapy and control), pre- test, post-test and follow up phase. The statistical population was 68 people with physically disabilities under therapy of Kashan Welfare Center. Among this population, 40 physically disabled women (20-40 years old), who had depression above 17, were selected and randomly divided equally in two groups (n=20). The research instruments were Treadwell intimacy attitude (1983), Beck depression (1996) and Eysenck’s self esteem (1976) inventories. Before the first group training session pre-test was conducted by using questionnaires in both groups. Then 8 sessions of logotherapy, twice a week, each lasting 120 minutes, were administered to test the group. For both groups, post-test (immediately after training sessions), and follow-up test (one month later) were taken. Analysis of variance with repeated measures was used to analyze data. Results: The results showed that group training through logotherapy, significantly decreased depression (р ≤0.01), and significantly increased self-esteem and intimacy attitude (р ≤ 0.01), and the sustainability of this effects at follow-up. Conclusion: The study concluded that training logotherapy can effectively increase intimacy attitude and self-esteem and decrease depression in physically disabled women, and so it implies the importance of paying attention to spiritual training and applying them in welfare centers. Keywords: Logotherapy, Intimacy attitudes, Self-esteem, Depression, Physically disabled Introduction disorders specially during premenstrual, pregnancy, Depression is a common mental disorder. Globally, post-pregnancy and menopausal times, so that more than 264 million people of all ages suffer prevalence of depression is estimated 13% (Parry from depression. Depression is a leading cause of & Newton, 2001). Depression appears in various disability worldwide and is a major contributor to forms and changes person’s view about self, others the overall global burden of disease and according to and the world (Ganji, 2010). Beck hypothesized the World Health Organization (2020), women are three factors for negative views in depression: 1) more affected by depression than men. Women have negative views of the self, 2) negative views about twice the incidence of major depression compared environment and desire to experience the world to men which caused from Chronobiological hostilely and demandingly, 3) waiting for suffering 1. Department of Psychology, Qom Branch, Islamic Azad University, and failure about future (Beck, 1972). Qom, Iran. Psychologists define intimacy as making 2. Department of Psychology, Qom Branch, Islamic Azad University, Qom, Iran. relations with others and express emotions and 3. Department of Motor Behaviour, Allameh Tabataba’i University, Tehran, Iran. know it as human natural expressions. Those who * Corresponding author, Email: [email protected] experience high intimacy in relationship, can www.SID.ir Archive of SID 102 Iranian Journal of Health Psychology; Vol. 2, No. 2, Autumn 2019-Winter 2020 show themselves desirable and express their needs mental health in people with disabilities, indicated effectively (Patrick, sells, Giordano & Tollerud, that social relationships play an important role in 2007; Better Health Channel, 2019; Czyzowska, mental health and reducing their depression. Moradi, Gurba, Czyowska, Kalus, Sitnik-Warchulska & Kajbaf and Qamrani (2007) in their study among Izydorczyk, 2019). Among those who have major disabled single women in Isfahan found positive problems in communicating with others and and significant relationship between desire to make expressing their emotions are the disabled people, intimate relationship and enhancing mental health who are often exposed to negative attitudes that and reducing depression. lead to discrimination and violation of their rights Self-esteem refers to amount of prestige, and higher rates of social exclusion. For example, acceptance, credibility and value that people they face challenges in terms of education and consider about themselves. Person with mental employment and health care (United Nations, 2019), health also has a higher level of self-esteem and and usually a low number of disabled people adapt to is successful in relation to others. Those with less these conditions, and most of them feel helpless and self-esteem avoid being in public which leads to it reduces their self-esteem and eventually become their isolation and then depression (Gharachedaghi, depressed (Mushtagh & Akhouri (2016). 2019). Negative attitudes and psychosocial barriers Supports in order to shape positive self-concept affect the mental health of disabled people and cause for these people can cause more social integration lower level of self-esteem than others (Atadokht, and personal value which finally decrease their Jokar Kamalabadi, Hoseini Kiasari & Basharpoor, depression (Elliott, Herrick, Patti, Witty, Godshall 2014). Nosek, Hughes, Swedlund, Taylor and & Spruell, 1991; United Nations, 2019; Tough, Swank (2003) found that women with physically Siegrist & Fekete, 2017). disabilities have lower self-efficacy and self-esteem According to WHO (2018), about 15% of the than other women and are more socially isolated. world’s population have some form of disability They also reported positive relationship between and around 110 to 190 million people, 15 years old intimacy and self-esteem and self-efficacy, and and older, have serious difficulties in functioning. negative relationship between intimacy and social WHO defines disability as disorder of relation isolation and depression in disabled women. between individual and environment. According Studies show that acquiring life meaning is to Iran’s welfare organization (2018), there are strong support against person’s affective instability 1,350,000 disabled under coverage of the welfare and guarantees mental health (Rathi & Ragstogi, organization, among whom 42% are physically 2007; Mohammadi, Shahraky Vahed, Nikbakht, disabled. Depression is one of the main and firouzkouhi & Khosravi Bonjar,2019 ; Mohammadi common disorder among physically disabled. In this & Rahimzada Tehrani, 2018). Logotherapy is a regard, Hughes, Robinson-Whelen, Taylor, Petersen philosophical approach about people and their and Nosek (2005), in their study about the level of existence and explains basic themes and subjects of depression among 443 physically disabled women life such as suffering, death and life, freedom and over 18 years old (cut of point 17 in the BDI-II), responsibility about themselves and others, finding reported that more than 51% of these women suffer meaning, and to get along with meaninglessness. from depression disorder, which impacts their life This approach allows people to see every day fundamental activities. Tough, et al. (2017) in a events beyond problems. Frankl’s logotherapy is a systematically review of 63 quantitative studies therapeutic process to access ability to achieve real exploring associations of social relationships with self, expand attitude regarding self and surroundings, www.SID.ir Archive of SID The Effect of Logotherapy Group Training on Changes of ... ; Golshan, et al 103 and make obvious all things which create life not abstract and a subjective case, and these are the meaningfulness for person in present and future people who give meaning to their life, not asking (Afkham Rezaei, Tabrizi & Shafieabadi, 2008). the question of what is the meaning of life. They should ask themselves what meaning they can create Main principles of logotherapy are: for their life and the meaning for life by accepting - Under any circumstances, life is meaningful, even responsibility (Frankl, 2011). the most tragic of its kind, Some main factors of logotherapy are in line - Our main motivation in life is our desire and with Quran’s teachings that meaningfulness and purpose to find the meaning and concept of life, purposefulness of life are among them which are We are free to understand the meaning of what mentioned in various verses. For example, in verse we do, what we experience, or at least, what we 115 of Sura Al-Muminoon, it is said that: “Then did faced with in painful and unchangeable situation you think that we created you uselessly and that (Mohammadpour Yazdi, 2011). Logotherapy by to Us you would not be returned?”(Farsinezhad & considering the temporality of entity and human Dezhabad, 2009). existence instead of pessimism and isolation, Other factors which Frankl emphasized are invite human to effort and activity and explain understanding sufferings and accepting them in life what knockout human is not sufferings undesirable (Frankl, 2006). Allah says in verse 4, Sura Al-Balad: nature, but their life meaninglessness which is “We have certainly created man into hardship”. tragic. If we accept suffering bravely, life will