Document Type : Research Article (s)
Authors
Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
Abstract
Background: With the spread of COVID-19, the restriction strategies happened in the educational organizations to the direction of virtual education, causing several challenges in the psychological and social components for students. The main purpose of the study was to examine the effect of cognitive-behavioral therapy (CBT) on resilience and psychological hardiness in the students during the COVID-19 pandemic.
Methods: The current study was a quasi-experimental design with pre-test/post-test scheme along with a follow-up with intervention and control groups. It was performed on 200 students of Dezful University of Medical Sciences (n=100, per each group) selected through stratified random sampling method in 2020. The intervention group was exposed to a four-month intervention based on CBT (nine interventional session). Data were collected using Connor-Davidson Resilience and Kobasa hardiness questionnaire. Data were analyzed through SPSS software version 27 using descriptive statistics same as mean and standard deviation, repeated measures ANOVA, and Bonferroni’s post-tests.
Results: The mean age of the students was 21.93±2.52 years reported as 22.21±2.89 in the intervention group and 21.61±2.62 in the control group (P=0.3115). Before the intervention, there were no differences between the intervention and control groups in the score mean of resilience (P=0.2770) and psychological hardness (P=0.1038). In the post-training period of cognitivebehavioral therapy, there was a statistically significant difference between the mean scores of resilience (P=0.0018), hardiness (P=0.0194), and their dimensions in the two groups. These differences were also observed in the follow-up after four months of intervention.
Conclusions: The results revealed that the application of cognitive-behavioral intervention in student counseling and psychological counseling centers increases the rate of resilience and happiness of students and could be employed to improve mental health and academic status of students.
Keywords
1. Dana A, Khajehaflaton S, Salehian MH, Sarvari S. Effects of an Intervention in Online Physical Education Classes on Motivation, Intention, and Physical Activity of Adolescents during the COVID-19 Pandemic. Int J School Health. 2021;8(3):158-166. doi: 10.30476/intjsh.2021.91103.1145. ## 2. Franchi T. The impact of the Covid‐19 pandemic on current anatomy education and future careers: A student’s perspective. Anat Sci Educ. 2020;13(3):312-315. doi: 10.1002/ase.1966. PubMed PMID: 32301588; PubMed Central PMCID: PMC7262338. ## 3. Norouzinia R, Heidari AE, Ahmadi Basiri E, Ahmadi M. The Relationship between Resilience and Locus of Control in Students of Alborz University of Medical Sciences in 2017. Sadra Medical Journal. 2017;6(1):67-76. Persian. ## 4. Tempski P, Santos IS, Mayer FB, Enns SC, Perotta B, Paro HBMS, et al. Relationship among medical student resilience, educational environment and quality of life. PLoS One. 2015;10(6):e0131535. doi: 10.1371/journal.pone.0131535. PubMed PMID: 26121357; PubMed Central PMCID: 4486187. ## 5. Farquhar J, Kamei R, Vidyarthi A. Strategies for enhancing medical student resilience: student and faculty member perspectives. Int J Med Educ. 2018;9:1-6. doi: 10.5116/ijme.5a46.1ccc. PubMed PMID: 29334480; PubMed Central PMCID: PMC5834818. ## 6. Eisenberg D, Hunt J, Speer N. Mental health in American colleges and universities: variation across student subgroups and across campuses. J Nerv Ment Dis. 2013;201(1):60-7. doi: 10.1097/NMD.0b013e31827ab077. PubMed PMID: 23274298. ## 7. Auerbach RP, Mortier P, Bruffaerts R, Alonso J, Benjet C, Cuijpers P, et al. WHO world mental health surveys international college student project: prevalence and distribution of mental disorders. J Abnorm Psychol. 2018;127(7):623-638. doi: 10.1037/abn0000362. PubMed PMID: 30211576; PubMed Central PMCID: PMC6193834. ## 8. Tagharrobi Z, Fakharian E, Mirhoseini F, Rasoulinejad S, Akbari H, Ameli H. Survey of educational drop-out Indexes and its related factors in alumni of paramedical faculty of Kashan Medical University. Journal of Babol University of Medical Sciences. 2010;12(5):76-89. Persian. ## 9. Nguyen TD, Shultz CJ, Westbrook MD. Psychological hardiness in learning and quality of college life of business students: evidence from Vietnam. Journal of Happiness Studies. 2012;13(6):1091-1103. doi: 10.1007/s10902-011-9308-0. ## 10. Ndlovu V, Ferreira N. Students’ psychological hardiness in relation to career adaptability. Journal of Psychology in Africa. 2019;29(6):598-604. doi: 10.1080/14330237.2019.1689468. ## 11. Wood JJ, Chiu AW, Hwang W-C, Jacobs J, Ifekwunigwe M. Adapting cognitive-behavioral therapy for Mexican American students with anxiety disorders: Recommendations for school psychologists. School Psychology Quarterly. 2008;23:515. doi: 10.1037/1045-3830.23.4.515. ## 12. Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359(26):2753-66. doi: 10.1056/NEJMoa0804633. PubMed PMID: 18974308; PubMed Central PMCID: PMC2702984. ## 13. Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognit Ther Res. 2012;36(5):427-440. doi: 10.1007/s10608-012-9476-1. PubMed PMID: 23459093; PubMed Central PMCID: PMC3584580. ## 14. Delgadillo J, Gonzalez Salas Duhne P. Targeted prescription of cognitive–behavioral therapy versus person-centered counseling for depression using a machine learning approach. J Consult Clin Psychol. 2020;88(1):14-24. doi: 10.1037/ccp0000476. PubMed PMID: 31841021. ## 15. Bieling PJ, McCabe RE, Antony MM. Cognitive-behavioral therapy in groups: Guilford press; 2009. ## 16. Happer K, Brown EJ, Sharma-Patel K. Children’s resilience and trauma-specific cognitive behavioral therapy: Comparing resilience as an outcome, a trait, and a process. Child Abuse Negl. 2017;73:30-41. doi: 10.1016/j.chiabu.2017.09.021. PubMed PMID: 28942056. ## 17. Samani S, Jokar B, Sahragard N. Effects of resilience on mental health and life satisfaction. IJPCP. 2007;13(3):290-295. Persian. ## 18. Baek H-S, Lee K-U, Joo E-J, Lee M-Y, Choi K-S. Reliability and validity of the Korean version of the Connor-Davidson Resilience Scale. Psychiatry Investig. 2010;7(2):109-15. doi: 10.4306/pi.2010.7.2.109. PubMed PMID: 20577619; PubMed Central PMCID: PMC2890864. ## 19. Khoshouei MS. Psychometric evaluation of the Connor-Davidson resilience scale (CD-RISC) using Iranian students. International Journal of Testing. 2009;9(1):60-66. doi: 10.1080/15305050902733471. ## 20. Kobasa SC. Stressful life events, personality, and health: an inquiry into hardiness. J Pers Soc Psychol. 1979;37(1):1-11. doi: 10.1037//0022-3514.37.1.1. PubMed PMID: 458548. ## 21. Janjani Z. The relationship between hardiness and lifestyle with the cognitive adjustment of the excitement and happiness of women in Kermanshah. IJPCP. 2013;13(2):29-37. ## 22. Ghorbani N, Watson P, Morris RJ. Personality, stress and mental health: evidence of relationships in a sample of Iranian managers. Personality and Individual Differences. 2000;28:647-657. doi: 10.1016/S0191-8869(99)00128-2. ## 23. Tabibzadeh F, Sepehrianazar F. The Effect of Cognitive-Behavioral Therapy on the Resilience and Obsessive Rumination among Multiple Sclerosis (MS) Patients. Middle Eastern Journal of Disability Studies. 2017;7. ## 24. Boolaghi Y, KianiMoghadam ASK. The effect of religious-based cognitive-behavioral therapy on psychological well-being and resilience in students. European Online Journal of Natural and Social Sciences: Proceedings. 2015;4. ## 25. Anjomshoaa H, Snagui Moharer R, Shirazi M. Comparing the Effectiveness of Training Cognitive Behavioral Therapy and Neuro-linguistic Programming Strategies on Enhancing Resilience of High School Students in Kerman, Iran. International Journal of Pediatrics. 2020;8(8):11877-11889. doi: 10.22038/ijp.2020.49918.3984. ## 26. Yamamoto T, Matsumoto Y, Bernard ME. Effects of the cognitive-behavioral you can do it! Education program on the resilience of Japanese elementary school students: a preliminary investigation. International Journal of Educational Research. 2017;86:50-8. doi:10.1016/j.ijer.2017.08.006. ## 27. Seligman LD, Ollendick TH. Cognitive-behavioral therapy for anxiety disorders in youth. Child Adolesc Psychiatr Clin N Am. 2011;20(2):217-38. doi: 10.1016/j.chc.2011.01.003. PubMed PMID: 21440852; PubMed Central PMCID: PMC3091167. ## 28. Yousefy A, Nekouei ZK. Basis of Cognitive-Behavioral Trainings and its Applications in Recovery of Chronic Diseases. Iranian Journal of Medical Education. 2011;10(5):792-800. Persian. ## 29. van der Sluis CM, van der Bruggen CO, Brechman-Toussaint ML, Thissen MA, Bögels SM. Parent-directed cognitive behavioral therapy for young anxious children: A pilot study. Behav Ther. 2012;43(3):583-92. doi: 10.1016/j.beth.2011.10.002. PubMed PMID: 22697446. ## 30. Hamdan-Mansour AM, Puskar K, Bandak AG. Effectiveness of cognitive-behavioral therapy on depressive symptomatology, stress and coping strategies among Jordanian university students. Issues Ment Health Nurs. 2009;30(3):188-96. doi: 10.1080/01612840802694577. PubMed PMID: 19291496. ## 31. Cook L, Mostazir M, Watkins E. Reducing stress and preventing depression (RESPOND): randomized controlled trial of web-based rumination-focused cognitive behavioral therapy for high-Ruminating University students. J Med Internet Res. 2019;21(5):e11349. doi: 10.2196/11349. PubMed PMID: 31094331; PubMed Central PMCID: PMC6536298. ## 32. He JA, Antshel KM. Cognitive behavioral therapy for attention-deficit/hyperactivity disorder in college students: a review of the literature. Cognitive and Behavioral Practice. 2016;24:152-73. doi: 10.1016/j.cbpra.2016.03.010. ## 33. Zyromski B, Joseph AE. Utilizing cognitive behavioral interventions to positively impact academic achievement in middle school students. Journal of School Counseling. 2008;6:n15. ## 34. Abbasi Asl M, Rahmati-Najarkolae F, Dowran B. Comparison of the Effectiveness of Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Therapy (CBT) on Psychological Hardiness, Caring Behavior and Coping Strategies in Patients with Type 2 Diabetes. J Mil Med. 2020;22(10):1073-1083. Persian. ## 35. Sahranavard S, Esmaeili A, Salehiniya H, Behdani S. The effectiveness of group training of cognitive behavioral therapy-based stress management on anxiety, hardiness and self-efficacy in female medical students. J Educ Health Promot. 2019;8:49. doi: 10.4103/jehp.jehp_327_18. PubMed PMID: 30993142; PubMed Central PMCID: PMC6432834. ## 36. Kowalski CM, Schermer JA. Hardiness, perseverative cognition, anxiety, and health-related outcomes: A case for and against psychological hardiness. Psychol Rep. 2019;122(6):2096-2118. doi: 10.1177/0033294118800444. PubMed PMID: 30253687. ## 37. Cohen JA, Mannarino AP, Staron VR. A pilot study of modified cognitive-behavioral therapy for childhood traumatic grief (CBT-CTG). J Am Acad Child Adolesc Psychiatry. 2006;45(12):1465-73. doi: 10.1097/01.chi.0000237705.43260.2c. PubMed PMID: 17135992. ## 38. Bani Hashemi S, Hatami M, Hasani J, Sahebi A. Comparing Effectiveness of the Cognitive-behavioral Therapy, Reality Therapy, and Acceptance and Commitment Therapy on Quality of Life, General Health, and Coping Strategies of Chronic Patient’s Caregivers. Journal of Clinical Psychology. 2020;12(1):63-76. doi: 10.22075/jcp.2020.18992.1757. ## 39. LaRocca MA, Scogin FR. The effect of social support on quality of life in older adults receiving cognitive behavioral therapy. Clin Gerontol. 2015;38(2):131-148. doi: 10.1080/07317115.2014.990598. PubMed PMID: 27011418; PubMed Central PMCID: PMC4801227. ##
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