The Effectiveness of Reality Therapy Program on Psychological Well-being, Cognitive Emotion Regulation, and Interpersonal Relationships of Mothers of Children With Developmental Disabilities

According to the American Psychiatric Association, developmental disabilities are a group of disabilities related to the developmental stages of childhood that occur with varying degrees of severity at birth. Given the prevalence of psychological distress among mothers with children with developmental disabilities and its negative effects on their individual and family functioning, it seems that providing psychological services in the form of treatment strategies such as reality therapy can regulate emotion, interpersonal relationships, and the psychological well–being of these mothers. Also, as the literature review showed, the effect of the mentioned intervention on the research variables in the target population, as far as the researcher examined, no direct study has been done, and a research vacuum is felt in this field. Therefore, the present study was conducted to determine the effectiveness of reality therapy programs on psychological well–being, cognitive emotion regulation, and interpersonal relationships of mothers of children with developmental disabilities.

The present study was a quasi–experimental study with a pretest–posttest design with a control group. The statistical population of this study included all mothers of children with developmental disabilities in Saqez City, Iran, in 2020–2019. Since at least 15 people were recommended for each group in the experimental methods, 30 mothers were selected from the eligible volunteers and randomly assigned to the experimental and control groups. Finally, the experimental group was trained in a reality therapy program, and the control group did not receive any intervention. The inclusion criteria were as follows: no history of mental illness and use of psychotropic drugs, no use of psychological interventions and other counseling, no psychotic disorders, dementia and mental retardation, alertness and ability to participate in mindfulness sessions, and ability to speak in Persian. The exclusion criteria included absence for more than two sessions in the treatment protocol and unwillingness to continue cooperating in training sessions. Finally, individuals were assured that all information was confidential and would be used for research purposes. For privacy reasons, participants' first and last names were not registered. The study data were obtained by the Ryff Scale Psychological Well–being (RSPWB, Revised Ryff, 1995), Cognitive Emotion Regulation Questionnaire (Garnefski, Kraaij, 2006), and Inventory of Interpersonal Problems Questionnaire (PII–32, Barkham, 1996) before and after the reality treatment. The obtained data were analyzed with univariate analyses of covariance in SPSS23. The significance level was considered 0.005.

The Shapiro–Wilk test was used to check the normality of the data before the analysis of covariance. The results showed that the assumption of normality was valid for psychological well–being data (p=0.922), interpersonal problems (p=0.782), and cognitive emotion regulation (p=0.686). The results of Levene's test for homogeneity of variance of psychological welfare dependent variable (p=0.909), interpersonal problems (p=0.556), and self–cognitive emotion regulation include two subgroups: adapted strategies (p=0.694) and uncompromising solutions (F=0.067, p=0.798). The results of Levene's test showed no significant difference in the variance of the groups, and therefore the assumption of the equality of variance was established. The results of the test assumed the homogeneity of the regression slope in the groups for the variables of psychological well–being (p=0.100), interpersonal problems (p=0.415), and cognitive emotion regulation (p=0.639), which shows that the default. The homogeneity of the regression slope based on the non–significance of the group*pretest interaction is confirmed. Therefore, the regression homogeneity assumption was established, and it can be ensured that the data of this study meet the assumptions underlying the analysis of variance. Also, the results of univariate analysis of covariance on the mean posttest scores of dependent variables with pretest control in the experimental and control groups showed that reality therapy training had a positive and significant effect on cognitive regulation, which increased the compromised strategies (p=0.002) and decreased the uncompromising strategies (p=0.003) in individuals. This treatment also increased psychological well–being (p=0.012) and decreased interpersonal problems in individuals (p=0.002).

In general, the results showed a significant difference between cognitive regulation of emotion, psychological well–being, and interpersonal relationships of mothers of children with developmental disabilities in the experimental and control groups. Therefore, using a reality therapy program alone or combined with other therapies can reduce psychological problems, regulate emotions, and improve mothers' relationships with children with developmental disabilities.