Effect of Spiritual Cognitive-Emotional Therapy on the Psychological Well-Being of Bereaved Women

Mourning is one of the problems that every person can experience shortly after the death of a loved one. Mourning the death of a loved one is a natural and necessary process that all people experience, but some people lack the skills and abilities to cope with mourning, which can result in many other problems. Studies show that grief affects women more than men, and dysfunctional thoughts such as suicide in women increase with losing loved ones; women experience higher stress, anxiety, and depression. Decreased levels of psychological well–being are some of the things that happen to bereaved people. Accordingly, therapeutic interventions are very important for this group, especially those who suffer from severe mourning. Spiritual cognitive–emotional therapy can promote positive moods and emotions in people, reduce the obsession with negative thoughts, and improve people's coping with negative life events. So, this study investigated the effect of spiritual cognitive–emotional therapy on the psychological well–being of bereaved women.

This research was a quasi–experimental study with a pretest–posttest and two months follow–up design, and a control group. The study's statistical population included all women living in the city of Babol, Iran, in 2019, who had been mourning for at least the last 12 months and still showed signs of mourning and depression. The study sample was selected from women referred to counseling and psychological services in Babol and met the inclusion criteria. From this group, 30 people were selected by a convenience sampling method. The inclusion criteria were an experience of grief and its symptoms according to DSM–5 (Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition) diagnostic criteria, the existence of depression according to the Beck Depression Inventory–II (1996), female gender, at least one year after the death of a loved one, no acute mental illness and personality, and with a minimum of a 9th–grade education. The exclusion criteria were unwillingness to cooperate and absence of more than two sessions from the treatment sessions. Then, 15 women were randomly placed in the spiritual cognitive–emotional intervention therapy group and 15 in the control group. To collect study data, we used the Ryff's Scale of Psychological Well–Being (Ryff, 1989). The spiritual cognitive–emotional therapy was performed in groups in ten 90–min sessions once a week based on Rajaee's (2010) training package. The control group received no intervention. To describe the data, descriptive statistics, including central and dispersion indicators such as mean and standard deviation, were used. Inferential statistics, including repeated measures analysis of variance and Bonferroni post hoc test, were used to analyze the data. The age of the subjects in the two groups was compared using the analysis of variance. The mentioned statistical analyses were performed in SPSS software version 24. The significance level of the tests was considered 0.05.

The analysis of the variance of the psychological well–being variable was significant for the effects of time (p<0.001), group (p=0.002), and the interaction of time and group (p<0.001). The effect size of the intervention for psychological well–being was also 0.28. There were also significant differences between the pretest and posttest stages (p<0.001) and between pretest and follow–up stages (p<0.001) in the scores of psychological well–being. However, no significant difference was observed between the posttest and follow–up (p=0.137) stages, showing the sustained effect of the therapeutic intervention over time.

According to the results of the study, spiritual cognitive–emotional therapy is effective in increasing the psychological well–being of mourning women.