The Effectiveness of unified protocol of trans-diagnostic treatment on Adolescent Anxiety and maternal parenting methods

Anxiety disorders and depression are the most common emotional disorders in adolescence, which in addition to the direct costs they impose on the community health and care system, also have indirect costs (functional decline) that are higher than other psychological disorders. Allocates the amount to itself (4).One of the most interesting aspects of anxiety disorders is the subtle interaction that exists between hereditary and environmental factors that cause these disorders (5). For this reason, paying attention to the family environment is very important in explaining and treating anxiety disorders. Each family uses special methods for individual and social upbringing of their children, which are called parenting methods. These methods are patterns of child rearing that are formed from the normal interaction of parents and their response to children's behavior (7).Since the mother's communication pattern plays an important role in the child's emotional and social development in the future and can improve children's behaviors, it seems that training sessions for parents to manage emotions in interaction with children can improve parents' skills. Equip them with good upbringing, and in these circumstances, parents can better behave decisively towards their children by setting constructive rules in the family and managing their negative emotions (10).In the meantime, integrated meta-diagnostic therapy in response to the limitations of cognitive-behavioral therapies such as the failure of these therapies to improve a significant portion of patients, the existence of multiple guidelines and treatment plans for each disorder and confusion in choosing the appropriate patient guidelines Has been (14). The main goal of integrated meta-diagnostic therapy is for individuals to acquire skills that can effectively manage their negative emotions (15). Given the above and the impact of anxiety on adolescents' personal, family and social lives and the imposition of heavy costs on the individual and society on the one hand, finding a way to reduce the negative effects of anxiety on the other hand and because reviewed research No research has been found on the subject at home or abroad. The researcher seeks to answer the question of whether an integrated transdiagnostic treatment program affects anxious adolescents and their mothers' parents.

To conduct the present quasi-experimental research, which was conducted as a pre-test-post-test with the experimental and control groups, among all anxious adolescent girls in the age range of 12-15 years in the first grade of high school in Tehran in the 98-99 academic year, 20 Paying attention to the entry and exit criteria from one of the schools in Tehran were selected and randomly assigned to experimental and control groups.Then the therapeutic stages of an integrated meta-diagnostic approach, including five main stages of treatment (emotional awareness based on mood 2. cognitive flexibility 3. emotional avoidance and behaviors caused by emotion 4. awareness and tolerance of bodily feelings and 5. endogenous and situational emotional exposure) ( 16). And 12-16 sessions and ranged approximately 50 to 60 minutes weekly. Also, to collect data, the Spence Anxiety Questionnaire was used to assess the anxiety of children aged 8-15 years old in 1997 and the Arjmandnia Parenting Methods Questionnaire 24 hours before and 48 hours after the intervention. Finally, the collected data were analyzed using univariate analysis of covariance (ANCOVA) and multivariate analysis (MANCOVA).

The results of descriptive statistics of children's anxiety showed that the mean obtained for the experimental group in the pretest is 142.70. With a decrease of 16.07 points in the experimental group, the average score in the post-test has reached 126.63.Regarding the effect of intervention on anxiety, the results of analysis of covariance showed that the integrated meta-diagnostic treatment program had a significant effect on reducing adolescent anxiety (F = 59.5). The average score for the experimental group in the pre-test is 27.53. With an increase of 3.96 points in the experimental group, the average score in the post-test has reached 31.49. Also in the component of authoritative behavior: the average achieved for the experimental group in the pre-test is 8.74. With an increase of 4.67 points in the experimental group, the average score in the post-test has reached 13.41. Finally, in the component of parental dependence: the average achieved for the experimental group in the pre-test is 9.53. With a decrease of 3.55 points in the experimental group, the average score in the post-test has reached 6.48.Regarding the effect of intervention on parenting, it was found that the value of Pilay effect is 0.72 and the value of Lambeda Wilkes is 0.28, both of which are significant at the level of P 0.0 0.01. Therefore, the dependent variables (parenting components) of the experimental and control groups are significantly different from each other.Finally, the results of univariate analysis of covariance on the components of parenting show that the value of F obtained in the two components of authoritarian behavior and parental dependence is significant at the level of P 0.0 0.01. Therefore, the difference between the experimental and control groups is significant in these components. Considering that in the component of authoritative behavior, the mean post-test score of the experimental group increased compared to the pre-test and in the component of parental dependence, there was a decrease in the component, so it can be said that integrated meta-diagnostic treatment program increased authoritarian and dependent behavior. reduces; But the effect of the independent variable on democratic parenting was not significant.

In general, meta-diagnostic therapies are an emotion-focused meta-diagnostic and cognitive-behavioral therapy that can be used for a wide range of emotional disorders using emotion regulation skills (22). Emotional response management is the core of transdisciplinary practices and seeks to teach individuals to recognize their emotional responses, modify and regulate their emotional habits to reduce the severity of emotional trauma (23). The use of negative cognitive emotion regulation strategies is associated with mental health problems. Among the negative strategies, self-blame, mental rumination and catastrophic captivity, strong correlation with negative emotions such as depression, anxiety, anxiety (24).In summary, to alleviate the problems associated with anxiety, researchers consider the use of cognitive-behavioral and emotional components in therapy necessary (17) and integrated programs have been used to identify multiple problems and benefit from cost-effective multiple therapies; But if these programs are not effective, it is necessary to reduce the anxiety, should consider the cognitive-emotional schemas of individuals and eliminate cognitive distortions, emotional schemas (24).