Exploring the Effectiveness of Compassion-Focused Therapy on Psychological Flexibility and Sense of Coherence in Mothers of Children with Attention-Deficit/Hyperactivity Disorder

Attention–Deficit/Hyperactivity–Disorder (ADHD) is one of the most common neurodevelopmental disorders, which has three essential characteristics: attention deficit, hyperactivity, and impulsivity. Behavioral and emotional problems of children with ADHD make parents face daily challenges in caring for and raising children. Cognitive flexibility in parenting is a self–regulation skill in the mother–child relationship. Also, the sense of coherence is one of the important psychological characteristics that need attention in mothers of children with ADHD. Compassion–focused therapy is one of the treatments that affect the mentioned variables. However, its role in the sample group of mothers of children with ADHD has not been well investigated, and the relevant studies are very few and limited. The present study was conducted to investigate the effectiveness of compassion–focused therapy on cognitive flexibility and sense of coherence in mothers of children with ADHD.

The present research method was quasi–experimental with a pretest–posttest and a two–month follow–up design with a control group. The statistical population of the present study consisted of all mothers of children with ADHD referred to counseling and psychology centers in Rasht City, Iran, in 2022 (March 21 to September 22). A total of 32 qualified volunteers of this population were included in the study by the purposive sampling method, and they were randomly assigned into two groups: compassion–focused therapy and control (16 people in each group). The inclusion criteria for mothers to enter the research were as follows: informed consent, at least one child aged 6 to 12 with ADHD (according to the medical record), aged 25 to 50 years, educational status of minimum diploma, cognitive flexibility scores less than 80 and sense of coherence less than 63. The exclusion criteria for mothers to leave the study included absence of more than two sessions, unwillingness and not cooperate with the researcher in the field of homework, chronic and severe physical or mental illness, and drug addiction. The cognitive flexibility inventory (Dennis & Vander Wal, 2010) and </sup>the </sup>Sense of Coherence Scale (Antonovsky, 1993) were the instruments employed in this research. To perform the therapeutic intervention, Gilbert's compassion–focused therapy (Gilbert, 2009) was implemented for the experimental group in 8 sessions, and at the same time, the control group did not undergo any psychotherapy intervention. In descriptive statistics, mean and standard deviation were used. In inferential statistics, the repeated measures analysis of variance, Bonferroni's post hoc test, the independent t test, and the Chi–square test were performed in SPSS software version 26 at a significance level of 0.05.

The demographic data of the participants were examined. No significant differences were observed between the groups in terms of age (p=0.991), education level (p=0.903), marital status (p=0.842), employment status (p=0.906), and number of children (p=0.884). The findings showed that the effects of time (p<0.001), group (p<0.001), and the interaction of group x time (p<0.001) on the variables of cognitive flexibility and sense of coherence were significant. The results showed a significant increase in the scores of the mentioned variables in the posttest and follow–up stages compared to the pretest in the intervention group (p<0.001). While none of the average differences in the control group were significant (p>0.05). At the follow-up stage, the intervention effect persisted for the cognitive flexibility variable (p=0.019) and the compassion-based treatment showed a persistence effect for the sense of coherence variable in the intervention group (p=1.00).

This study showed that compassion–focused therapy is effective in increasing cognitive flexibility and the sense of coherence of mothers of children with ADHD. Therefore, counselors and therapists may use this treatment to improve these variables in mothers of children with ADHD.