Comparing the Effectiveness of Mindfulness-Based Compassion Therapy and Positive Cognitive-Behavioral Therapy on Resilience of Female-Headed Households

Resilience is one of the main personality structures and one of the basic psychological resources in facing stress and problems (1). Resilience is a personal characteristic that helps people to cope with the hardships of life, to adapt and make good progress in difficult situations. This feature protects people from the consequences and effects of difficulties and traumatic events (2). The American Psychological Association defines resilience as being able to adapt well during hardships, trauma, threats, or even stressful situations (3). Resilience occurs when people engage in their inner strengths, such as using coping skills and attitudes, and are free from less helpful thoughts and behaviors (4). It is often observed that gender plays a role in resilience. Women are more vulnerable to shocks and stresses than men, and the strategies they use to manage and deal with risk are also different (5). Of course, this vulnerability also exists in female-headed households due to their living conditions;   these women are in a situation full of stress, and financial, economic, social and psychological pressure, which disrupts their performance in all aspects, including personal, family, social, and psychological aspects (6). According to research, among the effective interventions to improve resilience, we can mention mindfulness (10,11) and positive cognitive-behavioral therapy (12). Mindfulness is one of the tools to strengthen adaptive coping skills and resilience (4). Among the interventions emanating from the mindfulness approach is Mindfulness-Based Compassion Therapy. Kristin Neff introduces self-compassion as a kind of relationship with oneself, which consists of three components: self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus over-identification (14). These components interact with each other to create a compassionate frame of mind (15). Many studies have confirmed the relationship between self-compassion and well-being and state that self-compassion, on the one hand, is associated with higher levels of happiness, optimism, life satisfaction, gratitude, and psychological well-being, resilience and motivation (16,17) and on another hand, it is related to lower levels of depression, anxiety, stress, rumination, shame and fear of failure (18,19). In addition, one of the other interventions used to improve resilience is positive cognitive-behavioral therapy, which is based on the strengths of people and their resources, and is the main factor in helping to create change. One of the most important goals of this intervention is to improve self-efficacy, well-being, quality of life and resilience of people. Finally, this intervention helps therapists to increase and improve resilience by increasing the self-efficacy and self-respect of patients (21). Due to the importance of resilience in the ability to create immunity against problems and traumatic events and the lack of researches regarding the effectiveness of the above interventions in the community of female-headed households, the researcher was prompted to investigate and compare the effectiveness of Mindfulness-Based Compassion Therapy and positive cognitive-behavioral therapy on the resilience of female-headed households in Shahrekord.

The study was quasi-experimental with pre-test, post-test and follow-up design. The statistical population consisted of female-headed households in Shahrekord in 1401. 60 female-headed households were selected through purposive sampling and randomly assigned to two experimental groups and one control group (20 persons in each group). The informed consent to attend psychotherapy sessions and not participating in other therapeutic interventions at the same time were the criteria for entering the research, as well as having the absence of more than 2 sessions during the intervention and the occurrence of any disorder in the time of participation in the interventions were the criteria for leaving the research. Then experimental groups were treated with mindfulness-based compassion therapy and positive cognitive-behavioral therapy for 8 sessions of 120 minutes. Each group was assessed before, after, and 3 months later the interventions with the Connor-Davidson Resilience Scale. The data were analyzed using repeated measures Analysis of variance.

The results showed that at one time, at least one of the interventions had an effect on the resilience score and explained 40% of the variance of the resilience score. Also, the results showed that at least one of the interventions in one of the groups affected the resilience score in the post-test and 73.5% of the variance of the resilience score is explained by the interventions. Also, the difference between the mean of the pre-test and post-test and the difference between the mean of the pre-test and follow-up was significant, but the result of the post-test and follow-up was not significant, which indicates that positive cognitive-behavioral therapy and mindfulness-based compassion therapy had a significant effect on resilience in the post-test and their effect was continuous in the follow-up.

According to the findings, both mindfulness-based compassion therapy and positive cognitive-behavioral therapy are suitable options for increasing the resilience of female-headed households. Mindfulness makes a person understand that negative emotions may happen, but they are not a permanent element of personality. In this situation, instead of an involuntary response, a person responds to events with more thought and reflection. This increases the ability to observe states such as anxiety and, instead of automatic behavior patterns, enables a person to manage existing conditions and reduces stress and increases psychological well-being. The result of this process is increasing the ability to consciously face the problem and resilience and endurance in dealing with difficult situations, which leads to the relaxation of the person and finding a logical solution to the problem (10). Also, compassion helps female-headed households to experience less psychological distress and adapt to difficult conditions and show greater resilience (24). In explaining the effect of positive-cognitive therapy on resilience in female-headed households, it can be said that this intervention can overcome the lack of adaptive and problem-solving skills by using short-term solution-oriented approach techniques. In other words, because positive-cognitive therapy is a solution-oriented therapy, it can solve problems with its techniques. This intervention increases the person's adaptation to stressful situations so that he will be able to better adapt to adverse life events. Under this intervention, people do not lose their hope after experiencing failure and have better control over negative emotions such as sadness, fear, and anger, which strengthens the individual's resilience (21).