Effectiveness of Motivational Psychotherapy on Stress and Psychological Cohesion of Mothers of Students with Learning Disorders

Learning disorders (LD) is a kind of neuro-developmental disorders with biological origin, which is based on the level of cognition and with symptoms such as reading words incorrectly and with difficulty, difficulty in understanding meanings, spelling problems, difficulty in writing, difficulty in calculating numbers and understanding Mathematics is associated (6). In addition to learning problems, these children may have problems in various psychological and mental health areas, which turns the wishes and hopes of parents into despair and disrupts the psychological functions of the family, and this causes disruption in the quality of life. related to children's psychological well-being and this situation will potentially negatively affect the quality of life and well-being of parents (9). Mothers of children with learning disorders face extensive psychological pressures such as stress and psychological incoherence (11,12). One of the effective factors in psychological pressures is the feeling of psychological coherence, which is defined as a person's ability to manage psychological stressors and causes a person to tolerate a high level of stress and psychological pressure (13). People with a sense of psychological coherence will experience shorter periods of harmful pressures associated with negative experiences (17). One of the things that affect the life and relationships between parents and exceptional children such as autism and other cases such as learning disorders is mental health and integrity, which has faced many psychological challenges to the parents and especially the mothers of these children (18). Families with children with learning disabilities face emotional problems; They suffer from depression and endure high stress (21). Stress is the feeling of being overwhelmed or unable to cope with mental or emotional pressure that has cognitive, emotional and physical symptoms (22). Considering that the mother is the first person who has a direct relationship with the child, feelings such as guilt and blame, failure, sadness and the presence of disorder in the child can cause isolation and limited communication with the environment and also the decrease in self-confidence, the ability to express oneself, and the feeling of self-deprecation and worthlessness, sadness and unhappiness in the mother's person (25). An example of modern psychotherapy approaches that emphasizes the relationship between parents and children and shows that parents play an important role in shaping their children's personality and behaviors is Motivational Psychotherapy (26). Motivational psychotherapy in the field of personality formation believes that personality is formed during the stages of development and can be changed at any moment of life (27). Motivational psychotherapy, while emphasizing change and appropriate goals in life, can help people to draw a specific goal for themselves and dedicate their activities to it (28). Reviewing the Literature review related to motivational psychotherapy shows that motivational psychotherapy has a positive effect on the mental health of students (27) and women (29), in reducing many psychological problems such as behaviors high-risk (sexual behavior, violence) (28), high-risk sexual behaviors of addicted men (30), violence against women (31) and bullying behavior of students (32) are effective. Tt seems that the use of motivational psychotherapy approach can reduce the stress of mothers of children with learning disorders while strengthening psychological cohesion. Reviewing the background of the research also showed that so far, no research has focused on the effect of Motivational psychotherapy on the stress and psychological cohesion of different groups, and the use of this new approach was observed in limited researches. Therefore, the present study was conducted in order to investigate the effectiveness of motivational psychotherapy on stress and psychological cohesion of mothers of students with learning disabilities.

The present study was a semi-experimental study with a pre-test-post-test design with a control group, which was registered with the ethics ID IR.BUMS.REC.1400.421 from Birjand University of Medical Sciences and also the clinical trial code IRCT20220125053829N1. The statistical population of this research was made up of all the mothers of children with learning disabilities in the city of Zabul in the academic year of 2021-2022 who had files in the educational and rehabilitation center for students with special learning difficulties in Shahid Salavatian, Zabul (65 people). The number of samples consisted of 40 mothers who were willing to cooperate and met the criteria for entering the research, who were randomly selected into two experimental groups (20 people) and control (20 people) were attributed. Then the experimental and control groups were formed and the pre-test was performed. In the next stage, the experimental group received motivational psychotherapy training based on Sahebdel's motivational psychotherapy training package (2018) (33) during 8 sessions of 60 minutes for 8 weeks; While the control group did not receive any training. Then a post-test was taken from both groups to compare the results of the two groups. The tools used in the research included Lovibond & Lovibond (1995) psychological symptoms questionnaire of stress section, Flensborg-medsen, Ventegodt & Merrick (2006) mental coherence questionnaire and Sahebdel's motivational psychotherapy training package (2018) (33).

According to the demographic information of the present study, the research sample (40 people) were divided into two experimental and control groups, 20 people were in the experimental group and 20 people were in the control group, considering that mothers are discussed, the gender of all sample people was female. ANCOVA results show that by removing the effect of pre-test psychological coherence scores as a covariate, the main effect of motivational psychotherapy training on psychological coherence in the post-test is significant; In other words, the table shows that the observed difference between the average psychological coherence scores of the participants of the experimental-control group according to group membership in the post-test stage is significant with 95% confidence (P<0.05). The intervention rate was 0.87. The adjusted averages in the post-test showed that for all components, the average of the experimental group is lower than the control group; Therefore, at a significance level of 0.05, motivational psychotherapy training is effective on the stress of mothers of students with learning disorders. Also, the adjusted averages show that the average psychological coherence score of the experimental group has increased more compared to the control group; Therefore, at a significance level of 0.05, motivational psychotherapy training was effective on the psychological cohesion of mothers of students with learning disorders. The application of the results of this research is specific to the centers of learning disabilities to use the motivational psychotherapy approach in line with their interventions on the families of students with learning disabilities. Also, the application of the results of this research is aimed at the counselors and psychotherapists of the counseling centers, especially the counseling centers of the Ministry of Education, so that, along with other psychological and therapeutic interventions, with the aim of reducing stress and improving the psychological integrity of the mothers of students with Learning disorders can benefit from motivational psychotherapy and its techniques. This research, like any research, had its own limitations, among which we can point out the lack of consideration of the follow-up period due to time constraints, the use of purposeful sampling, and the use of self-reporting tools.

The results of the present study show the significant effect of motivational psychotherapy on reducing stress and improving the psychological coherence of mothers of students with learning disabilities; Therefore, it can be useful to use this therapeutic approach with the aim of reducing stress and mental pressures and strengthening the psychological cohesion of people. According to the results, it is suggested that psychiatrists and psychologists pay special attention in using motivational psychotherapy techniques in the treatment protocol of clients with similar conditions. Holding training courses and in-service training for school counselors and psychologists with the aim of teaching this new therapeutic approach is another practical proposal of the research.