The effect of cognitive behavioral group therapy program on cognitive flexibility and separation anxiety in adolescents in foster care centers

Document Type : Research Paper

Authors

1 Department of Personality Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.

2 Department of Psychology, Faculty of Psychology, Yazd Branch, Islamic Azad University, Yazd, Iran.

3 Department of Personality Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran.

4 Department of Psychology, Arsenjan Branch, Islamic Azad University, Arsenjan, Iran.

10.22038/JFMH.2025.83087.3175

Abstract

Introduction: Adolescent living in care centers encounter various psychological and social difficulties that can increase their risk of developing issues like anxiety and behavioral disorders. This study aims to explore how a Cognitive Behavioral Group Therapy (CBGT) program influences cognitive flexibility and separation anxiety in adolescents residing in care centers.
 
Materials and Methods: The study examined adolescents, both boys and girls, from welfare daycare centers in Tehran during the summer and fall of 2023. A total of 30 participants were selected using the convenient sampling method. Cognitive behavioral group therapy interventions were conducted over six sessions lasting 40 minutes each, once a week, separately for boys and girls in one of the centers offices for the experimental group. We used the Cognitive Flexibility Inventory (CFI) and Screen for Child Anxiety-Related Disorders (SCARED) to collection data. Data analysis was performed using SPSS version 27, covariance analysis with repeated measures and the Kruskal-Wallis H test.
 
Results: There was a significant difference between the experimental group and the control group after intervention in cognitive flexibility (P< 0.01). The separation anxiety in the experimental was significantly decreased compared to the control group in the post-test and follow-up stages (P< 0.01).
 
Conclusion: Based on the results, cognitive behavioral group therapy had a positive effect on improving cognitive flexibility and reducing separation anxiety in adolescents living in care centers.

Keywords

References

  1. Dubois-Comtois K, Bussieres EL, Cyr C, St-Onge J, Baudry C, Milot T, et al. Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis. Children Youth Serv Rev 2021; 127: 106100.
  2. Maguire D, May K, McCormack D, Fosker T. A systematic review of the impact of placement instability on emotional and behavioural outcomes among children in foster care. J Child Adolesc Trauma 2024; 17(2): 641-55.
  3. Kothari BH, Blakeslee J, Miller R. Individual and interpersonal factors associated with psychosocial functioning among adolescents in foster care: A scoping review. Children Youth Serv Rev 2020; 118: 105454.
  4. Westlake MF, Hillman S, Kerr-Davis A, Viziteu A, Silver M, Dykiert D. A systematic review and meta-analysis of the type and prevalence of mental health disorders and symptoms among children living in residential care. Dev Child Welfare 2023; 5(4): 223-46.
  5. Shekhawat K, Gopalan RT. Psychosocial profile of adolescents living in orphanages and adolescents living with biological parents. Int Neuropsychiatr Dis J 2023; 20(3): 9-20.
  6. Åkerblom S, Perrin S, Rivano Fischer M, McCracken LM. Predictors and mediators of outcome in cognitive behavioral therapy for chronic pain: The contributions of psychological flexibility. J Behav Med 2021; 44: 111-22.
  7. Amédée LM, Cyr-Desautels L, Bénard H, Pascuzzo K, Dubois-Comtois K, Hébert M, et al. Cognitive flexibility moderates the association between maltreatment and emotion regulation in residential care children of the middle childhood period. Dev Child Welfare 2022; 4(3): 217-34.
  8. Creswell C, Waite P, Hudson J. Practitioner review: Anxiety disorders in children and young people–assessment and treatment. J Child Psychol Psychiatry 2020; 61(6): 628-43.
  9. Kianoosh Z, Mirzaian B, Nejat H. [Comparing the effectiveness of cognitive-behavioral therapy and parent-child interaction therapy on the anxiety and loneliness of children with separation anxiety disorder]. Applied family therapy journal 2023; 4(2): 79-95. (Persian)
  10. Moussavi Y, Breivik K, Wergeland GJ, Haugland BS, Larsen M, Lehmann S. Internalizing symptom profiles among youth in foster care: A comparison study. Front Psychiatry 2021; 12: 711626.
  11. Hussain T, Masoodi Q. Psychiatric morbidity and loneliness among children living in orphanages: An observational study from Kashmir. Int J Acad Med Pharm 2023; 5(1): 212-5.
  12. Guo T, Su J, Hu J, Aalberg M, Zhu Y, Teng T, et al. Individual vs. group cognitive behavior therapy for anxiety disorder in children and adolescents: A meta-analysis of randomized controlled trials. Front Psychiatry 2021; 12: 674267.
  13. Pegg S, Hill K, Argiros A, Olatunji BO, Kujawa A. Cognitive behavioral therapy for anxiety disorders in youth: Efficacy, moderators, and new advances in predicting outcomes. Curr Psychiatr Rep 2022; 24(12): 853-9.
  14. Danaei Kousha M, Tabatabaei SS, Shahabizadeh F, Ahi G. [Comparison the effectiveness of group positive behavioral therapy and group cognitive-behavioral therapy on cognitive flexibility among women with breast cancer]. Feyz medical sciences journal 2022; 26(6): 691-702. (Persian)
  15. Bakhtiari M. [The effectiveness of cognitive behavioral therapy on the psychological flexibility of women suffering from marital burnout]. Positive psychology 2024; 1(1): 50-58. (Persian)
  16. Giani L, Caputi M, Forresi B, Michelini G, Scaini S. Evaluation of cognitive-behavioral therapy efficacy in the treatment of separation anxiety disorder in childhood and adolescence: A systematic review of randomized controlled trials. Int J Cognit Ther 2022; 15(1): 57-80.
  17. Abbasi Z, Amiri S, Talebi H. [The effectiveness of Modular Cognitive-Behavioral Therapy (MCBT) on reducing the symptoms of separation anxiety in 6 and 7 year old children]. Clinical psychology and personality 2020; 13(2): 51-64. (Persian)
  18. Kang H. Sample size determination and power analysis using the G* Power software. J Educ Eval Health Prof 2021; 18: 17. 
  19. Rajabi Z, Najafi M, Reza’i A. [Effectiveness of cognitive-behavioral group therapy in reducing children’s aggression]. Clinical psychology studies 2013; 3: 55-71. (Persian)
  20. Dennis JP, Vander Wal JS. The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cogn Ther Res 2010; 34: 241-53.
  21. Gorbani F. [Relationship between depression and cognitive flexibility with addictive behaviors with the mediating role of shame and guilt]. Scientific quarterly research on addiction 2020; 14: 279-97.
  22. Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. J Am Acad Child Adolesc Psychiatry 1999; 38(10): 1230-6.
  23. Dehghani Y, Joukar M. [Comparison of anxiety disorders and school phobia in dyslexic and normal students]. Journal of exceptional children 2016; 16(3): 75-84. (Persian)
  24. Behnamfar K, Rajaei AR, Teymouri S. [Comparison of cognitive-behavioral therapy and acceptance and commitment therapy on cognitive flexibility in mothers with autistic children]. Social determinants of health 2022; 8(1): 1-9. (Persian)
  25. Craig SL, Eaton AD, Leung VW, Iacono G, Pang N, Dillon F, et al. Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada. BMC Psychology 2021; 9(1): 94.
  26. Motevally Joybari F, Bakhshipour Joybari B, Abbasi Q. [The effectiveness of cognitive-behavioral intervention on social competence and school refusal of children with separation anxiety disorder]. Toloo-e-Behdasht 2024; 23(2): 81-99. (Persian)
Fundamentals of Mental Health
Volume 27, Issue 3
May and June 2025
Pages 189-198

Files

Share

How to cite

Statistics