Dissertation for Master's degree (M.A) in the field of
School Counseling
Effectiveness of teaching children's behavior management to mothers on mothers' mental health and attention deficit hyperactivity disorder syndromes in children
The aim of the present study was the effectiveness of behavior management training to mothers of children with attention deficit hyperactivity disorder on children's attention deficit hyperactivity syndrome and mothers' mental health. Using a post-test and post-test design with a control group, mothers of 34 children with attention deficit hyperactivity disorder were selected as available and randomly divided into two experimental and control groups. Subjects were evaluated by general health questionnaire and children's disease symptoms questionnaire in two stages (before and after the intervention). The data were analyzed using the multivariate analysis of covariance method. The results of the research showed that the implementation of the educational program has led to a significant increase in the mental health of the mothers of the experimental group compared to the mothers of the control group. Also, the training program has led to the reduction of attention deficit hyperactivity disorder. As a result, the children's behavioral management program is effective in improving the mental health of mothers with children with attention deficit hyperactivity disorder. Therefore, it is suggested that therapists use this method to help the mothers of this group of children.
Keywords: children's behavior management training, mental health, attention deficit disorder, hyperactivity
Attention deficit-hyperactivity disorder[1] is one of the most common reasons for referral to psychiatrists and psychologists. This disorder includes inappropriate developmental symptoms such as: hyperactivity, inattention and impulsivity (Saduk and Saduk, 2005). There is a possibility that in the case of coexisting with other disorders such as conduct disorder and learning disorder, it will affect the parent-child relationship (Behpejoh, Metwallipour, Farzad, Rostami, Habibi Askarabad, 2010). They interact, in other words, they have a two-way effect on each other. Examining the interactions of children with attention deficit hyperactivity disorder shows that the child's behavior acts as a stress stimulus and in turn has an effect on the parent's behavior and the interaction between the parent, especially the mother and the child (Yousfi, Soltanifar and Timuri, 2009). Children with attention deficit disorder show more inappropriate behaviors compared to normal children; They follow less and their parents are more negative and participate less in social activities (McBarnett and Pfiffner, 2008). These inappropriate and stressful relationships between parents and hyperactive children are in a vicious cycle (Lifor, Harlod and Chapar [2], 2008). Therefore, problems in parent-child relationships in families with children with attention deficit-hyperactivity disorder are among the characteristics of such families (Metolipour and Rashidi, 2009). As Kimiaei and Begi (2010) after years of working with families, they succeeded in identifying a vicious cycle in parent-child relationships in families with children with problems (such as children with attention deficit-hyperactivity disorder) and They called "the vicious cycle of maladaptive behavior". According to this cycle, the inconsistent behavior of the child creates an inappropriate feeling in the parents and affects the way they react and behave with the children. Thus, in many cases, parents' misbehavior can be considered as the main factor in increasing children's behavioral problems. Johnston [3] (1996) also investigated the interaction between parents and children with attention deficit hyperactivity disorder in a research and observed that the parents of this group of children showed more negative reactions in dealing with children and used less positive methods. In general, research results indicate that intra-family interactions in families with children with attention deficit-hyperactivity disorder are associated with high levels of incompatibility and disharmony. Because these children do not follow the orders of their parents and other family members, do not do their homework, and have more negative behaviors than their peers.
In general, such conditions will cause incompetence in family functions.It disrupts parent-child interaction and increases parental anxiety (Burr, Saunders, Markey-Dodds[4], 2002), parental anxiety, in turn, affects their punishment methods, and directly increases negative behaviors in children. According to the aforementioned, it seems logical that effective therapeutic interventions are needed to reduce the effects of inappropriate parent-child interactions. Meanwhile, the main role of preventing such conditions and re-establishing balance in the family is the responsibility of parents, especially mothers, who are considered as the main foundations of the family. have been established and teach parents how they can establish a positive interaction with children and reduce the amount of negative behaviors and internal conflicts in the family (Kazdin, 2000). Parent training programs are based on the view that children's behavioral disorders are caused and persisted as a result of incorrect interaction between the child and the parent (especially the mother). For this reason, attention to the education of mothers in the treatment of these children has increased significantly in recent decades. In this regard, various mothers' education programs have been created with an emphasis on the whole family system. In these programs, mothers' concerns about the etiology, treatment, and prognosis of their children's disorders are discussed in group meetings, and mothers can obtain the necessary information and support from those present in the meeting. Also, mothers can better understand children's problems in the light of obtaining new information, and through receiving the necessary training, they can be equipped with behavior management skills, and subsequently, their sense of self-efficacy will increase.
Statement of the problem
Attention deficit/hyperactivity disorder[5] is one of the most common behavioral disorders among students in most countries. According to a report in the United States, about 3-5% of students have this disorder (Foley[6] et al., 2008). The chronic form of this disorder severely disrupts people's functioning at home and school (Findling [7] 2008). Attention Deficit/Hyperactivity Disorder is a set of syndromes with a limitation of the attention field, which is inconsistent with the individual's developmental level and leads to poor concentration and sudden and hyperactive behavior. In other words, the main characteristic of this disorder is the existence of an unstable pattern of attention or hyperactivity and impulsivity. Raising a child who has excessive activity and irritability and does not follow orders is a difficult and tiring task. For this group of children, the usual methods of education, such as reasoning and awareness, often do not work. Because of this, their parents feel powerless and may punish and ridicule the child. The emergence of these reactions from parents causes confusion and anxiety among family members (Gorji, 2013). Since it is more difficult to control this group of children compared to their peers, they face more behavioral problems (Mohammed Ismail, 2013). In fact, due to impulsiveness and not paying attention to the consequences of their actions, the relationship of these children with their parents is darkened and the conflict between the child and the mother increases in preschool age and continues until adolescence (Cronis [8] et al., 2004). Evidence suggests that both environmental and genetic factors play a role in this disorder. Studies on twins in relation to attention deficit/hyperactivity disorder support the strong contribution of genetics in the formation of this disorder (Berger, Kaufman, Avishai[9], 2007). It seems that environmental factors also play a significant role in the occurrence of this disorder. The results of the studies indicate that the type of family relationships, child-parent interaction and family poverty are related to the growth and severity of this disorder. In this disorder, child-parent interactions are largely influenced by the symptoms of the child suffering from attention deficit hyperactivity disorder. These children are often more disobedient to parents' requests and fail to start and follow activities and give up early, and they are asked to pay more attention than non-sick children. Such behaviors create real stress for parents and caregivers (Barclay [10], DuPoll, McMurray, 1990).