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IRCT20170408033292N3 IRCT 2022-03-05 Islamic Azad University of Birjand Effectiveness of ACT Therapy and Mindfulness on Sleep Quality Effect of cognitive-based therapy on admission and commitment and mind-awareness on sleep quality of students with test anxiety 2016-04-20 anticipated 36 Complete https://irct.ir/trial/25718 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Education/Guidance, Randomization description: Of the students who had the test anxiety, 36 were randomly divided into three groups (one control group and two experimental groups), Blinding description: The experimental groups consisted of two groups that only one group received mindfulness treatment and the other group received cognitive therapy based on acceptance and commitment and no group was aware of the existence of another group and the study group. N/A sleep quality. Intervention 1: The first intervention group received 8 sessions of treatment based on acupuncture or cognitive therapy based on admission and commitment : Session 1: Creative Helplessness - In the process of creative helplessness, the client must come to the conclusion that he has made many efforts to solve his problems, but the problem still remains. Potential Support Activities: Extracting key goals from clients / Extracting past efforts to achieve those goals. Use the metaphor of a tug-of-war with a monster, the metaphor of a hungry tiger, the metaphor of a man in a well, or the metaphor of a well Session 2: Session Title: Control is the problem, not the solution. Objective of the second session: Potential supportive activities, control as a problem / control of private events, rope-pulling with monsters, interrupting avoidance patterns contrary to changing feelings and thoughts. Content of the session: Action and experience versus thought and excitement, the practice of differentiation or separation means to allow oneself to see thoughts as just thoughts and nothing more than that, going to the cinema, uninvited guests Session 3: Session Title: Cognitive Fault, Aim of the Session: The Fault Process in Act is to help clients recognize the hidden features of language that create fusion so that it can break the certainty of the reality of internal events and also between thought and thinker and Feel and feel the distance. Content of the meeting: Opening and acceptance: Opening means being open and creating space for emotions, impulses, and difficult sensations to flow in the presence of references, without controversy. Metaphor of the bus .Session 4, Session Title: Self as Background. Session Description: Act distinguishes between three concepts of "self". These three meanings include: self-conceptualized, self as a dynamic self-awareness process, and self-observer. Clients are more familiar with self-conceptualization, but less familiar with themselves as a dynamic self-awareness process, especially the observer. Purpose of the session: The purpose of the Act at this stage of treatment is to find an alternative for the self that is defined by thoughts, feelings, memories, and inner feelings (self-conceptualized), that is, from where one can feel oneself with a transcendent sense of Communicate with yourself, who is always present and not defined by fleeting thoughts and feelings. Who wanders. Session 5: Title of the session: Clarifying values, the purpose of the Act at this stage is for the person to identify the values of his life and take steps in that direction. The identification of values should be completely free. And the therapist must identify and eliminate the factors that may affect the process of identifying and measuring clients' values, and teach the individual to distinguish between value as a feeling and value as an action. In general, by introducing the importance of values and understanding how values lead to interest by clients, clients need to know how much interest is necessary in behavioral activation. Searching for Values: Work begins by describing the values of clients in each of the four areas of employment, education and recreation, relationships and health, and personal growth. Just as he dreams or imagines something he has always dreamed of, just as he now has the ability to achieve his dreams, people search and evaluate important goals in their lives. Orbital to run this week Provide worksheets, actions and achievements, provide worksheets for searching values Session 6: Session Title: Committed Action, Session Objective: After the values of the references have been specified and identified. Commitment exercises, both in the session and as an out-of-session homework, will be the main focus of the rest of the Act therapy sessions. The main purpose of the Act is to use the desire to support action in accordance with selected values. Commitment involves active participation in actions that are likely to evoke negative thoughts, emotions, and physical states. What is important at this stage of treatment is that some actions have immediate consequences, but some require time, and metaphors can be used to clarify this. Arboriculture metaphors are a useful metaphor at this stage Content of the session: Committed action (goal setting and practical action) Review of previous sessions and post-test for the group. Using the metaphor of begging, tree metaphor, identifying a valued behavior (behavioral goal) for people this week, presentation Worksheet of values and goals, time management practice. And the end of ACT: Objectives: 1- Teaching clients to be their own therapist. 2 - To maximize the likelihood that the client will continue to apply the skills learned in treatment after the sessions. 3- Addressing the concerns of the clients about the end of the meetings. 4- Preparing for the companies after the end of the meetings. 5 - Thinking about progress and ongoing goals of the references. Intervention 2: The second intervention group received 8 instructional sessions based on cognitive-mindedness therapy : Session 1: Automatic guidance Everyone experiences the effects of distraction at any given moment. They may read all the pages of a book but then find that they do not understand it. In such cases, they may or may not even know what they are focusing on. In automatic guidance, the components of negative thinking are taken into account with the possibility of control. Appears Purpose of the session: The general purpose of this treatment session is to create awareness about automatic guidance in clients. When the person realizes the automatic guidance, the mind is present. Home exercise: Focus on daily activities such as eating a meal, showering, and. Session 2: Title of the session: Dealing with obstacles. Aim of the session: The purpose of the second session is to challenge the obstacles that people face. First, a physical examination exercise is performed so that the participants reach the presence of mind during the exercise, and then, with the help of the exercise, they review what needs to be done. Attention and awareness training with limited thoughts related to test anxiety and sleep deprivation, full awareness of thoughts and feelings in a metacognitive way From it (the issue of focusing more on the body, the mental whispers become more obvious and lead to more control over daily events. Physical examination meditation, ten minutes of mental presence on the flow of breathing. Home exercise: 45 minutes of physical examination meditation, ten minutes of breathing with the presence of mind, focusing on a daily activity in different ways, recording daily reports of experiencing a pleasant event.Session 3: Presence of the mind on the breath and on the body. In this session, it becomes clear that the purpose of the trained exercises is not to find predetermined solutions to problems, and even at this stage, failure can occur. There may be many grounds for such failures. But one of the very strong common areas is that a person feels that with the ability to solve problems, he should be able to solve all the problems in his life, and this feeling does not go away easily. Aim of the session: Awareness is more than preoccupation and dispersion of the mind, so the person is trained to consciously and justly focus on breathing, to be able to be more focused and integrated. Controlling the wandering mind with a physical examination, reviewing negative spontaneous thoughts with the aim of being aware of the scattering and busy thoughts. Practicing seeing and hearing for 5 minutes, reviewing tasks, breathing with the presence of the mind, etc. Homework: practicing yoga, a list of unpleasant events and ... Session 4: Stay on time. People who have experienced negative emotions spend a lot of time and energy on comparisons. These people often suffer from feelings of loneliness, loss and despair, and feelings of rejection. From then on, they are easily saddened by unpleasant situations. These people have an innate tendency to look back and regret. Whereas in the mind-presence approach to mind control, positive mental images are not replaced by negative ones in the past, present or future, instead people are encouraged to let go of feelings of hopelessness and regret about the past. Content of the session: Realizing what is considered an unpleasant experience. Defining the realm of test anxiety or other areas in which the group is involved, such as: stress, sleep problems, initial insomnia. Five minutes of presence of visual or auditory mind, three minutes of breathing space, introduction of this method As a coping strategy for use in times when the current situation evokes difficult emotions. Walking with the presence of meditation mind. Homework: three minutes of breathing space three times a day, three minutes of breathing space as a coping strategy in the experience. Unpleasant feelings)Session 5: Acceptance and permission / permission to attend. Session description: People who have experienced unpleasant feelings in the past often try hard to drive away negative memories and emotions and avoid them. Avoiding unpleasant events and trying to minimize discomfort requires a lot of effort. The subject of this session is dealing with emotions, negative emotions and accepting it. . Different communication means allowing the experience to be present exactly as it is, without being judged or attempted to change what it is. Content of the meeting: Different communication means allowing the experience to be present, exactly as it is, without judging it or trying to change it from what it is. Reading the poem of the guest house by Rumi and identifying its theme and concept in the group, three minutes of breathing space. Homework: sitting meditation, three minutes of breathing space according to regular and regular routine (3 times a day), three minutes of breathing space as a coping strategy (Every time you notice unpleasant feelings.Session 6: Thoughts, not facts. Session description: Unconscious people infer facts, perceive the senses differently, and are rarely aware of what they are doing, as if the mind has an interpretation of all events. They easily understand how these interpretations take place and create a series of emotional reactions and make them last. For example, a friend's phone may be interpreted as "he needs me" or "he is abusing me". People's reaction depends entirely on the interpretation of an event. Different interpretations of events in different situations cause a lot of problems. People who are vulnerable to test anxiety and sleep problems have a certain style of interpreting events. The internal flow becomes difficult to suppress because subsequent events reinforce it: dissenting information is ignored and attention is given to information that is consistent with the thoughts. See them as thoughts, not truth. Content of the session: 40-minute sitting meditation, awareness of breathing and body, sounds and then thoughts, 3-minute breathing space. Homework: 4 minutes daily exercise, 3 minutes regular breathing space (3 times On the day)Session 7: How I can best take care of myself. Session Description: Receptivity to thoughts, feelings and bodily sensations during sessions is one of the most important issues. This acceptance helps people to recognize critical moments in which they are immersed in thinking in an old-fashioned and constructive way. Find activities that, by increasing them and changing their quality, can help them and increase their pleasant feelings. Content of the session: Paying attention to the relationship between activity and moodPay attention to the things they do during the day and which of the two groups they belong to: 1- There are things that calm the person and strengthen the person or 2- Things that make the person irritable and anxious and energy It reduces the person and eventually the person sees how he can spend more time on things that increase his energy and create more peace in him and skillfully deal with things that reduce his energy, irritate and make him anxious. Identify signs of anxiety and develop actions to deal with the threat). Sitting vigilance - awareness of breathing, body, sounds, thoughts and mindsets. Homework: Selecting activities to do after the program, regular three-minute breathing (twice a day) and breathing as a coping strategy, developing a practical plan to deal with test anxiety and insomnia. Recognize the warning signs of the problem (test anxiety, depression and insomnia, etc.) and deal with it with activities such as deep breathing, activities that in the past made the person feel good.Session 8: Using what they have learned to deal with subsequent mood swings (irritability, deafness and anxiety, etc.)Session Description: This session begins with a physical examination exercise to provide a complete cycle. Participants are then given the opportunity to recall their experiences from across the program and to do an exercise in which they think about the past. Session Objective: Regular practice of mindfulness helps maintain balance in life. Positive intentions are reinforced because these exercises are associated with positive reasons for self-care. Session Content: Exercise Examination, Review and Review of the Whole Program - What were the most valuable things in your life that these exercises could help you achieve? And run post-tests for groups. Intervention 3: The third group was the control group who did not receive any training and after completing the plan, they received several cognitive therapy sessions to observe the ethics of the research. Yes - There is a plan to make this available What will be shared: After the end of the study, the data on the main consequence of the possibility of sharing When: Get started two months after printing results To whom: Researchers and researchers of academic institutions Conditions: Use in similar research Where to obtain: Contact with Fatemeh Shahibizadeh, responsible for answering this study by email: F_shahabizadeh@yahoo.com How to obtain: They will send their request through the above email and will be sent after a maximum of two months. Comments:
public Fatemeh Shahibizadeh
No. 24, Modares 69, Modares Street
Birjand Iran (Islamic Republic of) 9718714195 +98 56 3203 4313 F_shahabizadeh@yahoo.com Islamic Azad University of Birjand scientific Fatemeh Shahibizadeh
End of Bulvar Shahid Ghaffari
Birjand Iran (Islamic Republic of) 9717813118 +98 56 3234 5525 f_shahabizadeh@yahoo.com Islamic Azad university Iran (Islamic Republic of) Having anxiety test of over 20 based on Sarason test Female being Secondary school student 14 years 17 years Female Those who have the test anxiety with another mental disorder can not be included in the study Behavior Behavior N/A The first intervention group received 8 sessions of treatment based on acupuncture or cognitive therapy based on admission and commitment : Session 1: Creative Helplessness - In the process of creative helplessness, the client must come to the conclusion that he has made many efforts to solve his problems, but the problem still remains. Potential Support Activities: Extracting key goals from clients / Extracting past efforts to achieve those goals. Use the metaphor of a tug-of-war with a monster, the metaphor of a hungry tiger, the metaphor of a man in a well, or the metaphor of a well Session 2: Session Title: Control is the problem, not the solution. Objective of the second session: Potential supportive activities, control as a problem / control of private events, rope-pulling with monsters, interrupting avoidance patterns contrary to changing feelings and thoughts. Content of the session: Action and experience versus thought and excitement, the practice of differentiation or separation means to allow oneself to see thoughts as just thoughts and nothing more than that, going to the cinema, uninvited guests Session 3: Session Title: Cognitive Fault, Aim of the Session: The Fault Process in Act is to help clients recognize the hidden features of language that create fusion so that it can break the certainty of the reality of internal events and also between thought and thinker and Feel and feel the distance. Content of the meeting: Opening and acceptance: Opening means being open and creating space for emotions, impulses, and difficult sensations to flow in the presence of references, without controversy. Metaphor of the bus .Session 4, Session Title: Self as Background. Session Description: Act distinguishes between three concepts of "self". These three meanings include: self-conceptualized, self as a dynamic self-awareness process, and self-observer. Clients are more familiar with self-conceptualization, but less familiar with themselves as a dynamic self-awareness process, especially the observer. Purpose of the session: The purpose of the Act at this stage of treatment is to find an alternative for the self that is defined by thoughts, feelings, memories, and inner feelings (self-conceptualized), that is, from where one can feel oneself with a transcendent sense of Communicate with yourself, who is always present and not defined by fleeting thoughts and feelings. Who wanders. Session 5: Title of the session: Clarifying values, the purpose of the Act at this stage is for the person to identify the values of his life and take steps in that direction. The identification of values should be completely free. And the therapist must identify and eliminate the factors that may affect the process of identifying and measuring clients' values, and teach the individual to distinguish between value as a feeling and value as an action. In general, by introducing the importance of values and understanding how values lead to interest by clients, clients need to know how much interest is necessary in behavioral activation. Searching for Values: Work begins by describing the values of clients in each of the four areas of employment, education and recreation, relationships and health, and personal growth. Just as he dreams or imagines something he has always dreamed of, just as he now has the ability to achieve his dreams, people search and evaluate important goals in their lives. Orbital to run this week Provide worksheets, actions and achievements, provide worksheets for searching values Session 6: Session Title: Committed Action, Session Objective: After the values of the references have been specified and identified. Commitment exercises, both in the session and as an out-of-session homework, will be the main focus of the rest of the Act therapy sessions. The main purpose of the Act is to use the desire to support action in accordance with selected values. Commitment involves active participation in actions that are likely to evoke negative thoughts, emotions, and physical states. What is important at this stage of treatment is that some actions have immediate consequences, but some require time, and metaphors can be used to clarify this. Arboriculture metaphors are a useful metaphor at this stage Content of the session: Committed action (goal setting and practical action) Review of previous sessions and post-test for the group. Using the metaphor of begging, tree metaphor, identifying a valued behavior (behavioral goal) for people this week, presentation Worksheet of values and goals, time management practice. And the end of ACT: Objectives: 1- Teaching clients to be their own therapist. 2 - To maximize the likelihood that the client will continue to apply the skills learned in treatment after the sessions. 3- Addressing the concerns of the clients about the end of the meetings. 4- Preparing for the companies after the end of the meetings. 5 - Thinking about progress and ongoing goals of the references. The second intervention group received 8 instructional sessions based on cognitive-mindedness therapy : Session 1: Automatic guidance Everyone experiences the effects of distraction at any given moment. They may read all the pages of a book but then find that they do not understand it. In such cases, they may or may not even know what they are focusing on. In automatic guidance, the components of negative thinking are taken into account with the possibility of control. Appears Purpose of the session: The general purpose of this treatment session is to create awareness about automatic guidance in clients. When the person realizes the automatic guidance, the mind is present. Home exercise: Focus on daily activities such as eating a meal, showering, and. Session 2: Title of the session: Dealing with obstacles. Aim of the session: The purpose of the second session is to challenge the obstacles that people face. First, a physical examination exercise is performed so that the participants reach the presence of mind during the exercise, and then, with the help of the exercise, they review what needs to be done. Attention and awareness training with limited thoughts related to test anxiety and sleep deprivation, full awareness of thoughts and feelings in a metacognitive way From it (the issue of focusing more on the body, the mental whispers become more obvious and lead to more control over daily events. Physical examination meditation, ten minutes of mental presence on the flow of breathing. Home exercise: 45 minutes of physical examination meditation, ten minutes of breathing with the presence of mind, focusing on a daily activity in different ways, recording daily reports of experiencing a pleasant event.Session 3: Presence of the mind on the breath and on the body. In this session, it becomes clear that the purpose of the trained exercises is not to find predetermined solutions to problems, and even at this stage, failure can occur. There may be many grounds for such failures. But one of the very strong common areas is that a person feels that with the ability to solve problems, he should be able to solve all the problems in his life, and this feeling does not go away easily. Aim of the session: Awareness is more than preoccupation and dispersion of the mind, so the person is trained to consciously and justly focus on breathing, to be able to be more focused and integrated. Controlling the wandering mind with a physical examination, reviewing negative spontaneous thoughts with the aim of being aware of the scattering and busy thoughts. Practicing seeing and hearing for 5 minutes, reviewing tasks, breathing with the presence of the mind, etc. Homework: practicing yoga, a list of unpleasant events and ... Session 4: Stay on time. People who have experienced negative emotions spend a lot of time and energy on comparisons. These people often suffer from feelings of loneliness, loss and despair, and feelings of rejection. From then on, they are easily saddened by unpleasant situations. These people have an innate tendency to look back and regret. Whereas in the mind-presence approach to mind control, positive mental images are not replaced by negative ones in the past, present or future, instead people are encouraged to let go of feelings of hopelessness and regret about the past. Content of the session: Realizing what is considered an unpleasant experience. Defining the realm of test anxiety or other areas in which the group is involved, such as: stress, sleep problems, initial insomnia. Five minutes of presence of visual or auditory mind, three minutes of breathing space, introduction of this method As a coping strategy for use in times when the current situation evokes difficult emotions. Walking with the presence of meditation mind. Homework: three minutes of breathing space three times a day, three minutes of breathing space as a coping strategy in the experience. Unpleasant feelings)Session 5: Acceptance and permission / permission to attend. Session description: People who have experienced unpleasant feelings in the past often try hard to drive away negative memories and emotions and avoid them. Avoiding unpleasant events and trying to minimize discomfort requires a lot of effort. The subject of this session is dealing with emotions, negative emotions and accepting it. . Different communication means allowing the experience to be present exactly as it is, without being judged or attempted to change what it is. Content of the meeting: Different communication means allowing the experience to be present, exactly as it is, without judging it or trying to change it from what it is. Reading the poem of the guest house by Rumi and identifying its theme and concept in the group, three minutes of breathing space. Homework: sitting meditation, three minutes of breathing space according to regular and regular routine (3 times a day), three minutes of breathing space as a coping strategy (Every time you notice unpleasant feelings.Session 6: Thoughts, not facts. Session description: Unconscious people infer facts, perceive the senses differently, and are rarely aware of what they are doing, as if the mind has an interpretation of all events. They easily understand how these interpretations take place and create a series of emotional reactions and make them last. For example, a friend's phone may be interpreted as "he needs me" or "he is abusing me". People's reaction depends entirely on the interpretation of an event. Different interpretations of events in different situations cause a lot of problems. People who are vulnerable to test anxiety and sleep problems have a certain style of interpreting events. The internal flow becomes difficult to suppress because subsequent events reinforce it: dissenting information is ignored and attention is given to information that is consistent with the thoughts. See them as thoughts, not truth. Content of the session: 40-minute sitting meditation, awareness of breathing and body, sounds and then thoughts, 3-minute breathing space. Homework: 4 minutes daily exercise, 3 minutes regular breathing space (3 times On the day)Session 7: How I can best take care of myself. Session Description: Receptivity to thoughts, feelings and bodily sensations during sessions is one of the most important issues. This acceptance helps people to recognize critical moments in which they are immersed in thinking in an old-fashioned and constructive way. Find activities that, by increasing them and changing their quality, can help them and increase their pleasant feelings. Content of the session: Paying attention to the relationship between activity and moodPay attention to the things they do during the day and which of the two groups they belong to: 1- There are things that calm the person and strengthen the person or 2- Things that make the person irritable and anxious and energy It reduces the person and eventually the person sees how he can spend more time on things that increase his energy and create more peace in him and skillfully deal with things that reduce his energy, irritate and make him anxious. Identify signs of anxiety and develop actions to deal with the threat). Sitting vigilance - awareness of breathing, body, sounds, thoughts and mindsets. Homework: Selecting activities to do after the program, regular three-minute breathing (twice a day) and breathing as a coping strategy, developing a practical plan to deal with test anxiety and insomnia. Recognize the warning signs of the problem (test anxiety, depression and insomnia, etc.) and deal with it with activities such as deep breathing, activities that in the past made the person feel good.Session 8: Using what they have learned to deal with subsequent mood swings (irritability, deafness and anxiety, etc.)Session Description: This session begins with a physical examination exercise to provide a complete cycle. Participants are then given the opportunity to recall their experiences from across the program and to do an exercise in which they think about the past. Session Objective: Regular practice of mindfulness helps maintain balance in life. Positive intentions are reinforced because these exercises are associated with positive reasons for self-care. Session Content: Exercise Examination, Review and Review of the Whole Program - What were the most valuable things in your life that these exercises could help you achieve? And run post-tests for groups. The third group was the control group who did not receive any training and after completing the plan, they received several cognitive therapy sessions to observe the ethics of the research Sleep Quality Score. Timepoint: Before the intervention and one month after the intervention. Method of measurement: Pittsburgh Sleep Quality Questionnaire. Sleep quality. Timepoint: One month after the intervention and workshop. Method of measurement: Sleep quality questionnaire. Islamic Azad University of Birjand Approved 2017-09-12 Ethics Committee of Birjand University of Medical Sciences Ayatollah Ghaffari Avenue Blvd Birjand South Khorasan Iran (Islamic Republic of)