اثر ادغام رفتار درمانی معقول و هنر درمانی بر عزت نفس و انعطاف پذیری

This research explored the effect of combined rational emotive behavior therapy (REBT) and the art therapy (engraving method) on improving self-esteem and resilience. The research method was quasi experimental. The study used the Coopersmith Self-esteem Inventory (SEI) and the Connor–Davidson Resilience Scale as pre- and post-test assessments to assess the effects on a sample of Iranian students. A sample of 24 Iranian university students were randomly placed in two groups, including one experimental group and one control group. This was followed by REBT and art therapy while students in the experimental group were taught for 10 sessions over a 10 weeks period there was no treatment for the control group over this time. The participants in both groups were evaluated before and after 10 sessions. The gathered data were analysed using the t-test method through the SPSS package. The results showed that the integration of REBT and art therapy for increase the self-esteem and resilience of students. Further, implications of the study and suggestions for future use are discussed.

Self-esteem is a central feature of the self-concept (Greenwald, Bellezza, & Banaji, 1988). It has been defined as “how much value people place on themselves” (Baumeister, Campbell, Krueger, & Vohs, 2003, p. 2). One important factor of mental health in university students is self-esteem. Many studies have emphasized that student's self-esteem is a predictor of different behaviors and psychological adjustments (Leary & MacDonald, 2005). Research findings have shown that there is a significant relationship between low self-esteem and many severe and difficult situations young people face, including dropping out of school (Guillon, Crocq, & Bailey, 2003), and destructive behaviors (Hawton, Rodham, Evans, & Weatherall, 2002). Low self-esteem is considered a factor leading to physical, mental and emotional problems (Kernis, 2005). In addition, high self-esteem inspires a feeling of worthiness and gladness (Branden, 1994). Oguz-Duran and Tezer (2009) described self-esteem as one of the factors that have strong and positive relationships in the well-being of a college student. Saadat, Ghasemzadeh, and Soleimani (2012), indicated that there is a relationship between self-esteem and academic development of students. In general, low self-esteem can lead to an unpleasant mental state while high self-esteem has many benefits for people (Harter, 1999). Having a comprehensive understanding of resilience in life can be potentially important for the promotion mental health (Campbell-Sills, Cohan, & Stein, 2006). Resilience has been shown to be a factor of positive well-being in positive psychology. Resilience is defined as the ability of persons to remain healthy when exposed to a negative event (Bonanno, 2004), as well as being able to adapt their conditions according to the problems that challenge them in life (Brenda, 2007). O’Connell Higgins (1994), studied the trait of resilience in adults and expressed that resilient people are proactive, loving, and possess a high level of faith. These people are characterized by optimism, positive coping, hardiness (Connor & Davidson, 2003) and high self-esteem (Rouse, 1998). Haddadi and Besharat (2010) conducted a study on a sample of 214 university students and revealed that resilience has a positive correlation with mental health and a negative correlation with vulnerability indexes including psychological distress, depression, and anxiety. In contrast, lower and weaker levels of resilience are connected to vulnerability and psychological disorders (Campbell-Sills et al., 2006). Peng et al. (2012) examined a sample of 1998 students in a survey study to assess the moderating effect of resilience between negative life events and mental health problems, and to investigate the factors that affect the mental health problems of the students. Results showed that mental health problems had a positive relationship with negative life events and neuroticism. Mental health problems have also shown a negative correlation with resilience. Researchers suggested that promoting resilience can be useful for the adjustment of university students in stressful situations. Cognitive behavior therapy (CBT) is described as a broad range of psychological approaches and methods. REBT is considered an important view to CBT as the approach uses cognitive (thinking), emotive (feeling), and behavioral (acting) techniques for the improvement of clients and treatment of mental disorders (Jena, 2008). The REBT approach has been seen as an effective approach for changing the self-esteem among students (Lim et al., 2010). CBT has been used effectively in the treatment and improvement of a broad range of disorders as well as for individuals and groups to treat or improve the level of mental health (Harrington et al., 1998 and Jena, 2008). CBT supports clients that are willing to cope, and realize for themselves the challenges in the external world and the problems the future may bring (Chen, Lu, Chang, Chu, & Chou, 2006). Previous research has described the usefulness of CBT, showing marked improvement for depression (Jamal and Kordi, 2006 and Scott et al., 2000), increasing self-esteem in depressed clients (Chen et al., 2006), improving aspects of self-awareness, self-esteem, and resilience (Coholic, 2011), raising levels of self-esteem (Lim et al., 2010) while decreasing anxiety disorders (Lorian, Titov, & Grisham, 2012). Art therapy refers to an application all of arts in therapy with all ages, families, and groups to increase healing, and the well-being in individuals (Malchiodi, 2005). Art therapists frequently report the arts as facilitating self-expression, self-actualization, reaching a more integrated self, preparing a sense of autonomy, decision making, self-worth (e.g., Case and Dalley, 1992, Payne, 1992, Reynolds, 2000 and Reynolds, 2002), and increasing self-esteem (Langner, 2009 and Mahmoudi et al., 2010). Rubin (2005) argued that the therapeutic effect is within all the arts and many people have found crafts very healing. The art used in this study is called engraving. Engraving is described as the art of filigree and creative engraving upon soft metals is accomplished by cutting grooves into the material with a chisel and hammer (Haghshenas, 2003). Engraving is a 3000 year old art history in Iran (Ramazani, 2001). Iranians have used arts such as music, storytelling, theater, painting, and cinema to enhance their mental health. Art has had a valuable place in Iranian culture and has been very influential in the lives of Iranians throughout history. Iranian art is meaning centered, cooling and trust worthy. It has always played the role of self-awareness and discovering of creative representations for Iranians. There are a numerous cases in Iranian literature, poetry, drama, traditional arts, handicraft, and music to use in experimental studies in the field of art therapy. Nevertheless, art theory is rarely used in Iran and it seems necessary that Iranian universities should pay more attention to this field of study. Some Iranian researchers in recent years, have carried out investigations on using music, telling story, theater, painting, poetry, and cinema as art therapy techniques in mental health improvement, and they have confirmed the positive effects of art therapy on a wide variety of mental health including depression reduction in university student (Afrooz et al., 2006, Biglari, 2006 and Mohammadian et al., 2011); reduction of anxiety and stress (Mohammadian et al., 2011); improving mental health (Arabi, 2006 and Toluie et al., 2009); increase self-esteem (Noein, 2009), improvement of self-confidence (Mokhtarnia, 2012). Nevertheless, little attention has been paid to the crafts, especially handy crafts and traditional arts. With the exception of a few cases, handicrafts, such as engraving and miniature are not usually practiced. Research on cross-cultural counseling and psychology recommends that classical approaches of psychotherapy may be adapted to accommodate different cultures to best serve clients from a various range of backgrounds (Atkinson, Hackett, & Sue, 1995). Art itself can be an essential aspect of culture which plays an important part in psychological functioning (Sato, 2011). Therefore, the interventions designed in this paper have incorporated perspectives and conceptions of engraving as a traditional Iranian art into the methods of psychological intervention (REBT interventions).

In conclusion, it should be said that the main limitation of our findings was small sample size as well as the lack of a suitable workshop (studio art therapy) for engraving and other art work. Despite this, all the students completed their work and members continued the program until the end of the process. Nevertheless, combined REBT interventions and art therapy is useful as an intervention tool to increase self-esteem and resilience in university students. The results add up to a very limited body of quantitative research on the subject of art therapy on self-esteem and resilience in the related literature. This study involves university students in one region of Iran and, therefore, it is difficult to generalize to all university students in Iran or the students beyond the borders of Iran. It is necessary to apply art therapy group in various branches that in university life in order to increase self-esteem and the resilience of students to help them in improve their mental health. From the results of the current research the following suggestions can be made. First, considering the fact that there was a change in the self-esteem and resilience of the participants, with little distinction between art therapy and the REBT interventions, studies that this issue and determine the effects of their integration seem necessary. Second, it is essential to evaluate the stability of the change shown as a result of art therapy through follow-up study. Third, it is necessary to utilize counseling sessions with various approaches as REBT and CBT, in addition to art therapy, for clients who have symptoms of low self-esteem and resilience. Finally, it is critical to compare this method with other methods. Using creative art as engraving and miniature with traditional verbal methods is also recommended.