Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Cerebral palsy refers to a group of multidimensional and non–stationary disturbances in movement. Children with cerebral palsy need careful attention from their caregivers, especially their mothers, in their daily living activities. Therefore, psychological interventions are essential to reduce marital conflict and increase mothers' self–efficacy. Acceptance and Commitment Therapy (ACT) is a process–oriented approach among the third–generation psychotherapies. The overall goal of this treatment is to achieve psychological flexibility so that there is no need to eliminate the bad feeling; instead, the person moves toward behavior based on the value of thought. On the other hand, the main purpose of motivational interviewing is to promote intrinsic motivation to form and perpetuate behavioral changes. This study aimed to compare the effectiveness of group counseling through motivational interviewing (MI) and acceptance and commitment therapy (ACT) on marital satisfaction and self–efficacy of mothers with children with cerebral palsy.
Methods: This quasi–experimental study with non–equivalent groups employed a pretest–posttest with a follow–up (1 month) design and a control group. The statistical population of the present study included all mothers of children with cerebral palsy who were referred to educational and rehabilitation centers for the physically disabled in Kermanshah City, Iran, in 2021. The research sample comprised 34 volunteer mothers selected by available sampling based on the results of the pretest (ENRICH Marital Satisfaction Questionnaire and Self–Efficacy Scale) and inclusion criteria. They were randomly divided into three groups: trial motivational interview (11 people), acceptance and commitment therapy (10 people), and control group (13 people). The inclusion criteria were as follows: bearing a minimum high school education, having children with cerebral palsy, expressing consent to participate in the research, and having physical health. Mothers without the ability to read, absence of more than two consecutive sessions in the treatment process, simultaneous membership in treatment and rehabilitation groups, non–compliance with group rules, and lack of respect and consent to continue the sessions were the criteria for leaving the study. The instruments used in this study were the ENRICH Marital Satisfaction Questionnaire (Fowers & Olson, 1993) and the Self–Efficacy Scale (Sherer et al., 1982), which were completed before, immediately after, and one month after the intervention by mothers in the experimental and control groups. Participants in the experimental groups received ACT–based therapy in 12 sessions (90 minutes per session) and MI in 11 sessions (90 minutes per session), during which time the control group received no training. Data analysis was performed in descriptive statistics (mean and standard deviation) and the inferential section (analysis of covariance mixed with repeated measures and post hoc Bonferroni test) at a significance level 0.05 in SPSS software version 26.
Results: In the posttest stage, the total score of the marital satisfaction variable and its components, including ideal distortion, marital satisfaction, personality issues, conflict resolution, leisure activities, children, and parenting, as well as the self–efficacy variable, were significantly different between the two experimental groups and the control group (p<0.05). In the follow–up stage, in the total score of the marital satisfaction variable and its components, including ideal distortion, personality issues, conflict resolution, children and parenting, family and friends, as well as the self–efficacy variable, the differences between both experimental groups and the control group were significant (p<0.05). The difference between the two experimental groups in the posttest and follow–up stages was not significant in the total score of the marital satisfaction variable and all its components, as well as the self–efficacy variable (p>0.05).
Conclusion: Based on the findings of the research, the use of treatment techniques based on ACT and MI for mothers of children with cerebral palsy increases the marital satisfaction and self–efficacy of these mothers.