Background: At the end of 2019, the world faced a phenomenon that plunged all human beings into extreme fear and anxiety. A new type of coronavirus began to spread among people around the world, and this was the beginning of one of the greatest pandemics and its problems in the world.
Objectives: The present study aimed to study the effect of Emotion-Focused Therapy (EFT) on reducing post-traumatic stress and depression among Covid-19 patients. The statistical population was all English language students at the University of Tehran who had recovered from Covid-19. A total of three students (with a mean age of 22±2 years old) were selected from those who had recovered from Covid-19 using convenience sampling.
Results: The data were analyzed using visual inspection, Reliable Change Index (RCI), and percentage change formula. The results of the study indicated that the mean improvement of post-traumatic stress variable for the three patients in the post-treatment and follow-up was 42.39% and 41.54%, respectively. Additionally, this value for the depression variable was 60.78 and 60.22% in the post-treatment and the follow-up.
Conclusion: Based on the results of the study, EFT was effective on post-traumatic stress and depression in students infected with Covid-19. Therefore, it is recommended to use this treatment to reduce post-traumatic stress and depression in patients with Covid-19.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. doi: 10.1001/jama.2020.1585. [PubMed: 32031570]
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976. [PubMed: 32202646].
Chen L, Liu W, Zhang Q, Xu K, Ye G, Wu W, et al. RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak. Emerg Microbes Infect. 2020;9(1):313-9. doi: 10.1080/22221751.2020.1725399. [PubMed: 32020836].
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-7. doi: 10.1056/NEJMc2004973. [PubMed: 32182409].
Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu T, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl). 2020;133(9):1015-24. doi: 10.1097/CM9.0000000000000722. [PubMed: 32004165].
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. [PubMed: 31986264].
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90. doi: 10.1001/jamaneurol.2020.1127. [PubMed: 32275288].
Shahyad SH, Mohammadi MT. Psychological impacts of Covid-19 outbreak on mental health status of society individuals: a narrative review. J Mil Med. 2020;22(2):184-92. doi: 10.30491/JMM.22.2.184.
Bo HX, Li W, Yang Y, Wang Y, Zhang Q, Cheung T, et al. Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China. Psychol Med. 2021;51(6):1052-3. doi: 10.1017/S0033291720000999. [PubMed: 32216863].
Kessler RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry. 2000;61(Suppl 5):4-12. [PubMed: 10761674].
Sun L, Sun Z, Wu L, Zhu Z, Zhang F, Shang Z, Jia Y, et al. Prevalence and risk factors of acute posttraumatic stress symptoms during the COVID-19 outbreak in Wuhan, China. MedRxiv. 2020;10:1-7. doi: 10.1101/2020.03.06.20032425.
Gelder M, Gath D, Mayou R. Oxford textbook of psychiatry. Oxford: Oxford University Press; 2001.
Alamdar Baghini A, Mohammadtehrani H, Behbodi M, Kiamanesh AR. Comparison of effectiveness of eye movement desensitization and reprocessing, cognitive behavioral therapy, and emotional freedom technique in reducing anxiety in patients with post-traumatic stress disorder. Quart Appl Psychol. 2020;13(4):625-50.
St Cyr K, McIntyre-Smith A, Contractor AA, Elhai JD, Richardson JD. Somatic symptoms and health-related quality of life among treatment-seeking Canadian Forces personnel with PTSD. Psychiatry Res. 2014;218(1-2):148-52. doi: 10.1016/j.psychres.2014.03.038. [PubMed: 24745465].
Yang L, Wu D, Hou Y, Wang X, Dai N, Wang G, et al. Analysis of psychological state and clinical psychological intervention model of patients with COVID-19. MedRxiv. 2020;3(22):1-8. doi: 10.1101/2020.03.22.20040899.
Xiang X, Leggett A, Himle JA, Kales HC. Major depression and subthreshold depression among older adults receiving home care. Am J Geriatr Psychiatry. 2018;26(9):939-49. doi: 10.1016/j.jagp.2018.05.001. [PubMed: 29884541].
Akbari H. The Effectiveness of training emotional-experimental therapy strategies on reducing test anxiety of female high school students in Tehran. Educ Psychol. 2015;37:187-205.
Timulak L, McElvaney J, Keogh D, Martin E, Clare P, Chepukova E, et al. Emotion-focused therapy for generalized anxiety disorder: an exploratory study. Psychotherapy (Chic). 2017;54(4):361-6. doi: 10.1037/pst0000128. [PubMed: 29251955].
Timulak L, Keogh D, Chigwedere C, Wilson C, Ward F, Hevey D, et al. A comparison of emotion-focused therapy and cognitive-behavioural therapy in the treatment of generalised anxiety disorder: study protocol for a randomised controlled trial. Trials. 2018;19(1):506. doi: 10.1186/s13063-018-2892-0. [PubMed: 30231910].
Greenberg L, Watson J. Experiential therapy of depression: differential effects of client-centered relationship conditions and process experiential interventions. Psychother Res. 1998;8(2):210-24. doi: 10.1080/10503309812331332317.
Dai LL, Wang X, Jiang TC, Li PF, Wang Y, Wu SJ, et al. Anxiety and depressive symptoms among COVID-19 patients in Jianghan Fangcang Shelter Hospital in Wuhan, China. PLoS One. 2020;15(8):e0238416. doi: 10.1371/journal.pone.0238416. [PubMed: 32857826].
Carletto S, Borghi M, Bertino G, Oliva F, Cavallo M, Hofmann A, et al. Treating post-traumatic stress disorder in patients with multiple sclerosis: a randomized controlled trial comparing the efficacy of eye movement desensitization and reprocessing and relaxation therapy. Front Psychol. 2016;7:526. doi: 10.3389/fpsyg.2016.00526. [PubMed: 27148134].
Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM. The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Inannual Convention of the International Society for Traumatic Stress Studies, San Antonio, TX; 1993.
Goodarzi MA. Post-traumatic stress disorder scale reliability and validity Mississippi (scale). J Psychol. 2003;26(2):12-6.
Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio. 1996;78(2):490-8.
Scogin F, Beutler L, Corbishley A, Hamblin D. Reliability and validity of the short form Beck Depression Inventory with older adults. J Clin Psychol. 1988;44(6):853-7. doi: 10.1002/1097-4679(198811)44:6<853::aid-jclp2270440604>3.0.co;2-7. [PubMed: 3216010].
Emad Y, Hadianfard H. Forecasting suicide based on sexuality, marital status, coping strategies, religious orientation, and depression rate. Iran J Psychiatry Clin Psychol. 2019;25(2):178-93. doi: 10.32598/ijpcp.25.2.178.
Jacobson NS, Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991;59(1):12-9. doi: 10.1037//0022-006x.59.1.12. [PubMed: 2002127].
Blanchard EB, Schwarz SP. Clinically significant changes in behavioral medicine. Washington, DC: Behavioral Assessment; 1988.
Fisher WW, Kelley ME, Lomas JE. Visual aids and structured criteria for improving visual inspection and interpretation of single-case designs. J Appl Behav Anal. 2003;36(3):387-406. doi: 10.1901/jaba.2003.36-387. [PubMed: 14596583].
Church D. The treatment of combat trauma in veterans using EFT (Emotional Freedom Techniques): a pilot protocol. Traumatology. 2010;16(1):55-65. doi: 10.1177/1534765609347549.
Soudani M, Karimi J, Mehrabizadeh M, Neisi A. Effectiveness of emotion oriented couple therapy on reducing the damage caused by marital infidelity. J Res Behav Sci. 2012;10(4):258-68.
Robinson L, McCague B, Whissell C. Single-case investigation of an emotion-focused therapy group for anxiety and depression. Int J Integrat Psychother. 2012;3(1):59-81.
Jernigan DB; CDC COVID-19 Response Team. Update: public health response to the coronavirus disease 2019 outbreak - United States, February 24, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(8):216-9. doi: 10.15585/mmwr.mm6908e1. [PubMed: 32106216].
Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet. 2020;395(10225):689-97. doi: 10.1016/S0140-6736(20)30260-9. [PubMed: 32014114].
Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924. [PubMed: 32081636].
Calisher C, Carroll D, Colwell R, Corley RB, Daszak P, Drosten C, et al. Statement in support of the scientists, public health professionals, and medical professionals of China combatting COVID-19. Lancet. 2020;395(10226):e42-3. doi: 10.1016/S0140-6736(20)30418-9. [PubMed: 32087122].
Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145-51. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003. [PubMed: 32064853].
Nourisaeid A, Shabahang R, Bagheri Sheykhangafshe F, Saeedi M, Mousavi M. Comparison of online health information utilization, online shared identity, and online shared information usage in different levels of COVID-19 anxiety. J Res Psychol Health. 2020;14(1):28-39.
Li D, Li D, Wu N, Wang Z. Intergenerational transmission of emotion regulation through parents' reactions to children's negative emotions: tests of unique, actor, partner, and mediating effects. Child Youth Serv Rev. 2019;101:113-22. doi: 10.1016/j.childyouth.2019.03.038.
Jones-Corneille LR, Wadden TA, Sarwer DB, Faulconbridge LF, Fabricatore AN, Stack RM, et al. Axis I psychopathology in bariatric surgery candidates with and without binge eating disorder: results of structured clinical interviews. Obes Surg. 2012;22(3):389-97. doi: 10.1007/s11695-010-0322-9. [PubMed: 21088923].
Asmaribardezard Y, Mohamadaminzade D, Hosiesabet F. Effectiveness of emotion-focused therapy on depression and anxiety in women with binge eating disorder referring to Sina hospital in 1396. Navid No. 2018;21(65):11-22. doi: 10.22038/NNJ.2018.29485.1119.
Gili S, Haghayegh SA, Sadeghifiroozabadi V, Alizadehghavidel A, Rezayijamalooyi H. Effectiveness of emotionally-focused therapy on depression of patients with coronary heart disease. Iran J Health Psychol. 2020;3(1):91-8. doi: 10.30473/IJOHP.2020.53999.1101.
Ellison JA, Greenberg LS, Goldman RN, Angus L. Maintenance of gains following experiential therapies for depression. J Consult Clin Psychol. 2009;77(1):103-12. doi: 10.1037/a0014653.
Greenberg LS, Auszra L, Herrmann IR. The relationship among emotional productivity, emotional arousal and outcome in experiential therapy of depression. Psychother Res. 2007;17(4):482-93. doi: 10.1080/10503300600977800.
Khoshnam S, Borjali A, Karegari Padar L, Amiri H. Effectiveness of emotion-focused therapy on patients with major depression disorder. Contemporary Psychol Biannual J Iran Psychol Assoc. 2014;9(1):95-106.
Webster M. A critical review of emotionally focused treatment for depression. New York: Springer Publishing Company; 2007.
Robbins RA, Klotz SA. Brief review of coronavirus for healthcare professionals February 10, 2020. Southwest J Pulmon Crit Care. 2020;20(2):69-70. doi: 10.13175/swjpcc011-20.
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648. [PubMed: 32091533].
Bajema KL, Oster AM, McGovern OL, Lindstrom S, Stenger MR, Anderson TC, et al. Persons evaluated for 2019 novel coronavirus - United States, January 2020. MMWR Morb Mortal Wkly Rep. 2020;69(6):166-70. doi: 10.15585/mmwr.mm6906e1. [PubMed: 32053579].
Jiang Z, Zhu P, Wang L, Hu Y, Pang M, Ma S, et al. Psychological distress and sleep quality of COVID-19 patients in Wuhan, a lockdown city as the epicenter of COVID-19. J Psychiatr Res. 2021;136:595-602. doi: 10.1016/j.jpsychires.2020.10.034. [PubMed: 33153759].