Comparing the Effectiveness of Mentalization-Based Therapy and Emotion-Focused Therapy on Obsessive-Compulsive Symptoms and Caregiving Burden in Mothers of Children with Attention-Deficit/Hyperactivity Disorder
Keywords:
Mentalization-Based Therapy, Emotion-Focused Therapy, Obsessive-Compulsive Symptoms, Caregiving Burden, Attention-Deficit/Hyperactivity Disorder, MothersAbstract
ABSTRACT
This study aimed to compare the effectiveness of mentalization-based therapy and emotion-focused therapy on obsessive-compulsive symptoms and caregiving burden among mothers of children with attention-deficit/hyperactivity disorder. This quasi-experimental study used a pretest-posttest-follow-up design with two experimental groups and one control group. The statistical population included mothers of children aged 6 to 12 years diagnosed with attention-deficit/hyperactivity disorder who had attended clinics in Tehran during the previous year. Forty-five participants were selected through voluntary sampling and randomly assigned to mentalization-based therapy, emotion-focused therapy, and control groups. Data were collected using the Maudsley Obsessive-Compulsive Inventory and the Caregiving Burden Scale. Assessments were conducted at pretest, posttest, and three-month follow-up. Data were analyzed using descriptive statistics, repeated-measures mixed analysis of variance, tests of variance homogeneity, and Bonferroni post hoc comparisons in SPSS version 26. The between-group analysis showed no significant differences among the three groups in obsessive-compulsive symptom components, including checking (F=1.376, p=.264, η²=.061), washing (F=1.202, p=.311, η²=.054), slowness-repetition (F=2.158, p=.128, η²=.093), and doubt-conscientiousness (F=.518, p=.599, η²=.024). For caregiving burden, significant between-group effects were found for general strain (F=8.067, p=.001, η²=.278) and hopelessness (F=6.335, p=.004, η²=.232), whereas loneliness, emotional involvement, and environmental burden were not significant. Bonferroni comparisons indicated significant differences in general strain between mentalization-based therapy and emotion-focused therapy (p=.014) and between mentalization-based therapy and control (p=.001). Hopelessness differed significantly between mentalization-based therapy and control (p=.003). Mentalization-based therapy and emotion-focused therapy did not produce significant between-group effects on obsessive-compulsive symptoms, but mentalization-based therapy showed stronger effectiveness in reducing selected dimensions of caregiving burden, particularly general strain and hopelessness.
Downloads
References
1. Si Y, Ma JL, Zhang J. Factors influencing parenting stress among Chinese families of children with attention-deficit/hyperactivity disorder. Children and Youth Services Review. 2020;116:105148. doi: 10.1016/j.childyouth.2020.105148.
2. Ringer N, Wilder J, Scheja M, Gustavsson A. Managing children with challenging behaviours: Parents'. 2020.
3. Polat H, Karakas SA. An examination of the perceived social support, burnout levels and child-raising attitudes of mothers of children diagnosed with attention deficit hyperactivity disorder in Turkey. International Journal of Caring Sciences. 2019;12(2):1165-74.
4. Duru E, Balkis M, Turkdogan T. Relational violence, social support, self-esteem, depression and anxiety: A moderated mediation model. Journal of Child and Family Studies. 2019;28(9):2404-14. doi: 10.1007/s10826-019-01509-2.
5. Besharat A, Mohammad Dehghani S, Masoudi M, Pourkhaghan F, Motahari S. Predicting obsessive-compulsive disorder symptoms on the basis of difficulties in emotion regulation, impulsivity, and anger. 2023.
6. Pour Afkari N. Comprehensive English-Persian Psychiatry Dictionary, Volume II. Tehran: Institute of Contemporary Culture; 2016.
7. Denckla CA, Cicchetti D, Kubzansky LD, Seedat S, Teicher MH, Williams DR, et al. Psychological resilience: An update on definitions, a critical appraisal, and research recommendations. European Journal of Psychotraumatology. 2020;11(1):1822064. doi: 10.1080/20008198.2020.1822064.
8. Choi KW, Stein MB, Dunn EC, Koenen KC, Smoller JW. Genomics and psychological resilience: A research agenda. Molecular Psychiatry. 2019;24(12):1770-8. doi: 10.1038/s41380-019-0457-6.
9. Jalilian M, Karami J, Parhoon H. The Effectiveness of Parenting Training Based on Acceptance and Commitment on Parent-Child Interaction, Self-Efficacy and Psychological Flexibility Of Mothers with Children with Attention Deficit/Hyperactivity Disorder. Journal of Rafsanjan University of Medical Sciences. 2025.
10. Rajaeizadeh MS, Khayatan F. Effectiveness of Schema Therapy on Distress Tolerance, Resilience, Emotion Regulation, and Parenting Styles in Mothers of Children with Attention-Deficit/Hyperactivity Disorder. Rooyesh-e-Ravanshenasi. 2025;14(2):123-34.
11. Zargarinejad G, Shortt JW, Eddy JM, Ebadi Zare S, Gharraee B, Farahani H, et al. A Randomized Clinical Trial Comparing the Effectiveness of Emotion-Focused and Behavioral Parent Training in Families of School-aged Children with Attention-Deficit/Hyperactivity Disorder. Child Psychiatry & Human Development. 2025:1–16. doi: 10.1007/s10578-025-01868-6.
12. Zhang ZJ, Lo HHM, Bögels SM, Cheung RY, Lau ENS, Lee EKP, et al. A Randomized Controlled Trial for Evaluating the Effects of an Online Mindfulness-Based Intervention for Parents of Children with Attention-Deficit/Hyperactivity Disorder: A Study Protocol. BMC Psychology. 2025;13(1):610. doi: 10.1186/s40359-025-02929-0.
13. Dehkordian P, Hamid N, Beshlideh K, Mehrabizadeh HM. The effectiveness of mindful parenting, social thinking, and exercise on quality of life in ADHD children. International Journal of Pediatrics. 2017;5:4295-302.
14. Bateman A, Fonagy P. Mentalization-Based Treatment for Personality Disorders: A Practical Guide. New York: Oxford University Press; 2016.
15. Fonagy P, Bateman AW. Mechanisms of change in mentalisation-based therapy with BPD. Journal of Clinical Psychology. 2016;62(4):411-30. doi: 10.1002/jclp.20241.
16. Midgley N, Ensink K, Lindqvist K, Malberg N, Muller N. Mentalization-Based Treatment for Children: A Time-Limited Approach. Washington, DC: American Psychological Association; 2017.
17. Greenberg L, Watson J. Emotion-Focused Therapy for Depression. Washington: American Psychological Association; 2022.
18. Asmari Barde Z, Khanjani S, Musavi Asl E, Dolatshahi B. The effectiveness of emotional therapy on anxiety, depression, and difficulty in regulating emotions in binge eating disorder. Iranian Journal of Psychiatry and Clinical Psychology. 2021;27(1):2-15. doi: 10.32598/ijpcp.27.1.3246.1.
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2026 Maral Dast Anbouyeh (Author); Kolsoum Akbarnataj Bisheh; Asghar Norouzi (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
