Design and Validation of a Mentalization Promoting Program for Parents of a Child with Type 1 Diabetes and its Effectiveness on Parents' Reflective Functioning and the Child's Emotional-Behavioral Problems: A Single-Subject Study

Tayebeh Madanifar; Parisa Sadat Seyed Mousavi; Mahin  Hashemipour; Mehdi Tabrizi; Majid Koohi Esfahani

doi:10.18502/qjcr.v23i89.15791

Tayebeh Madanifar Ph. D. Candidate in Counseling, Department of Counseling, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr/Isfahan, Iran
Parisa Sadat Seyed Mousavi Ph. D. in Psychology, Assistant Professor, Shahid Beheshti University, Family Research Institute, Tehran, Iran
Mahin Hashemipour Ph. D. in Endocrinology & Metabolism, Professor, Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Mehdi Tabrizi Ph. D. in Counseling, Assistant Professor, Department of Counseling, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr/Isfahan, Iran
Majid Koohi Esfahani Ph. D. in Management, Administrator, Behroyan Scientific Company, Isfahan, Iran

DOI: https://doi.org/10.18502/qjcr.v23i89.15791

Keywords: Mentalization, Children with type 1 diabetes, Reflective functioning, Emotional-behavioral problems.

Abstract

Aim: This research was conducted with the aim of designing and validating the Mentalization promoting program for parents of a child with type 1 diabetes and investigating its effectiveness on parents' reflective Functioning and emotional-behavioral problems of the child. Methods: A mixed method was used in this research. In the qualitative part, the mentalization problems of 18 children with T1D and 22 of their parents were extracted through the analysis of interviews with the method of transcendental phenomenology, and three general themes,18 main sub-themes and 50 sub-themes were obtained. Then, based on these themes and within the framework of the concepts of mentalization theory, a program to promote the mentalization of parents with a child with type 1 diabetes was designed. After confirming the content validity based on the CVI, with a semi-experimental method and a single-subject design of the type (A-B) with different subjects, 5 parents of children with diabetes who met the criteria for entering the research, were selected with a purposeful sampling method and participated in the program. The effectiveness of this program was assessed in four phases (baseline, during intervention, after intervention and follow-up) using the Child Behavior Checklist (CBCL) and the Parental Reflective Functioning Questionnaire (PRFQ) and indicators of program goals. Then data was checked based on visual analysis indicators. Results: The final outcome of this phenomenological study is the extraction of three general themes, including the underlying factors of breakdowns in mentalizing, types of common mentalizing problems, and the consequences of breakdowns in mentalizing which became the basis for design the program to promote the mentalization of parents with a child with type 1 diabetes The results showed that the designed program, while having sufficient validity, was effective in increasing the parents reflective Functioning and reducing the emotional-behavioral problems of the child, and this effectiveness continued in the follow-up phase. Conclusion: Considering the validity of this program and its effectiveness, it is suggested that this program be widely implemented to help improve the physical and mental health of children with diabetes and their families, and also for children with other chronic diseases should also be adapted.