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수용전념치료(ACT)에서 과정변인이 여성의 우울증에 미치는 효과

The Effects of Process Variables in Acceptance Commitment Therapy for Women's Depression

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초록

본 연구에서는 성인 전기 여성을 대상으로 하여 우울증에 대한 수용전념치료(ACT) 효과를 검증하였으며, 이 과정에서 우울증의 변화를 이끌어내는데 영향을 미치는 과정 변인의 매개 효과를 살펴보았다. 우울증 판별을 위한 사전 선별 평가를 통해 선발된 31명 중 ACT 집단에 16명, 대기 통제 집단에 15명이 할당 되었다. 이들은 Beck 우울척도, 수용 행동 질문지, 자기 자비 척도, 마음챙김 주의 자각 척도로 구성된 설문지를 사전, 중간, 사후에 수행하였다. 또한 ACT 집단의 경우 집단치료 프로그램이 진행되는 도중 2주 간격으로 중간 평가를 4회 실시하였으며, 치료 프로그램 종결 2개월 후와 4개월 후에 추적 조사를 실시하였다. 그 결과, ACT 집단은 대기 통제 집단에 비해 우울 수준이 현저하게 감소하였을 뿐만 아니라 과정 변인인 수용 행동, 자기 자비, 마음챙김 역시 대기 통제 집단과 유의한 차이를 나타냈다. 뿐만 아니라 집단치료 종결 4개월 후의 추적 조사까지 모든 변인에 대한 치료 효과가 안정적으로 유지되었다. 특히 수용 행동, 자기 자비는 우울증에 대한 수용전념치료(ACT) 효과를 매개하는 과정 변인으로 확인되었다. 이러한 결과는 수용전념치료(ACT)가 여성의 우울증 완화에 효과적이며 장기적인 치료 효과의 지속으로 재발 방지에도 기여할 수 있음을 보여준다. 마지막으로 본 연구의 시사점과 함께 제한점 및 후속 연구를 위한 제언에 대해 논의하였다.

Abstract

The present study examined the effectiveness of group therapy based on acceptance commitment therapy for women’s depression. In screening evaluation for depression, thirty one young adult females with depression were selected as participants in group therapy from volunteers. Sixteen of them attended group therapy of acceptance commitment therapy for depression, which consisted of 10 weekly 120 min sessions. The other fifteen were assigned to waiting list control. Participants completed a self-report questionnaire comprised of Beck’s depression inventory, acceptance action questionnaire, self-compassion scale, and mindfulness attention awareness scale at pretreatment, middle term, and posttreatment. In the ACT group, outcome variable (depression) and process variables (acceptance, self-compassion, and mindfulness) were assessed at two week intervals for ten weeks, as well as twice at follow up. The ACT group not only showed remarkable reduction of depression, but also process variables (acceptance, self-compassion, and mindfulness) showed significantly greater change at the time of entry. Further, their changes were maintained until follow up after a four month lapse. In particular, mediational analysis verified that change of acceptance and self-compassion mediated the effect of intervention on depression at follow up. The results of this study suggest that group therapy of ACT for depression is not only effective for reduction of women’s depression, but also contributes to prevention of relapse of women's depression because of the persisting effect of acceptance commitment therapy. Finally, implication and limitation of this study, and recommendation for a future study were discussed.

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