International Journal of Basic Sciences & Applied Research. Vol., 4 (11), 682-687, 2015 Available online at http://www.isicenter.org ISSN 2147-3749 2015 The Effectiveness of Hypnotherapy to Increase Self-esteem of Patients Treated with Methadone Meysam Kord 1, Mehdi Pourasghar 2* 1 Department of Clinical Psychology, Sari Branch, Islamic Azad University, Sari, Iran 2 Ph.D, Faculty member of Mazandaran, Iran University of Medical Sciences, Psychiatrist of Hypnosis Forum * Corresponding Author Email: Me_pourasghar@yahoo.com Abstract The aim of this study was to survey the effectiveness of hypnosis therapy to increase public self-esteem of patients treated with methadone. The statistical population of this study was included patients treated with the drug of methadone maintenance in Sari, Iran and 30 individuals were selected as the sample of the study (male and female). This was a semi-experimental study with pre-test and post-test. Data was collected using selfesteem questionnaire of Cooper Smith and after completing it, people with lower selfesteem of 30 were replaced in two groups of test (n = 15) and control (n = 15). The test group was treated by hypnosis in 4 session of 40-minute and the control group did not receive the hypnosis. Hypotheses were analyzed using analysis of covariance. The results showed the effectiveness of the hypnosis therapy on public self-esteem. Keywords: Public Self-esteem, Hypnosis, Addiction, Patients Treated with Methadone. Introduction In recent decades, the world of shocking statistics faced with the prevalence of drug addiction in the community. This phenomenon is very common in our country. There are more than two millions drug addicts in Iran among young population, lowering of the age of addiction, the spread of drug addiction in schools, as well as prisoners with addiction noted the necessity of etiology more than the past (Kheyri, 2013). Low self-esteem can cause addiction and can be considered deviant behavior. Kernburg (1999) in the treatment of opium addiction considered methadone treatment as long-term maintenance of therapy as one of the recognized approaches in maintaining abstinence and prevention of relapse, after stopping the drug. Although, methadone treatment is a common approach which is effective, it seems that this treatment alone is not enough and other treatments such as psychological, social relationships and environment must be considered for patients (Momeni, 2013). Researches also approved this matter. Including Kheyri et al (2011) showed that correlated emotional intelligence, self-esteem, attachment style and addicts and non-addicts were different and considered as an important factors and risk of drug addiction. In another study Bawi et al (2009) studied the drug abusers therapeutic community center in the city of Ahvaz, Iran and revealed that psychological rehabilitation services had a significant impact on public self-esteem. Keykhah-Farzaneh et al (2010) in private addiction treatment centers in Zahedan, Iran on self-esteem and attitude concluded that cognitive behavior in group therapy increased the self-esteem and negative attitudes toward drug 682
addicted to drug. So, a successful conservative treatment does not rely on drug treatment only and also considered the other person's life problems. In fact, without intervention and non-intervention in patients with mood disorders, psychiatric problems, problems of communication with the family and the community should have expected and factors and stimulating substance surrounding the patient lead him to slip or relapse (addiction medicine, 2013). Because the temptation of self-esteem and its impact on the performance of the individual, career and academic performance, personality disorders, depression, pain, self-efficacy and so on are very important issues, one of the main goals of this study was to evaluate the efficacy of hypnosis therapeutic to the increase of self-esteem of patients treated with methadone. Therefore, due to the influence of hypnosis therapy also reduced self-esteem and psychological problems, drug addicts are one of the challenges of modern societies and deep challenge. The lack of adequate research on hypnosis therapy and its effect on self-esteem of the people should pay special attention to the need for this issue. The basic assumption of hypnosis treatment is that emotions play an important role in creating, sustaining, back addiction and opium dependence. So, this principle is used to help addicts in raising self-esteem, consequently the reducing of anxiety, the temptation of food, modified and used negative self-concept (Badeleh, 2013). The aim of this study was to evaluate the efficacy of therapeutic hypnosis on self-esteem of patients treated with the drug with methadone maintenance. Increasing of appropriate self-esteem can have a significant effect on individual deal with temptations and reduce the probability of failure of treatment failure. Methodology This was a semi-experimental study with pre-test and post-test. The questionnaire was designed to evaluate the efficacy and interventional implementation. Thus, 30 patients (male and female) who were addicted to methadone were assigned in test group and control group (14 men and one woman) and control (14 males and one female). How to answer the test was explained for the participants before the intervention. And it was decided that each of the participants who received methadone from clinic to the same day, for hypnosis therapy for 30 to 40 minutes to set up and also for therapy are not receiving any money. Also, during the interview, participants were asked about specific problems that have psychiatric and physical problems and how much information they have about hypnosis. After agreement with the participants and with the consent and knowledge of the treatment, therapy sessions and also the date of the meeting they were match up in every meeting, in accordance with that in the control group or the experimental therapeutic interventions were necessary. The statistical population consisted of all men and women between 20 and 60 years from the date March 2015 to September 2015 in order to receive methadone addiction clinic doctor Pourasghar located in the city of Sari, Iran 90 people attended complained that the self-esteem questionnaire of Cooper Smith and eventually 43 individuals who scored lower than 30, 30 of them after the mental disorders (psychosis, depression, suicide, anti-social, etc.) and physical disorders (Cancer, kidney failure, etc.) had no problems participated as test group and after talking with them about how to work with the consent of the patients were randomly assigned to two experimental and control groups. Self-Esteem Questionnaire of Cooper Smith: Cooper Smith (1967) prepared questionnaire based on selfesteem scale revision on Raymond (1954) was awarded with 58 items and a total of four in the original scale (the field social education - family and general) and a sub-scale lie detector is formed. The reliability of the test of Pearson correlation coefficient was equaled to 0.83 (Falsafinejad, 1993) and internal consistency using Cronbach's alpha reliability coefficient was 0.81 (Biabangard, 1992). Results To compare the age of the two groups, two-sample t-test was used and the results are shown in the following table1: Table 1. Comparison of age in control and experiment groups, two-sample t-test. Group Number Mean Standard deviation The standard error T (comparis on) P-value Freedom degree Age 1 15 33.60 9.280 2.396 2 15 37.53 9.015 2.328-1.177 0.249 27.977 683
Based on the calculated results in the table1 above, there was a significant difference between the two groups in terms of age composition, therefore, with respect to this case it can be concluded that the two groups were in the same age composition. To compare the duration of addiction in both groups, after checking the normality of the two groups, the results are shown in the table below: Table 2. Normality Test for both control and experiment groups. Time Kolmogorov-Smirnov Shapiro-Wilk Group Freedom Statistic Freedom degree P-value Statistic degree P-value 1 0.233 15 0.027 0.680 15 0.000 2 0.184 15 0.181 0.927 15 0.246 According to the results in the table 2 above and the calculated p- value for Shapiro Wilk were less than 0.001 for the first group. In order to compare the structure of the two groups of test (Mann-Whitney) were used. So, there was no significant difference between the two groups (following the p-value of 0.967) that turnout is shown below in the table: Table 3. Ranking of the control and experiment groups. Table 4. Statistical Test. Ranks Group Number Average ranks Total ranks Mann-Whitney U duration 111.000 Time 1 15 15.40 231.00 2 15 15.60 234.00 Wilcoxon W 231.000 Z -0.063 Asymp. Sig. (2-tailed) 0.950 Exact Sig. [2 * (1-tailed Sig.)] 0.967 b For comparison of the basis points related to the structure of the final scores of Cooper Smith s Self-Esteem Scale using the Shapiro-Wilk test to evaluate the normality and it was determined that some of the groups were not normal, and the results were given in the following table: Table 5. Normality test for both groups of control and experiment (components of self-esteem). Self-esteem general Kolmogorov-Smirnov a Shapiro-Wilk Group Statistic Freedom degree P-value Statistic df Sig. 1 0.127 15 0.200 * 0.964 15 0.766 2 0.110 15 0.200 * 0.968 15 0.834 1 0.191 15 0.146 0.935 15 0.324 Social family 2 0.163 15 0.200 * 0.918 15 0.179 1 0.169 15 0.200 * 0.913 15 0.153 684
2 0.233 15 0.027 0.926 15 0.240 educational Lie detection 1 0.233 15 0.027 0.877 15 0.043 2 0.180 15 0.200 * 0.894 15 0.078 1 0.212 15 0.069 0.917 15 0.175 2 0.248 15 0.014 0.910 15 0.133 * This is a lower bound of the true significance. Table 6. Rank and Mean ratings of the components of the self-esteem in the experiment and control groups. Self-esteem Group Number Average ranks Total ranks 1 15 14.97 224.50 general 2 15 16.03 240.50 1 15 15.20 228.00 Social 2 15 15.80 237.00 1 15 14.57 218.50 Familial 2 15 16.43 246.50 1 15 16.60 249.00 Education 2 15 14.40 216.00 1 15 15.37 230.50 Lie detector 2 15 15.63 234.50 1 15 14.90 223.50 Total 2 15 16.10 241.50 To compare the basic values of the Mann-Whitney nonparametric test was used and the results were shown in the following tables: Table 7. Comparison of the base values, non-parametric test of Mann-Whitney. general Social Familial Education lie detector Total Mann-Whitney U 104.500 108.000 98.500 96.000 110.500 103.500 Wilcoxon W 224.500 228.000 218.500 216.000 230.500 223.500 Z -0.334-0.191-0.594-0.700-0.086-0.376 Asymp. Sig. (2-tailed) 0.739 0.848 0.553 0.484 0.932 0.707 Exact Sig. [2*(1-tailed Sig.)] 0.744 b 0.870 b 0.567 b 0.512 b 0.935 b 0.713 b a. Grouping Variable: grope b. Not corrected for ties. Regarding to the calculated p-value, after the comparison of two groups it showed that there was no significant difference between the two groups in terms of total point s values and the values highlighted various structures. Therefore, we can say that the two groups were identical in every respect with the structure and what can be the difference could be due to the intervention. 685
Hypothesis Analysis For comparisons of public structures in taken measurements after the survey carried out using marginal analysis analyze data belong to the above, the (Generalized Estimating Equation) was used. The results are shown in the following table: Table 8. Mean estimation and standard deviation of test and control groups. Group Mean confidence interval 95 % Standard Down deviation Up boundary boundary Experiment 16.31 0.765 14.81 17.81 Control 13.38 1.048 11.32 15.43 Table 9. Hypothesis related to the overall scores of self-esteem in both groups. Parameter Measure Standa rd deviati on Down boundary Up boundary Hypothesis Wald Chi-Square Freedom degree P-value (Intercept) 13.378 1.0479 11.324 15.432 162.971 1 0.000 Experime nt 2.933 1.2974 0.390 5.476 5.112 1 0.024 Control 0 a...... (Scale) 18.003 Confidence interval 95 % Hence, the results are shown in the table above were determined according to the rating of Coopers Smith Selfesteem was significant <0.024). And in the intervention group was more than in the control group, the experimental group average was 2.9 (P-value <0.024). Discussion and Conclusion The findings of this research showed that based on the basis of the results obtained by the two-sample T-test, there was no significant difference between the experimental and control groups in terms of age. The following calculated P-value of Shapiro-Wilk test and compared the structure of two groups by Mann-Whitney test showed no significant difference in duration of the test substance and control groups were observed. The findings of this study proved the effectiveness of hypnosis therapy in patients treated with methadone as well as increasing the public selfesteem (P <0.024). The results with the results of research of Badeleh (2013), and Bawi (2009) also showed the effect of consistent psychological services, self-concept and self-esteem on the addicts. But to compare the selfesteem, social, educational and family that all three of the following measures, the following measures were selfesteem, after investigation by the relevant analysis marginal analysis, the results of treatment was not significant for patients treated with methadone and other results. So that, they were obtained (P <0.098) for social self-esteem, (P <0.383) for the family self-esteem and (P <0.072) self-esteem, respectively. Perhaps one of the reasons for this result was during the design dictates, these designs so that public safety and self-esteem was in the areas of education, social and family self-esteem, paid not much attention. Maybe in addicted patients who lose their social 686
and familial status over time the need for more time to participate in family and community is more in the place and regain of their self-confidence. Because the definitions of self-esteem in different approaches to this issue noted that the self-esteem of early childhood and child development in areas with different shaped and are expected to recover and reclaim self-esteem in the same way require more time to reach to the results and observing more efficient in these people. Unfortunately, there was not a lot of domestic and foreign research on the effects of not being able to point them out. Finally, the scale lie detector, which has 8 items for validity and validity of the 58 words self-esteem questionnaire was placed, the foundation calculated for the following scale was not significant meaning (P < 0.724). This suggested that the validity and reliability of study was appropriate. Conflict of interest The authors declare no conflict of interest References Badeleh M, Fathi M, Aghamohamadian-sherbaf HR, 2013.. Comparison of the effectiveness of hypnotherapy and cognitive behavioral therapy, cognitive behavior therapy on increasing self-esteem. Journal of Mental Health. 15. Bawi S, Borna MR, 2009. The impact of psychological rehabilitation services of self-concept anxiety, depression and self-esteem, drug abusers therapeutic community center in the city of Ahvaz. Science and Applied Research. 11 (39). Biabangard I, 1994. Ways to increase self-esteem in children and adolescents. Tehran: Publication of parent-teacher associations. Kheyri T, Abdolahi MH, Shahghelian M, 2013. Comparing emotional intelligence, attachment and self-esteem in the addicted and non-addicted. Journal of Health Psychology. 2. Momeni F, Moshtagh N, Pourshahbaz A, 2013. The effectiveness of cognitive behavioral group therapy on improving the quality of life for opium addicts treated with methadone. Journal of Addiction Studies. 7 (27). 687