| Objective1.To understand the psychological flexibility level of Students with mental health problems,and to construct their psychological rigidity model.2.Explore a group counseling program that can improve the psychological flexibility of Students with mental health problems,and test the actual effect of the program.Methods1.Research object1.1 convenience sampling were uses to select the following two groups of people from a medical college in Guangxi from February to March 2018 as members of the case group,namely Students with mental health problems.The first category: hospital diagnosed with mood disorders,anxiety disorders,obsessive-compulsive disorder and other psychological diseases and continue to scholars;The second category: those who meet the following two conditions at the same time:(1)in October 2017,in the psychological census,SCL-90 score of any factor or total average score is more than 3 points,or UPI "want to light up" title is the affirmative option;(2)Major accidents,emergencies or abnormal behaviors have occurred in the past six months.34 eligible students were selected as members of the case group.1.2 cluster sampling method was adopted to select 342 ordinary college students majoring in clinical medicine,preventive medicine and pharmacy of grade 2017 as members of the control group.2.Research methods2.1 Self-designed general situation questionnaire,Cognitive Fusion Questionnaire-F(CFQ-F),Acceptance and Action Questionnaire-II(AAQ-II),and Core Self Evaluation Scale(CSES)were used to investigate and analyze the case group and health group to understand their psychological flexibility.2.2 Semi-structured interview method was used to conduct interviews of the case group one by one around the theme of "characteristics of psychological rigidity".Nvivo11.0 was used to sort out the data,and three-level coding was carried out through grounded theory,so as to construct the psychological rigidity model of Students with mental health problems.2.3 Development of group counseling program: based on the acceptance and commitment therapy,a structured group counseling program covering six processes of psychological flexibility is developed.There are 13 times of this program,which is divided into two stages,among which the 1st to the 4th and the 13 th sessions are themed activities of 120 minutes each,and the 5th to the12 th sessions are mindfulness exercises of 60 minute each.2.4 Group counseling implementation: the members of the case group were divided into three groups,with 10-12 members in each group.One and two being the intervention group and the third being the waiting group.The intervention group members were first intervened,and then waited for the intervention group members.Activities once or twice a week,all groups use the same group counseling program.2.5 Intervention effect evaluation: after the intervention of the intervention group,questionnaire assessment was conducted and compared with the waiting group members;At the end of the intervention,all the members' self-evaluation was collected and evaluated by questionnaire.Six months after the intervention,the social function of the members of the case group was tracked,and the indicators included academic performance,truancy,suspension,interpersonal conflict,love affairs and community activities.2.6 Statistical analysis: qualitative data were coded using grounded theory;Quantitative data were analyzed by T-test to compare the difference of psychological flexibility level between the intervention group and the waiting group,the case group before and after intervention,and the case group and the healthy group.Pearson correlation analysis was used to analyze the relationship among the dimensions of psychological flexibility,and rank sum test was used to analyze the social function of the case group before and after intervention.The test level of bilateral ?< 0.05 was used.Results:1.The level of psychological flexibility in the case group was lower than that in the healthy group: the level of cognitive fusion was higher than that of the health group(45.53±10.17,34.01±8.89,t=6.72,P=0.000);the level of empirical avoidance was higher than that of the health group(27.83±6.10,20.89±5.94,t=6.12,P=0.000);and the level of core self-evaluation was lower than that of the health group(29.37±4.40,35.73±5.74,t=5.58,P=0.000).2.Psychological rigidity includes cognitive rigidity and behavioral rigidity.Cognitive rigidity is characterized by low self-esteem,low self-efficacy and deviation from self-worth.The main characteristics of behavioral rigidity are avoidance and control.3.Comparison of psychological flexibility level between the intervention group and the waiting group: before the intervention,there was no statistical difference between the two groups;After intervention,the level of cognitive fusion was higher than that of the waiting group: the level of cognitive fusion was lower than that of the waiting group(35.90±7.20,45.50±10.80,t=2.91,P=0.007).The empirical avoidance level was lower than that of the waiting group(21.30±4.04,27.00±7.24,t=2.32,P=0.039).Core self-evaluation was higher than waiting group(33.70±3.37,31.10±5.24,t=1.65,P=1.65).4.After intervention,the level of psychological flexibility of the case group was higher than that before intervention: the level of cognitive fusion was lower than that before intervention(37.00±7.74,45.43±10.17,t=7.81,P=0.000).The empirical avoidance level was lower than that before intervention(21.83±4.27,27.83±6.10,t=4.95,P=0.000).Core self-evaluation was higher than before intervention(33.80±4.05,29.73±4.40,t=4.14,P=0.000).5.Social function status: half-year follow-up showed that the social function of the members of the case group was good.Academically,5participated in the undergraduate innovation project;According to the result statistics of the two semesters before and after the intervention,10 members had failed records,and 7 of them had a decline in failing grades or no failing grades after the intervention.Social interaction: 3 fell in love and 1 became thePresident of the student club;Before the intervention,7 had interpersonal conflicts such as violence,and 9 had truancy.After the intervention,no interpersonal conflicts occurred,no truancy,and no one dropped out of school due to psychological problems.Conclusion1.The psychological flexibility level of college students with mental health problems is lower than that of ordinary college students.2.Cognitive rigidity of Students with mental health problems is mainly characterized by low self-esteem,low self-efficacy and deviation from self-worth;Behavioral rigidity is mainly characterized by avoidance and control.Rigid cognition and rigid behavior promote each other,leading to psychological rigidity.3.Group counseling based on improving psychological flexibility can effectively improve the level of psychological flexibility of Students with mental health problems. |
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