Effectiveness of Training Package of Hope-Based Therapy Through Cognitive Spiritual Method on the Psychological Wellbeing and Rumination of the Parents of the Children with Cancer

Document Type : Research Paper


1 PhD Student in Counseling, Islamic Azad University, Isfahan Branch (Khorasgan), Isfahan, Iran.

2 Assistant Professor, Department of Psychology, Islamic Azad University, Isfahan Branch (Khorasgan), Isfahan, Iran. (Corresponding Author)

3 Associate Professor, Department of Psychology, Islamic Azad University, Isfahan Branch (Khorasgan), Isfahan, Iran.


Introduction: The emergence of chronic physiologic diseases such as cancer in the children causes acute psychological and emotional damages in the parents. So the present study was conducted aiming to investigate the effectiveness of training package of hope-based therapy through cognitive spiritual method on the psychological wellbeing and rumination of the parents of the children with cancer.
Methods: The present study was quasi-experimental with pretest, posttest and control group design and two-month follow-up stage. The statistical population included all the parents of the children with leukemia and lymphoma in the city of Isfahan in 2019 who referred to therapy centers and their children were under therapy. 30 parents with cancer were selected through purposive sampling method and they were randomly accommodated into experimental and control groups (each group of 15 parents). The parents in the experimental group received 10 sessions of hope-based training package through cognitive spiritual method during two-and-a-half months. 3 people were excluded from the experimental group and so were 2 people from the control group after the beginning of the intervention. The questionnaire of psychological wellbeing (Ryff, 1996) and rumination questionnaire (Hoxema and Marrow, 1991) were used in the present study. The data from the study were analyzed repeated measurement ANOVA.
Results:  The results showed that training package of hope-based therapy has significant effect on the psychological wellbeing and rumination of the parents of the children the cancer (P<0.001) in a way that this package succeeded in the improvement of psychological wellbeing (54%) and the decrease of rumination (62%) in these parents.
Conclusion: Considering the results of the present study, hope-based training package through cognitive-spiritual method can be assumed as an efficient method to improve psychological wellbeing and decrease rumination of the parents with the children with cancer employing hope therapy, cognition therapy and spirituality therapy.


Bedillion, M.F., Ansell, E.B., Thomas, G.A.(2019). Cancer treatment effects on cognition and depression: The
moderating role of physical activity. The Breast, 44: 73-80.
Buono, R., Longo, V.D.(2018). Starvation, Stress Resistance, and Cancer. Trends in Endocrinology and
Metabolism, 29(4): 271-280.
Carney CE, Harris AL, Moss T, Edinger JD. (2010). Distinguishing rumination from worry in clinical insomnia.
Behav Res Ther; 48: 640-546.
Cho, J., Martin, P., Margrett, J., MacDonald, M. and Poon, L.W. (2011). The Relationship between Physical Health
and Psychological Well-Being among Oldest-Old Adults, Journal of Aging Research, 2011, Article ID 605041,
Connolly, S.L., Alloy, L.B.. (2017). Rumination interacts with life stress to predict depressive symptoms: An
ecological momentary assessment study. Behaviour Research and Therapy, 97: 86-95.
DeCaroli, M.E., Sagone, E. (2014). Stress and Support in Relation to Parental Self: A Comparison between
Mothers of Children in Cancer Treatment and Mothers of Healthy Children. Procedia - Social and Behavioral
Sciences, 114, 211-215.
Dierendonck, D. (2005). The construct validity of Ryff Scale of psychological well-being its extension with
spritual well-being. Personality and Individual Differences, 36(1), 629-643.
Doumit, M.A.A., Rahi, A.C., Saab, R., Majdalani, M.(2019). Spirituality among parents of children with cancer
in a Middle Eastern country. European Journal of Oncology Nursing, 39: 21-27.
Ellison, C.G., Burdette, A.M., Hill, T.D. (2009). Blessed assurance: religion, anxiety, and tranquility among US
adults. Social Science Research, 38(3): 656-67.
Giovagnoli, A.R., Paterlini, C., Meneses, R.F., Da Silva, A.M.(2019). Spirituality and quality of life in epilepsy
and other chronic neurological disorders. Epilepsy & Behavior, 93, 94-101.
Gumport, N.B., Dong, L., Lee, J.Y., Harvey, A.G.(2018). Patient learning of treatment contents in cognitive
therapy. Journal of Behavior Therapy and Experimental Psychiatry, 58: 51-59.
Jimenez-Fonseca P, Lorenzo-Seva U, Ferrando PJ, Carmona-Bayonas A, Beato C, García T, del Mar Muñoz M,
Ramchandani A, Ghanem I, Rodríguez-Capote A, Jara C,Calderon C. (2018). The mediating role of spirituality
(meaning, peace, faith) between psychological distress and mental adjustment in cancer patients. Supportive Care
in Cancer; 26(5): 1411-1418.
Kaye, EC., Jerkins, J., Gushue, CA., DeMarsh, S., Sykes, A., Lu, Z., et al.(2018). Predictors of Late Palliative
Care Referral in Children With Cancer. Journal of Pain and Symptom Management, 55(6): 1550-1556.
Kelly, E.P., Paredes, A.Z., Tsilimigras, D.I., Hyer. J.M., Pawlik, T.M. (2020). The role of religion and spirituality
in cancer care: An umbrella review of the literature. Surgical Oncology, In Press, Corrected Proof.
Kingdon, D., Turkington, D.(2019). Cognitive therapy of psychosis: Research and implementation. Schizophrenia
Research, 203: 62-65.
Liu, J., Peh, P., Simard, S., Griva, K., Mahendran, R.(2018). Beyond the fear that lingers: The interaction between
fear of cancer recurrence and rumination in relation to depression and anxiety symptoms. Journal of Psychosomatic
Research, 111: 120-126.
Madi D, Clinton M.(2018). Pain and its Impact on the Functional Ability in Children Treated at the Children's
Cancer Center of Lebanon. Journal of Pediatric Nursing; 39: 11-20.
Mori, M., & Tanno, Y. (2015). Mediating role of de-centering in the associations between self-reflec-tion, selfrumination, and depressive symptoms. Psychology, 6, 613-621.
Muscara F, McCarthy MC, Woolf C, Hearps SJ, Burke K, Anderson VA. Early psychological reactions in parents
of children with a life threatening illness within a pediatric hospital setting. Eur Psychiatry. 2015. pii: S0924-
9338(14)00662-2. doi: 10.1016/j.eurpsy.2014.12.008.
Nolen-Hoeksema, S. (2007). Responsesto depression and their effects on the duration of depressive episodes.
Journal of abnormal psychology, 100(4), 569-582.
Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms
after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115-
Nolen-Hoeksema, S., Wisco, E.B., Lyubomirsky, S. (2008). Rethinking rumination. Journal of Perspectives on
Psychological Science, 3(5), 400-424.
Paukert, A.L., Phillips, L., Cully, J.A., Loboprabhu, S.M., Lomax, J.W., Stanley, M.A. (2009). Integration of
religion into cognitive-behavioral therapy for geriatric anxiety and depression. Journal of Psychiatry Practice,
15(2): 103-12.
Rosmarin DH, Alper DA, Pargament KI. (2016). Religion, Spirituality, and Mental Health. Reference Module in
Neuroscience and Biobehavioral Psychology. Encyclopedia of Mental Health (Second Edition). 23-27.
Saracino, R.M., Rosenfeld, B., Nelson, C.J.(2018). Performance of four diagnostic approaches to depression in
adults with cancer. General Hospital Psychiatry, 51: 90-95.
Ullgren, H., Tsitsi, T., Papastavrou, E., Charalambous, A.(2018). How family caregivers of cancer patients manage
symptoms at home: A systematic review. International Journal of Nursing Studies, 85: 68-97.
Vazquez C., Hervas G., Rahona J. J., & Gomez D. (2009). Psychological wellbeing and health. Contributions of
positive psychology. Annuary of Clinical and Health Psychology, 5, 15-27.
Yi, J.C., Syrjala, K.L.(2017). Anxiety and Depression in Cancer Survivors. Medical Clinics of North America,
101(6): 1099-1113.
Zhang, W., Yan, T., Du, Y., Liu, X.(2013). Relationship between coping, rumination and posttraumatic growth in
mothers of children with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(10): 1204-1210.
Zhou, K., Li, X., Li, J., Liu, M., Dang, S., Wang, D., & Xin, X. (2015). A clinical randomized controlled trial of
music therapy and progressive muscle relaxation training in female breast cancer patients after radical mastectomy:
results on depression, anxiety and length of hospital stay. European journal of oncology nursing, 19(1): 54-59.