Sınav Kaygısına Yönelik Bilişsel Grup Terapisi

Sınav kaygısı; öğrencilerin duygusal, mesleki ve akademik durumunu etkileyen önemli bir sorundur ve bu nedenle birçok tedavi stratejisi geliştirilmiştir. Bilişsel davranışçı terapi, sınav kaygısında etkili bir tedavi olmakla beraber; bilişsel ve davranışçı müdahalelerden hangisi/hangilerinin etkili olduğuyla ilgili çalışmalar kısıtlıdır. Bu araştırmada; bilişsel müdahalelerinin davranışçı müdahalelerden bağımsız olarak etkililiğinin araştırılması amaçlanmıştır. Sınav kaygısı yakınmalarıyla başvuran 38 birey çalışmaya alınmış, dört gruba ayrılarak her bir gruba haftada bir 90 dakikalık toplam altı seans bilişsel grup terapisi programı uygulanmıştır. Katılımcılar; Sınav Kaygısı Ölçeği (SKÖ), Beck Anksiyete Envanteri (BAE), Durumluluk ve Sürekli Kaygı Envanteri (STAI-II), Ruminatif Düşünce Biçimi Ölçeği (RDBÖ) ve Otomatik Düşünceler Ölçeği (ODÖ) ile değerlendirilmiştir. Ölçümler değerlendirildiğinde tedavi sonrasında BAE toplam puan, BAE bilişsel ve somatik alt-boyutları, ODÖ ve STAI-II toplam puan sıralar ortalamasında istatistiksel olarak anlamlı fark saptanmıştır. STAI-I ve RDBÖ toplam puan sıralar ortalamasında ise istatistiksel olarak anlamlı bir fark tespit edilmemiştir. SKÖ toplam puanında, alt boyutlardan 'Başkalarının görüşü', 'Gelecek ile ilgili endişeler' ve 'Hazırlanmakla ilgili endişeler ve genel sınav kaygısı'nda istatistiksel olarak anlamlı fark saptanmıştır. Bu araştırma, bilişsel müdahalelerinin davranışçı teknikler olmadan da sınav kaygısında etkili olabildiğini, bununla birlikte kaygının benlik ilişkili algılama boyutu ve ruminatif yanıt biçimlerine yönelik etkisinin ise şüpheli olduğunu göstermektedir. Bu nedenle, bilişsel müdahalelerin yanında davranışçı tekniklerin de eklenmesi tedavinin etkililiğini artırabilecektir.

Cognitive Group Therapy for Test Anxiety

Cognitive Group Therapy for Test Anxiety Test anxiety is a major problem that affects students’ academic, vocational and emotional state and several treatment strategies have been developed and applied. Cognitive behavioral therapy is one of the efficacious treatments for test anxiety, but we know little about whether cognitive or behavioral techniques (or both) are effective. The aim of this study is to assess the efficacy of cognitive techniques without behavioral interventions. The study was carried out with 38 individual who complained of test anxiety and were divided into four groups. Six 90 min sessions of cognitive group therapy is applied weekly. Test Anxiety Inventory (TAI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI), Ruminative Thought Style Questionnaire (RTSQ) and Automatic Thoughts Questionnaire (ATQ) were given to attendants. There was statistically significant difference between first and last evaluation of mean rank of BAI total and its cognitive and somatic subscales, ATQ and STAI-II. There was no significant difference for mean rank of STAI-I and RTSQ total scores. Statistically significant difference was found between first and last evaluation of total TAI and 3 subscales of TAI which were ‘Others’ opinions’, ‘Worry about future’, ‘Worry about preparation and unspecified test anxiety’ Cognitive techniques are effective for treatment of test anxiety even without behavioral interventions. However, its effect on self-related perception component of test anxiety and ruminative response styles are uncertain. Adding behavioral interventions to cognitive techniques may increase the efficacy of treatment for test anxiety.

Kaynakça

Asghari, A., Kadir, R.A., Elias, H. & Baba, M. (2012). Test anxiety and its related concepts: A brief review.

Gesj: Education Science and Psychology, 22(33), 3-8.

Bahçeci, D. (2006). Anatomi dersinde portfolyo kullanmanın öğrencilerin bilişsel ve duyuşsal özellikleri üzerine etkisi. (Yayınlanmamış Doktora Tezi). Gazi Üniversitesi/Eğitim Bilimleri Enstitüsü, Ankara.

Bahçeci, D. (2009). Portfolyo değerlendirmenin sınav kaygısı, çalışma davranışı ve tutum üzerine etkisi. Ahi Evran Üniversitesi Kırşehir Eğitim Fakültesi Dergisi, 10, 169-182.

Baltaş, A. (1999). Stres altında ezilmeden öğrenmede ve sınavlarda üstün başarı (17.Baskı). İstanbul: Remzi Kitapevi.

Barlow, D.H., Craske, M.G., Cerney, J.A. & Klosko, J.S. (1989). Behavioral treatment of panic disorder. Behavior Therapy, 20(2), 261–282.

Barrett, P.M. (1998). Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. Journal of Clinical Child Psychology, 27(4), 459-468.

Beck, A.T., Emery, G. & Greenberg, R. (1985). Anxiety Disorders and Phobias. New York: Basic Books,. Beck, A.T., Epstein, N., Brown, G. & Steer, R.A. (1988) An inventory for measuring clinical anxiety:

Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893-897.

Behar, E., DiMarco, I.D., Hekler, E.B. Mohlman, J. & Staples, A.M. (2009). Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders, 23(8), 1011-1023.

Borkovec, T.D., Ray, W.J. & Stöber, J. (1998). Worry: A cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy Research, 22(6), 561-576.

Brinker, J.K. & Dozois, D.J.A. (2009). Ruminative thought style and depressed mood. Journal of Clinical Psychology, 65(1), 1–19.

Brown, L.A., Forman, E.M., Herbert, J.D., Hoffman, K.L., Yuen, E.K. & Goetter, E.M. (2011). A randomized controlled trial of acceptance-based behavior therapy and cognitive therapy for test anxiety: a pilot study. Behavior Modification, 35(1), 31-53.

Can, P.B., Dereboy, Ç. & Eskin, M. (2012). Yüksek riskli sınav kaygısının azaltılmasında sistematik duyarsızlaştırma ile bilişsel yeniden yapılandırmanın etkililiğinin karşılaştırılması. Türk Psikiyatri Dergisi, 23(1), 9-17.

Cassady, J.C. & Johnson, R.E. (2002). Cognitive test anxiety and academic performance. Contemporary Educational Psychology, 27, 270–295.

Chapman, L.K., Williams, S.R., Mast, B.T. & Woodruff-Borden, J. (2009). A confirmatory factor analysis of the Ciesla, J.A. & Roberts, J.E. (2002). Self-directed thought and response to treatment for depression: A preliminary investigation. Journal of Cognitive Psychotherapy: An International Quarterly, 16(4), 435 453.

Clark, D.A. & Beck, A.T. (2011). Cognitive therapy of anxiety disorders: Science and Practice. New York: Guilford Press.

Deacon, B.J. & Abramowitz, J.S. (2004). Cognitive and behavioral treatments for anxiety disorders: a review of meta-analytic findings. Journal of Clinical Psychology, 60(4), 429-441.

Donker, T., Griffiths, K.M., Cuijpers, P. & Christensen, H. (2009).

Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC Medicine, 7: 79. doi:10.1186/1741-7015-7-79

Edwards, S.L., Rapee, R.M. & Franklin, J. (2003). Post-event rumination and recall bias for a social performance event in high and low socially anxious individuals. Cognitive Therapy Research, 27(6), 603–617.

Ergene, T. (2003). Effective interventions on test anxiety reduction: A meta-analysis. School Psychology International, 24(3), 313-328.

Eysenck, M.W. & Berkum, J.V. (1992). Trait anxiety, defensiveness and the structure of worry. Personality and Individual Differences, 13(12), 1285-1290.

Fathi-Ashtiani, A., Salimi, S.H. & Emamgholivand, F. (2006). Test-anxiety in Iranian students: Cognitive therapy vs. systematic desensitisation. Archieves in Medical Science, 2(3), 199-204.

Foa, E.B. & Rauch, S.A. (2004). Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 72(5), 879-84.

Foa, E.B. & McLean, C.P. (2015). The efficacy of exposure therapy for anxiety-related disorders and its underlying mechanisms: The Case of OCD and PTSD. Annual Review of Clinical Psychology, 12(1), 1 28.

Goldfried, M.R., Linehan, M.M. & Smith, J.L. (1978). Reduction of test anxiety through cognitive restructuring. Journal of Consulting and Clinical Psychology, 46(1), 32-39.

Gregor, A. (2005). Examination anxiety live with it, control it or make it work for you? School Psychology International, 26(5), 617-635.

Hanrahan, F., Field, A.P., Jones, F.W. & Davey, G.C. (2013). A meta-analysis of cognitive therapy for worry in generalized anxiety disorder. Clinical Psychology Review, 33(1), 120-132.

Hayes, S.C. (1994). Content, context, and the types of psychological acceptance. In Hayes SC, Jacobson NS, Hembree, R. (1988). Correlates, causes, effects and treatment of test anxiety. Review of Educational Research, 58, 47-77.

Hollon, S.D. & Kendall, P.C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4(4), 383-395.

Holroyd, K. (1976). Cognition and desensitization in the group treatment of test anxiety. Journal of Consulting and Clinical Psychology, 44(6), 991-1001.

Karatepe, H.T., Yavuz, K.F. & Türkcan, A. (2013). Ruminatif Düşünme Biçimi Ölçeği’nin Türkçe geçerlilik ve güvenilirliği. Klinik Psikofarmakoloji Bulteni, 23(3), 231-241.

Manassis, K., Mendlowitz, S.L., Scapillato D., Avery, D., Fiksenbaum, L., Freire, M., Monga, S. & Owens, M. (2002). Group and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial. Journal of the American Academy of Child & Adolescence Psychiatry, 41(12), 1423 1430.

Munshi, K., Eisendrath, S. & Delucchi, K. (2013). Preliminary long-term follow-up of mindfullness-based cognitive therapy-induced remission of depression. Mindfulness, 4(4), 354-361.

Orbach, G., Lindsay, S. & Grey, S. (2007). A randomised placebo-controlled trial of a self-help: Internet-based intervention for test anxiety. Behavior Research and Therapy, 45(3), 483–496.

Öner, N. & Le Compte, A. (1985). Durumluk sürekli kaygı envanteri el kitabı. İstanbul: Boğaziçi Üniversitesi Yayınları,.

Özbaş, A.A., Sayın, A. & Coşar, B. (2012). Üniversite sınavına hazırlanan öğrencilerde sınav öncesi anksiyete düzeyi ile erken dönem uyumsuz şema ilişkilerinin incelenmesi. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi, 1(2), 81-89.

Rajiah, K. & Saravanan, C. (2014). The effectiveness of psychoeducation and systematic desensitization to reduce test anxiety among first-year pharmacy students. American Journal of Pharmaceutical Education, 78(9), 1-7.

Roemer, L. & Orsillo, S.M. (2007). An open trial of an acceptance-based behavior therapy for generalized anxiety disorder. Behavior Therapy, 38(1), 72-85.

Sarason, I.G. (1984). Stress, anxiety, and cognitive interference: reaction to test. Journal of Personality and Social Psychology, 46(4), 929–938.

Savaşır, I. & Şahin, N.H. (1997). Bilişsel davranışçı terapilerde değerlendirme: Sık kullanılan ölçekler. Ankara: Türk Psikologlar Derneği Yayınları,.

Silverman, W.K., Kurtines, W.M., Ginsburg, G.S. Weems, C.F., Lumpkin, P.W. & Carmichael, D.H.. (1999) Treating anxiety disorders in children with group cognitive-behavioral therapy: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 67(6), 995-1003.

Spielberger, C.D. (Ed.). (1972). Anxiety as an emotional state: Anxiety-current trends in theory and research (pp. 23-49), New York: Academic Press.

Spielberger, C.D., Gorssuch, R.L., Lushene, P.R. & Jacobs, G.A. (1983) Manual for the state-trait anxiety inventory. Palo Alto: Consulting Psychologists Press.

Spielberger, C.D. & Vagg, P.R. (Ed.). (1995). Test Anxiety: A transactional process model. Test Anxiety: theory, assessment and treatment (pp. 6-7). Washington, DC: Taylor & Francis.

Sportel, B. E., de Hullu, E., de Jong, P. J., & Nauta, M. H. (2013). Cognitive bias modification versus CBT in reducing adolescent social anxiety: a randomized controlled trial. Plos One, 8(5), e64355.

DOI:10.1371/journal.pone.0064355.

Ulusoy, M. (1993). Beck Anksiyete Envanteri: geçerlik ve güvenirlik çalışması. (Uzmanlık tezi), Bakırköy Prof.Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul.

Williams, L.M. (2006). Acceptance and commitment therapy: An example of third-wave therapy as a treatment for Australian Vietnam War veterans with posttraumatic stress disorder. (Unpublished dissertation).

Charles Stuart University/Bathurst, New South Wales.

Zeidner, M. (1998). Test anxiety: The state of the art. New York: Plenum Press.

Zettle, R.D. (2003). Acceptance and commitment therapy (ACT) vs. systematic desensitization in treatment of mathematics anxiety. The Psychological Record, 53, 197-215.

Kaynak Göster