Effectiveness of Systemic Therapy on Resilience and Hope in Patients with Thalassemia
Keywords:
Systemic therapy, resilience, hope, thalassemiaAbstract
Objective: This study aimed to determine the effectiveness of systemic therapy on resilience and hope among patients with thalassemia.
Methods and Materials: A quasi-experimental pretest–posttest–follow-up design with a control group was used. The population included thalassemia patients aged 10–30 years in Zahedan. Thirty participants were selected and randomly assigned to experimental and control groups. The experimental group received eight 90-minute sessions of systemic therapy. Data were collected using the Connor–Davidson Resilience Scale and the Hope Scale. Statistical analyses included multivariate analysis of covariance and repeated-measures analysis of variance.
Findings: Systemic therapy produced a significant improvement in resilience and a significant increase in hope in the experimental group compared with the control group. These therapeutic effects remained stable at the follow-up stage.
Conclusion: Systemic therapy is an effective psychological intervention for enhancing resilience and increasing hope in patients with thalassemia, with sustained outcomes over time.
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References
Abbas, A., & Lieberman, J. (2015). Pharmacological treatments for schizophrenia. In P. E. Nathan, J. M. Gorman, & th (Eds.), A guide to treatments that work (pp. 175-216). Oxford University Press. https://doi.org/10.1093/med:psych/9780199342211.003.0006
Abood, H. T., & Hasan, A. M. A. (2025). Physical and Psychological Aspects of School-Age Children with Major Thalassemia. Culture, 12(2), 129-136. https://doi.org/10.61838/ijbmc.v12i2.852
Alahdadi, N., Mirzaei, E., & Makhsous, A. (2024). The Study of Social Life of Patients with Thalassemia: a Foundation Data Study. Social Welfare Quarterly, 24(94). https://doi.org/10.32598/refahj.24.94.2594.6
Ali, S., Mumtaz, S., Shakir, H. A., Khan, M., Tahir, H. M., Mumtaz, S., Mughal, T. A., Hassan, A., Kazmi, S. A. R., Sadia, Irfan, M., & Khan, M. A. (2021). Current status of beta‐thalassemia and its treatment strategies. Molecular Genetics & Genomic Medicine, 9(12), e1788. https://doi.org/10.1002/mgg3.1788
Arab, F., Mardpour, A., & Mahmoudi, A. (2025). Comparing the Effectiveness of Structural Family Therapy and Transactional Analysis Therapy on Marital Apathy in Couples with Marital Dissatisfaction. Modern Psychological Research Journal, 19(76), 230-243. https://psychologyj.tabrizu.ac.ir/article_18947.html
Dallos, R., & Draper, R. (2024). Introduction to Family Therapy. McGraw-Hill Education. https://books.google.com.na/books?id=-L1NFqkRaJEC&source=gbs_navlinks_s
Danjou, F., Anni, F., & Galanello, R. (2011). Beta-thalassemia: from genotype to phenotype. Haematologica, 96(11), 1573. https://doi.org/10.3324/haematol.2011.055962
Farrer, E., Seal, K., O'Shaughnessy, R., & Dallos, R. (2025). Developing systemic therapies in a specialist perinatal mental health service using an attachment narrative therapy approach. Human Systems, 5(1), 3-19. https://doi.org/10.1177/26344041241270212
Fishman, C. (1975). The structure of family therapy. Brunner/Mazel.
Ghanavati, A., Joharifard, S., & Ehteshamzadeh, P. (2025). The Effectiveness of Group Emotion-Based Family Therapy on Self-Differentiation and Alexithymia in Adolescent Girls with Psychosomatic Disorders. Rooyesh-e-Ravanshenasi Journal, 13(9), 121-130. https://frooyesh.ir/article-1-5385-en.html
Goldenberg, I., & Goldenberg, H. (2012). Family therapy: An overview. Brooks/Cole. https://books.google.com/books/about/Family_Therapy.html?id=3bJ1tQAACAAJ
Gunn Jr, W. B., Haley, J., Prouty, A. M., & Robertson, J. (2015). Systemic approaches: Family therapy. In Counseling and Psychotherapy with Children and Adolescents: Theory and Practice for School and Clinical Settings, Fifth Edition (pp. 317-355). https://doi.org/10.1002/9781394259496.ch9
Heatherington, L., Friedlander, M. L., Diamond, G. M., Escudero, V., & Pinsof, W. M. (2014). 25 Years of systemic therapies research: Progress and promise. Psychotherapy Research, 25(3), 348-364. https://doi.org/10.1080/10503307.2014.983208
Hemmatipour, A., Rokhafrooz, D., Ghahfarokhi, S. M. R., & Mirmoghtadaie, Z. (2024). Effect of Family-Centered Empowerment Model Using Mobile Learning on the Quality of Life in Children with Thalassemia: A Quasi-Experimental Study. Jundishapur Journal of Chronic Disease Care, 13(1). https://doi.org/10.5812/jjcdc-138139
Hikmatipour, B., & Doostkam, M. (2020). The Effectiveness of Systemic Therapy on the Sense of Psychological Coherence and Family Functioning in Families with a Child Affected by Attention Deficit/Hyperactivity Disorder (ADHD). The Third International Conference on Psychology, Counseling, Education, and Training, https://en.civilica.com/doc/1197516/
Karanian, F., Arefi, M., & Amiri, H. (2021). Comparing the Effectiveness of Bowenian Family Therapy and Acceptance and Commitment Therapy (ACT) on the Differentiation of Mothers with an Only Child. Journal of Iranian-Islamic Family Studies, 1(1), 31-44. https://www.magiran.com/paper/2457503/a-comparison-of-the-effectiveness-of-bowenian-family-therapy-and-acceptance-and-commitment-based-therapy-act-on-differentiation-of-mothers-with-one-child?lang=en
Kazemi Zeinlani, A. (2024). Family Therapy: New Concepts and Approaches in Treating Family Problems. The Second International Conference on Sociology, Social Sciences, and Education with a Future-Oriented Approach, https://en.civilica.com/doc/2152852/
Kumar, P. P., Manohar, J. S., Janardhan, A., & Raman, R. (2025). Psychiatric morbidity and cognitive ability in children with β-thalassemia: A hospital-based cross-sectional study. Archives of Mental Health. https://doi.org/10.4103/amh.amh_219_24
Minuchin, S. (1974). Families and family therapy. Harvard University Press. https://doi.org/10.4159/9780674041127
Minuchin, S., Nichols, M. P., & Lee, W. Y. (2011). Assessing families and couples: From symptom to system. Javdaneh Publishing. https://books.google.com/books/about/Assessing_Families_and_Couples.html?id=zw3dAAAACAAJ
Minuchin, S., Reiter, M. D., & Borda, C. (2021). The Craft of Family Therapy: Challenging Certainties. Routledge. https://doi.org/10.4324/9781003110996
Mobus, G. E., & Kalton, M. C. (2014). Principles of Systems Science. Springer. https://doi.org/10.1007/978-1-4939-1920-8
Nichols, M. P., & Tafuri, S. (2013). Techniques of Structural Family Assessment: A Qualitative Analysis of how experts promote a systemic perspective. https://pubmed.ncbi.nlm.nih.gov/23763681/
Origa, R. (2017). β-Thalassemia. Genetics in Medicine, 19(6), 609-619. https://doi.org/10.1038/gim.2016.173
Pinquart, M., Oslejsek, B., & Teubert, D. (2014). Efficacy of systemic therapy on adults with mental disorders: A meta-analysis. Psychotherapy Research, 26(2), 241-257. https://doi.org/10.1080/10503307.2014.935830
Ranayi, Z., Soleimaniyan, A. A., Mohammadzadeh Ebrahimi, A., & Ghasemi Motlaq, M. (2023). Comparing the Effectiveness of Bowenian Systemic Therapy and Combined Bowenian Systemic Therapy and Neurofeedback on Reducing the Resilience Level of Students. Journal of Knowledge & Research in Applied Psychology, 24(94), 227-244. https://www.magiran.com/paper/2703803/comparison-of-the-effectiveness-of-bowen-s-system-therapy-and-the-combination-therapy-of-bowen-s-system-and-neurofeedback-on-reducing-students-anxiety?lang=en
Retzlaff, R., von Sydow, K., Beher, S., Haun, M. W., & Schweitzer, J. (2013). The efficacy of systemic therapy for internalizing and other disorders of childhood and adolescence: A systematic review of 38 randomized trials. Family Process, 52(4), 619-652. https://doi.org/10.1111/famp.12041
Robinson, R. (2025). Systemic family therapy through the eyes of a clinical psychology trainee in 2024: History, context and clinical application. Human Systems. https://doi.org/10.1177/26344041251319529
Sari, T. T., Rahmartani, L. D., Wirahmadi, A., Selene, N. B., Iskandar, S. D., & Wahidiyat, P. A. (2024). Psychological Burden among Pediatric Thalassemia Major Patients in Indonesia: A Review. Thalassemia Reports, 14(2), 33-43. https://doi.org/10.3390/thalassrep14020005
Scaramellini, N., Panzieri, D. L., & Cappellini, M. D. (2025). Gene therapy for sickle cell disease and thalassemia. Current Opinion in Hematology, 32(3), 120-129. https://doi.org/10.1097/MOH.0000000000000867
Sefiddari, L., Mohammadzadeh Ebrahimi, A., & Hemat Afza, P. (2022). The Effectiveness of Bowenian Systemic Therapy on Chronic Resilience and Differentiation in Patients with Psychosomatic Disorders. Journal of Psychological Science, 21(115), 1375-1390. https://doi.org/10.52547/JPS.21.115.1375
Sener, D., Sadri, S., & Gursoy, V. (2024). Investigation of Depression, Anxiety, Sleep Quality, and Fatigue in Thalassemia Major Patients: A Study of the Correlation Between Sleep Quality and Laboratory Findings. Cureus, 16(10). https://doi.org/10.7759/cureus.72614
Shiri, F., & Goodarzi, M. (2020). The Effectiveness of Systemic-Behavioral Couple Therapy on Family Functioning and Sexual Function of Women with Addicted Husbands. Journal of Applied Psychology, 14(4), 345-368. https://www.magiran.com/paper/2242166/the-effectiveness-of-systemic-behavioral-couple-therapy-on-family-function-and-sexual-function-of-women-with-addicted-spouse?lang=en
Sikandar, A., Anwar, A., Afzal, A., & Nayab, M. (2024). Psycho-Social Challenges and Coping Strategies of Caregivers of Thalassemia Patients in District Gujrat. Journal of Asian Development Studies, 13(1), 945-958. https://doi.org/10.62345/jads.2024.13.1.78
Tarım, H. Ş., & Öz, F. (2022). Thalassemia major and associated psychosocial problems: A narrative review. Iranian Journal of Public Health, 51(1), 12-18. https://doi.org/10.18502/ijph.v51i1.8287
Tuo, Y., Li, Y., Li, Y., Ma, J., Yang, X., Wu, S., Jin, J., & He, Z. (2024). Global, regional, and national burden of thalassemia, 1990-2021: A systematic analysis for the global burden of disease study 2021. EClinicalMedicine, 72, 102619. https://doi.org/10.1016/j.eclinm.2024.102619
Ul Hassan Rashid, M. A., Abbasi, S. S., & Manzoor, M. M. (2020). Socio-religious prognosticators of psychosocial burden of beta thalassemia major. Journal of religion and health, 59(6), 2866-2881. https://doi.org/10.1007/s10943-020-01069-6
Vafaei, M., Azad, M., Shiyargar, P., & Kazemi Haki, B. (2015). Investigating the Quality of Life of Patients with Major Thalassemia Referring to the Thalassemia Clinic of Booali Hospital in Ardabil in 2013-2014. Journal of Medical Sciences, Islamic Azad University, 25(4), 305-310. https://www.magiran.com/paper/1478679/quality-of-life-in-patients-with-thalassemia-major-referred-to-ardabil-buali-hospital-in-2012-13?lang=en
Wang, M., Huang, M., & Hong, Y. (2022). Psychological intervention in children with transfusion‐dependent β‐thalassaemia. Vox Sanguinis, 117(3), 386-392. https://doi.org/10.1111/vox.13201
Zare, K. (2012). Investigating the Quality of Life of Thalassemia Patients at the Thalassemia Center of Shafa Hospital and Their Caregivers. Chronic Disease Care, 1(1), 45-53. https://www.magiran.com/paper/1137805/quality-of-life-in-children-with-thalassemia-who-referred-to-thalassemia?lang=en
Zhang, S., Dong, Z., Yan, W., Wang, W., Pei, Y., & Feng, Z. (2025). The Progress in Treatment of β-Thalassemia and Research on Animal Models of the Disease. Applied Sciences, 15(3), 1661. https://doi.org/10.3390/app15031661
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