Comparison of the Effectiveness of the Transactional Analysis , Existential , Cognitive , and Integrated Group Therapies on Improving Problem-Solving Skills

Bahramali A. Ghanbari-e-Hashem-Abadi, Mustafa Bolghan-Abadi, Zahra Vafaei-e-Jahan, Raheleh Maddah-Shoorcheh, Elaheh Maddah-Shoorcheh Ferdowsi University of Mashhad, Mashhad, Iran; Family Counseling, Ferdowsi University of Mashhad, Mashhad, Iran; General Psychology, Ferdowsi University of Mashhad, Mashhad, Iran; Tabaran Institute Higher Education, Tabaran, Iran. Email: mbolghan@gmail.com Received January 15, 2011; revised March 18, 2011; accepted April 25, 2011.


Introduction
Problem-solving is a cognitive process by which the individual tries to find a suitable solution for the problem (Perla & O' Donnel, 2004).In problem-solving, finding a specific solution for a specific problem is not that much important, the thing that matters is to find an abstract rule or principle that can be generalized for other situations (Khoshkam, Malekpoor, & Molavi, 2008).Problem-solving is a vital skill for life.Today in all activities, the authorities are called for thinking in a high level and problem-solving skills, whether in normal or complicated activities.And most of them emphasize that problem-solving skills must be improved (Poshtiban, 2007).When facing a Program, every individual uses a different method of problem-solving.Methods of problem-solving are: helplessness in solving a problem, problem-solving control, avoidance style, creative style, problem-solving confidence and approach style.The first there styles are called ineffective problem-solving methods and the last three styles are called effective problem-solving methods (Cassidy & Long, 1996).Problem-solving is a coping skill which increases self-confidence and has a connection with good personal compatibility (Eizadi & Scpasi-Ashtiani, 2010).In problem-solving approach, therapy begins with focusing present goals.Focusing on present goals probably persuades the clients to concentrate on the problem and after that he/she will concentrate on the solutions.
Solutions are the results of conversations and each solution is unique (Prochaska & Norcross, 2010).In the late 1960s and the early 1970s, problem-solving started as a port of cognitive-behavioral movement to modify behavior.D'Zurilla & Aoldfried who are the founders of this method in on article at American Psychological Association conference in 1968-emphasized on the necessity of teaching problem-solving skill in the program of teaching social skills.Since then, this method is used in a vast range of clinical counseling and psychotherapy situations and positive results are reported (Nezu & D'zurrila, 2001).
Problem-solving is an intellectual process and is part of larger problem process that includes problem finding and problem shaping.Considered the most complex of all intellectual functions, problem-solving has been defined as higher-order cognitive process that requires the modulation and control of more routine or basic skills (Goldstein & Levin, 1987).Problemsolving requires a variety of skills including clarifying informa-tion, programming and working methodically, checking outcomes and trying alternative strategies (Muir, Beswick, & Williamson, 2008).
The issue of Problem-solving has attracted the attention of many researchers.The findings show that it is not so much important that people face problems and difficulties in their lives, but the thing which is important is to behave correctly when facing problems.Some people are not even able to solve their routine Problems and when facing a trivial problem they become embarrassed, upset and tense (Shokohi-Yekta & Parands, 2008).According to the aforementioned materials, the necessity of teaching problem-solving skill becomes evident.The purpose of the present study is to find answers to this question: Is there any difference on improving problem-solving skill between the four therapy groups?
To achieve this goal, transactional analysis, existential, cognitive and integrated group therapies were formed which were based on teaching problem-solving skill.The hypothesis of the study suggests that after group therapies, there is difference between control group and experimental groups in the extent of problem-solving skill.Similar studies in problem-solving skill show that teaching problem-solving skill has been effective in decreasing Parent-child conflicts (Moradi & Sanayi-e-zaker, 2006).Shafea-Abad & shams (2000) found that problem-solving skills instruction can significantly decrease the tendency to suicide, frustration and negative feelings of the youths who have attempted suicide.Heydori & Rasolzadeh ( 2007) used teaching problem-solving skill decrease girl's escape from home and it was effective.Said et al., (2010) found that teaching problem-solving skill to families with children who have chronic asthma is effective on improving their life quality that is related to the children's health.A meta-analysis of the researches done in the field of problem-solving therapies was indicative of the fact that most of the problem-solving therapies had positive results on treating depression (Cuijpers, Straten, & Warmerdam, 2007).In another meta-analysis on the effectiveness of problem-solving therapies in decreasing problems relating to physical and mental health showed that all the studies done in this area had a significant effect on decreasing psychical and mental health problems (Malouff, Thorsteinsson, & Schutte, 2007).
The results of a study showed that cognitive group therapy which was based on problem-solving has positive effects on losing weight & changing lifestyle of middle-aged American women (Murawsk et al., 2009).Cognitive functions and problem-solving skills have a significant difference between schizophrenia and healthy people (Zanello, Perring, & Huguclet, 2006).
The purpose of the present study is to compare the effectiveness of the transactional analysis, existential, cognitive, and integrated group therapies on improving problem-solving skills.The hypotheses of the study are: 1) At the end of group therapies, there is a significant difference is posttest scores of control group and experimental groups.
2) At the end of group therapies, there is a significant difference in posttest scores of transactional analysis, existential, cognitive, and integrated experimental groups.

Method
The present study is a Pre-test/Post-test control group design.The population of the study was all clients who were referring to the Ferdowsi University of Mashhad's Mental Health Centre.From this population 65 subjects were selected randomly and were placed in 5 groups in random assignment method (13 participants in each group).

Procedure
Methods of interventions were transactional analysis, existential, cognitive and integrated group therapies with teaching problem-solving skills.Participants were randomly selected among students who had referred to the Ferdowsi University of Mashhad's Mental Health Centre.They were then randomly divided into five groups of 13.Pretest measures were administered prior to the intervention.The experimental groups received eight 2-hourly intervention sessions which were weekly apart and last in 8 weeks.The same measures were administered at the posttest, which followed the last intervention session.

Measure
Problem-solving styles questionnaire: this questionnaire which was designed by Cassidy & long (1996) containers 24 Items that have two choices which totally evaluates 6 factors or problem-solving styles.These factors are: 1) Helplessness style which shows that the individual is totally helplessness in problematic situation.2) Control style that reflects inner-outer control in problematic situations.3) Creative style which shows planning and considering various solutions.4) Confidence style that believes the individual can solve the problem.5) Avoidance style that reflects ignoring and rejecting the problem rather than facing it.6) Approach style that shows positive attitude towards problems and tendency to face them.
Studies that result in designing and finding a norm are indicative of the fact that this measure is a useful, valid and reliable instrument to evaluate problem-solving methods (Mohammadi, 1997).Mohammadi and Sahebi (2001) reported the reliability of this instrument using Cronbach's alpha coefficient that equaled 0.66.In a study conducted by Babapoor Kheyrodin and Ezhey (2002) alpha coefficient was equal to 0.77.On the other hand, with considering the reliability index as validity coefficient (validity coefficient equals the second root of reliability coefficient) then validity coefficient is 87% (Babapoor kheyrodin & Ezhey, 2002).

Results
Table 1 shows means of posttests (which are modified after controlling the effect size of pretest) and standard deviation for problem-solving styles.Regarding research hypothesis and research method which was pretest-posttest experimental de-sign with control group, to analyze the data analysis of covariance test (ANCOVA) was used.Table 2 shows the results of analysis of covariance.
The results of analysis of covariance on the effect of 4 methods of group therapies that was accompanied with teaching problem-solving skills on improving problem-solving skills of According to Table 2, the main effect of group therapy is significant in all problem-solving styles except avoidance style.Therefore, to compare pairwise of groups Bonferroni post hoc test was used.According to Table 3 the results of Bonferroni post hoc test showed that in confidence, approach, and creative styles there was no significant difference between intervention groups.In control style existential intervention group (I) was more effective comparing integrated intervention group (J) (p = 0.018, MD 1 = 0.80), and also transactional analysis intervention group was more effective comparing integrated intervention group (p = 0.002, MD = 0.96).In helplessness style integrated intervention group (I) was more effective comparing existential (J) and transactional (J) intervention groups.In avoidance style, none of the intervention groups were effective on its improving.

Conclusion
The aim of the study is the comparing the effectiveness of the transactional analysis, existential, cognitive, and integrated group therapies on improving problem-solving skills.The results of the study show that transactional analysis, existential, cognitive, and integrated intervention groups are effective on improving problem-solving skills.It is to be noted that transactional analysis and existential group therapies had better function comparing to integrated group therapy.

Discussion
Problem-solving intervention therapy has been effective in reducing depression symptoms (Bell & D'Zurilla, 2009), changing and improving child-rearing style (Shure & Spivack, 1978), reducing self-efficiency and improving students' scores (Dekovis & Buist, 2005), reducing family's emotional contribution (Shokohi-Yekta & Parand, 2008), reducing exam's anxiety and improving students' educational issues (Eizadi & Sepasi-Ashtiona, 2010), reducing symptoms of Attentionseficit/hyperactivity disorder (Neshatdoost, Kalantari, & Solati, 2001).Since group therapies were based on problem-solving and the results of group therapies were effective on improving problem-solving styles, therefore, it can be concluded that these group interventions or group therapies can improve student's problem-solving styles and it is hoped to result in improving other psychic aspects.According to the previous studies the problem-solving is an important skill in life, then individuals have this skill can cope with your depression (Bell & D'Zurilla, 2009), can improve your parenting style (Shure & Spivack, 1978), have self-efficacy in your life (Dekovis & Buist, 2005), and so on.

Table 1 .
Estimated marginal means and Standard Deviation of Problem solving styles.

Table 2 .
Analysis of Covariance to control for the effect size of pre test.

Table 3 .
Pairwise comparisons by Bonferroni post hoc test.