Effectiveness of strength oriented family therapy on hope, anxiety, stress and depression among mothers of children with cancer

Document Type : Original Article


1 دانشگاه محقق اردبیلی

2 cM.A. in Family Counseling, Department of Educational Sciences, University of Mohaghegh Ardabili, Ardabil, Iran

3 PhD in Translation Studies, Department of Education, Faculty of Social Sciences and Liberal Arts, UCSI University Malaysia.


The aim of the present research was to study the effectiveness of strength-oriented family therapy on hope, anxiety, stress and depression among mothers of children with cancer. The research method was quasi-experimental with experimental and control groups by pre-test and post-test. The statistical population included all mothers of children with cancer in Ardabil city of Iran in 2015. A group of 30 mothers were selected by convenience sampling method, and they were placed randomly in two groups (15 persons in the experimental group and 15 persons in the control group). All participants completed the Persian version of the Herth Hope Index (HHI-Persian version) and Depression, Anxiety and Stress Scale (DASS). The experimental group received the strength-oriented intervention in 10 sessions. Multivariate analysis of covariance was applied to analyze the data. Results indicated that the strength-oriented family therapy causes a significant change in increase hope and reduce stress and depression in the experimental group. But there is no significant difference between groups in anxiety.


Amini, M., Ibrahim- González, N. (2012). The washback effect of cloze and multiple-choice tests on vocabulary acquisition. Language in India. 12 (7).
Abdi, N., Taghdisi, M.H., and Naghdi, S. (2010). Evaluate the effectiveness of interventions   promoting hope in patients with cancerin Sanandaj city. Faslname armaghane danesh, 14 (3), 13-21.
Allison, S., Stacy, A., Dadds, K., Roeger, A., Wood, A. and Martin, G. (2003). What the            family brings: gathering evidence for strengths- based work. Journal of Family         Therapy, 25(3), 263-248.
Beckwitt, S., and Jacobson, J. (2009). Children's reaction to illness and hospitalization. In: Sadock VA, Ruiz PK. Kaplan and Sadock's comprehensive Text book of     psychiatry, 9th Edition, 381.
Brown, C. (2005). "Hope and quality of life in hospice patients with cancer". Graduate Theses and Dissertations. http://scholarcommons.usf.edu/etd/2797
Brown. R., Madan-Swain, A., and Lambert, R. (2003). Posttraumatic stress symptoms in adolescent survivors of childhood cancer. Journal of Traumatic Stress, 16(4), 309–18.
Dahlquist, L., Czyzewski, D., and Jones, C. (1996). Parents of children with cancer: A longitudinal study of emotional distress, coping style, and marital adjustment two and twenty months after diagnosis. Journal of Pediatric Psychology, 21 (4), 541–54.
Dahlquist, L., Czyzewski, D., Copeland, K., Jones, C., Taub, E., and Vaughan, J. (1993). Parents of children newly diagnosed with cancer: anxiety, coping, and marital distress. Journal of pediatric psychology, 18(3), 365–76.
Earle, E. A., Clarke, S.A., Eiser, C., and Sheppard, L. (2007). ‘Building a new normality’: mothers’ experiences of caring for a child with acute lymphoblastic leukaemia. Child Care Health and Development, 33(2), 155-60.
Eiser, C. H. (2004). Cancer: the quality of life. Journal of pediatric psychology, 29(8), 579-590.
Eiser, C. H., Lawrence, E. (2006). Children with cancer: the Quality Of Life. Newjersey, USA: s8, 79-93.
Epstein, M. (1999). The development and validation of a scale to assess the emotional and behavioral strengths of children and adolescents. Remedial and Special Education, 20 (5), 258-262.
Epstein, M.H., and Sharma, J.M. (1998). Behavioral and emotional rating scale: A strength-based approach to assessment. Austin, TX: PRO-ED.
Fotokian, Z. (2004). Survey quality of life in first degree relatives of patients with cancer in care center in Tehran central Imam Khomeini (RA) Hospital, dissertation a master Iran University of Medical Sciencesand Health Services School of Nursing and Midwifery.
Hall, J. A., Smith, D.C., Tarwater, B., Steine, S. and Turnbough., M. (2005). Strengths oriented family therapy (SOFT): A Manual Guided Treatment for Substance-Involved Teens and Families, 1-44.
Harter, J. K., Schmidt, F.L., and Hayes, T.L. (2002). Business-unit-level relationship between employee satisfaction, employee engagement, and business outcomes: A meta-analysis. Journal of Applied Psychology, 87(2), 268-279.
Henry, J.D., and Crawford, J.R. (2005). The short-form version of the Depression         Anxiety Stress Scales (DASS-21): Construct validity and normative data in a           large non-clinical sample. British Journal of Clinical Psychology, 44, 227–239.
Herth, K. (1992). An abbreviated instrument to measure hopes: development and psychometric evaluation. Journal of Advanced Nursing, 17 (10), 1251-1259.
Hosseini Ghomi, T., and Salimi Bajestani, H. (2013). Effectiveness of training resiliency to stress in mothers of children with cancer in Imam Khomeini hospital in Tehran. Journal of Health Psychology, 4, 97-109.
Johnson, N.G. (2003). On treating adolescent girls: Focus on strengths and resiliency in psychotherapy. Journal of Clinical Psychology, 59 (11), 1215-1224.
Kazak, A., Stuber, M., Barakat, L., Meeske, K., Guthrie, D., and Meadows, A. (1998). Predicting posttraumatic stress symptoms in mothers and fathers of survivors of childhood cancers. Journal of the American Academy of Child and Adolescent Psychiatry, 37(8), 823–31.
Larson, L., Wittrock, A., and Sandgren, A. (1994).When a child is diagnosed with cancer: I. Sex differences in parental adjustment. Journal of Psychosoconcol, 12(1-2), 123–42.
Laursen, E. (2000). Strength based practice with children in trouble. Reclaiming Children and Youth, 9 (2), 70-75.
Libov, B., Nevid, J., Pelcovitz, J., and Carmony, T. (2002). Posttraumatic stress symptomatology in mothers of paediatric cancer survivors. Psychology and Health, 17(4), 501–11.
Lietz, C. A. (2007). Strengths-Based Group Practice: Three Case Studies. Journal of Social Work with Groups, 30(2), 73-87.
Lyrakos, G.N., Arvaniti, C., Smyrnioti, M., Kostopanagiotou, G. (2011). Translation and validation study of the depression anxiety stress scale in the Greek general population and in a psychiatric patient’s sample. Eur. Psychiatry, 26, 1731.
Manne, S., Lesanics, D., Meyers, P., Wollner, N., Steinherz, P., and Redd, W. (1995). Predictors of depressive symptomatology among parents of newly diagnosed children with cancer. Journal of Pediatric Psychology, 20(4): 491–510.
Manthey, T.J., Knowle,B., Asher, D., and Wahab, S. (2011). Strengths-based practice and motivational interviewing. Advances in Social Work, 12(2), 126-151.
McCaffrey, N.C. (2006). Major stressors and their effects on the well-being of children with cancer. Journal of Pediatric Nursing, 21(1), 59-66.
McCormack, J. (2007). Recovery and strengths based practice.  Glasgow Association for Mental Health. N.6.
McDonald, B., Boyd, A., Clark, D., and Stewart, E. (1995). Recommended individualized wraparound strategies for foster children with emotional/behavioral disturbances and their families. Community Alternatives: International Journal of Family Care, 7 (2).
McGrath, P. (2002). Beginning treatment for childhood acute lymphoblastic leukemia: Insights from the parents’ perspective. Oncol Nurs Forum, 29(6), 988 -96.
Melnyk, B.M., Feinstein, N.F., Moldenhouer, Z., and Small, L. (2000).Coping in parents of children who are chronically ill: strategies for assessment and intervention. Pediatric nursing, 27(6):548-58.
Ministry of Health and Medical Education, Center for disease control and prevention, Noncommunicable disease unit, Cancer office. Iranian annual of national cancer registration report 2008-2009. Tehran: Tandis; 2012.
Moldovan, M. (2009). Risk perception, worry and communication as predictors of lung, colon and skin cancer-related behaviors. Florida: Florida State University Communication.
Ortiz, E.V. (2005). Strength oriented models of counseling and resiliency. University of Miami behavioral health, 1-27.
Rahimi, F., EsfandiarI, M.R. & Amini, M. (2016). An Overview of Studies Conducted on Washback, Impact and Validity. Studies in Literature and Language, 13(4), 6-14.
Ramírez -Johnson, J.R., Diaz, H.L., Feldman, J.B., Ramírez-Jorge, J.R. (2013). Empowering Latino church leaders to deal with the HIV-AIDS crisis: A strengths-oriented service model. Journal of religion and health. 52(2), 570-588.

Reynolds, J.C. (2012). The effect of a strengths-oriented approach to leadership development on the psychological capital and authentic leadership capacities of leaders in faith-based higher education institutions. Azusa pacific university, 164.

Rodrigues, N., and Patterson, J.M. (2007). Impact of severity of a child’s chronic condition on the functioning of two-parent families. Journal of Pediatric Psychology, 32(4), 417-26.
Runesson, I., and Elander, G. (2000). Observed parental needs during their child's hospitalization. Journal of pediatric nursing, 17(2), 140-8.
Saegrove, S. (2005). Health, quality of life and cancer. International Nursing Review, 52(3), 533-40.
Scheel, M.J., Davis, C. K. and Henderson, J.D. (2012). Therapist use of client strengths: A qualitative study of positive processes. The Counseling Psychologist, 1-36, 15-16.
Sharry, J. (2004). Counselling children, adolescents and families: A strength-based approach. London: Sage Publications.
Sheldon, K., Frederickson, B., Rathunde, K., and Csikszentmihalyi, M. (2000). Positive psychology manifesto (Rev.ed.)-[On-line]. Available: http://www.positive psychology.org/akumalmanifesto.htm.
Sloper, P. (2000). Predictors of distress in parents of children with cancer: A prospective study. Journal of Paediatric Psychology, 25(2), 79–91.
Smith, D.S. and Hall, J. (2008). Strength- oriented family therapy for adolescents with substance abuse problems. National Association of Social Workers (social work), 53(2), 185-188.
Svavarsdottir, E.K., Sigurdardottir, A.O., and Tryggvadottir, G.B. (2014). Strengths-oriented therapeutic conversations for families of children with chronic illnesses: Findings from the Landspitali University Hospital Family Nursing Implementation Project: Journal of Family Nursing, 20(1), 13–50.
Turnell, A. (2010). The Signs of Safety: A comprehensive briefing paper: Resolutions Consultancy Pty Ltd.
Walsh, F. (2006). Strengthening family resilience. New York, London: Guilford Publications.
Wong, D., Hockenberry, M., Wilson, D., Winkelstein, M., and Kline, N. (2003). Wong’s nursing care of infants and children, Mosby, St. Louis, Mo.
Woodgate, R. L., and Yanofsky, R.A. (2010). Parents’ experiences in decision making with childhood cancer clinical trials. Cancer Nursing, 33(1), 11-8.
Woodgate, R.L., and Degner, L.F. (2002). Nothing is carved in stone! Uncertainty in children with cancer and their families. European Journal of Oncology Nursing, 6(4), 191-202.
Yaqubi, M. Tahir R. I. & Amini, M. (2018). Translation of Onomatopoeia: Somewhere between Equivalence and Function. Studies in Linguistics and Literature. 2 (3), 205-222.