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. 2020 Jul 20;2020(7):CD013684. doi: 10.1002/14651858.CD013684

Roghanchi 2013.

Methods Study design: RCT
Study grouping: parallel group
Unit of randomisation: individuals
Power (power & sample size calculation, level of power achieved): small sample size (n = 24) as main limitation; achieved power not specified
Imputation of missing data: not specified
Participants Country: Iran
Setting: university
Age: mean = 21.53 (SD = 1.86); range = 19 ‐ 24 years
Sample size (randomised): 24
Sex: 16 women, 8 men
Comorbidity (mean (SD) of respective measures in indicated, if available) at baseline: not specified
Population description: first year undergraduate students admitted into the counselling centre at Razi University, Iran
Method of recruitment: not specified
Inclusion criteria: not specified
Exclusion criteria: not specified
Attrition (withdrawals and exclusions): not specified
Reasons for missing data: not specified
Interventions Intervention: Rational emotive behaviour therapy (REBT) and art therapy (engraving on copper) (n = 12)
  • delivery: face‐to‐face, group sessions

  • provider: researchers

  • duration of treatment period and timing: 10 weekly 2‐hour sessions; REBT sessions: presenting programme of REBT for 50 minutes + summarising for 10 minutes; homework assignments

  • description:

    • purpose of REBT interventions in this research: change cognitive (thinking), emotive (feeling) with behavioural (acting) techniques for the improvement of participants and to assist them in the development of their individual adaptive behaviour

    • SESSION 1: a) REBT: introducing, “Quick Autobiographies” technique, aims and process group, consent and contract forms, summary and conclusion; b) art: “Breathing” technique, talking about craft, engraving and art therapy, process of engraving, disputing about selected images, summary

    • SESSION 2: a) REBT: “name games” technique, reviewing previous session, “here and now”, presenting A‐B‐C model: A (activating events), B (behaviour), and C (consequence), “self‐talk”, “Shame‐attacking” technique and role‐playing, summary and conclusion; b) art: practising “Mirroring” technique and role‐playing, pasting pictures onto plates of wood, appearing feeling and thinking about art‐making, summary

    • SESSION 3: a) REBT: recalling A–B–C model, representing A–B–C–D–E, “should”, “ought”, and “musts”, presenting homework about A–B–C–D–E model and self‐help form, summary and conclusion; b) art: presenting “Self‐portraits: Realistic Tools” technique, making chisel, engraving into wood, encouraging members to express their feelings and thinking about process of the meeting and presenting feedback to each other, summary

    • SESSION 4: a) REBT: recalling A–B–C–D–E model, learning of Ellis’s 15 main irrational, monitoring negative automatic thoughts and presenting homework assignments, summary and conclusion; b) art: Masks” technique, continuous engraving on the wood and pasting pictures on copper plates, disputing, summary

    • SESSION 5: a) REBT: presenting a summary of previous week sessions, monitoring homework assignment, “cognitive disputing” technique, and role‐playing, presenting homework, summary and conclusion; b) art: training “Advertisements” technique and role‐playing, starting engraving onto copper, discussing about artwork, presenting feedback, summary

    • SESSION 6: a) REBT: reviewing the previous session; monitoring homework assignment; “Reframing” technique, role‐playing and feedback; “Coping self‐statements” technique, role‐playing, feedback; presenting homework; summary and conclusion; b) art: presenting “Aspects of Self” technique, role‐playing; continuous engraving onto plates of copper, discussing about artwork, feedback; summary

    • SESSION 7: a) REBT: reviewing the previous session; monitoring homework assignment, training “imaginal disputing” technique, role‐playing, feedback; presenting homework about “imaginal disputing” technique, summary; b) art: presenting “self‐statements” technique and role‐playing; continuous engraving, discussing about artwork and presenting feedback; summary

    • SESSION 8: a) REBT: reviewing the previous session; monitoring homework assignment, training “behaviour disputing” technique, role‐playing, feedback; presenting homework about “behaviour disputing” technique, summarise; b) art: presenting “good or bad” technique, role‐playing; continuation of engraving, discussing about artwork, feedback; summary

    • SESSION 9: a) REBT: reviewing the previous session; monitoring homework assignment, explaining “cost‐benefit analysis” technique, “lifeline” technique; presenting a design for change in future life; summarise and conclusion; b) art: presenting “Losses” technique and role‐playing; continuation of engraving, discussing about artwork, presenting feedback; summary

    • SESSION 10: a) REBT: reviewing the previous session; expressing final sentences by the counsellor, sharing thoughts and feelings concerning the final of the group; encouraging members to express changes, understanding, and insights themselves during the process of REBT; participants wrote a letter about themselves to important people in their lives; b) art: describing “Reviewing Artwork”; separating images created from the pitch; the facilitator closed the group session with arguments of tenderness, presenting positive feedback; post‐test assessments (Self‐esteem and Resilience Questionnaire) were completed by participants

  • compliance: not specified

  • integrity of delivery: not specified

  • economic information : not specified

  • theoretical basis: Rational emotive behaviour therapy: important view to cognitive‐behavioural therapy (CBT) as the approach uses cognitive (thinking), emotive (feeling), and behavioural (acting) techniques for the improvement of participants and treatment of mental disorders; art therapy based on Liebmann 2004: warming up, art‐making, discussion


Control: wait‐list control (n = 12)
  • compliance: not specified

Outcomes Outcomes collected and reported:
  • resilience ‐ CD‐RISC Persian version

  • self‐esteem ‐ Persian version of Coppersmith’s Self‐esteem Inventory


Time points measured and reported: 1) pre‐intervention; 2) post‐intervention
Adverse events: not specified
Notes Contact with authors: We contacted the authors for the SDs for both outcomes at both time points and if there had been any missing data. We also asked if healthcare students had been included in the final sample, but received no response
Study start/end date: not specified
Funding source: not specified
Declaration of interest: not specified
Ethical approval needed/obtained for study: not specified
Comments by study authors: not relevant
Miscellaneous outcomes by the review authors: unclear if healthcare students were included in the study
Correspondence: Mahmoud Roghanchi, PhD; School of Social Science, Razi University, Kermanshah, Iran and School of Educational Studies, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia; mahmoudroghanchi@yahoo.com