مقایسه اثربخشی مواجهه‌درمانی روایتی و سایکودرام بر افکار منفی مرتبط با تروما در زنان پناهنده افغان: یک مطالعه نیمه‌آزمایشی

معصومه  دلسوز; علی پولادی ریشهری; مولود  کیخسروانی

Authors

Masoumeh Delsouz PhD Student, Department of Psychology, Bu.C., Islamic Azad University, Bushehr, Iran. Author https://orcid.org/0009-0002-0335-4931
Ali Poladi Rishari Associate Professor, Department of Psychology, Payame Noor University, Tehran, Iran. Author https://orcid.org/0009-0001-9726-0030
Moloud Keikhosravani Department of Psychology, Bu.C., Islamic Azad University, Bushehr, Iran. Author https://orcid.org/0000-0001-7663-4980

Keywords:

Narrative exposure therapy, psychodrama, negative trauma, related thoughts, Afghan refugee women, trauma

Abstract

Objective: This study aimed to compare the effectiveness of narrative exposure therapy and psychodrama in reducing trauma-related negative cognitions among Afghan refugee women.

Methodology: A quasi-experimental pretest–posttest design with a control group was employed. The study population consisted of Afghan refugee women aged 18 years or older residing in Tehran in 2025. Sixty eligible women were recruited through convenience sampling and randomly allocated by lottery to narrative exposure therapy, psychodrama, and control groups, with 20 participants in each group. Narrative exposure therapy was delivered in ten weekly individual sessions lasting 90–120 minutes, whereas psychodrama was provided in ten weekly 90-minute group sessions. The control group received no intervention during the study period. Data were collected using the Life Events Checklist and the Posttraumatic Cognitions Inventory. Analysis of covariance and Bonferroni-adjusted pairwise comparisons were conducted using SPSS version 27 and JASP version 0.19.

Findings: Analysis of covariance demonstrated a significant and large group effect on trauma-related negative cognitions after controlling for pretest scores (F=64.324, p<0.001, η²=0.749). However, the effects of time, the time-by-pretest interaction, and the time-by-group interaction were not statistically significant (p>0.05). Bonferroni-adjusted comparisons indicated that narrative exposure therapy produced significantly lower negative cognition scores than psychodrama (MD=-4.805, SE=0.575, p<0.001) and the control condition (MD=-6.188, SE=0.566, p<0.001). Psychodrama also resulted in a statistically significant reduction compared with the control group (MD=-1.383, SE=0.554, p=0.049).

Conclusion: Both interventions reduced trauma-related negative cognitions; however, narrative exposure therapy was more effective than psychodrama. The structured reconstruction of life narratives, gradual exposure to traumatic memories, and reprocessing of trauma-related meanings may make narrative exposure therapy a particularly appropriate culturally sensitive intervention for Afghan refugee women.

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