Benha University
Mental HealthDepartment
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A research plan
Entitled
TheEffectiveness OfEye Movement DesensitizationandReprocessing (EMDR) For Reducing The Social Anxiety DisorderAmong The University Students
Submitted for the registration of the PhD degree in Education
"Mental health”
Prepared by
Hazem Shawky Mohamed Mohamed EL-Tantawy
Assistant Lecturerat Mental Health department
Under the Supervision of
Dr. Nariman Mohamed Refaie Dr. Mustafa Ali Ramadan Mazloom
Professor of Mental Health Associate Professor of Mental Health
Faculty of Education, Department,Faculty of Education,
Benha University Benha University
Dr. Wagdi Abdul-Latif Zedan
Associate Professor of Mental Health Department,
Faculty of Education, Benha University
1436 AH – 2015 AD
Study motive:
The university stage is one of the most important and dangerous age stageswhich the individual undergoes through the developmental age.it is a transitional stage between teenage and adolescence, it is important in building the individual’s personality, developing of the level of thinking and culture. It is a stage in which the individual needs to express his ideas and emotions through the communication and interaction with the others in different social situations. In these situations, he encounters internal and external problems and challenges, which may be caused by the nature of the university stage itself, or it may be caused by bad experiences and shocking situations he faces when he was a child. These situations have a constant effect and cause many problems and psychological disorders which affect the academic, social and personal adjustment.
The communication and the interaction with others in different situations is one of the normal standards of the individual and the essence of the social life. The individual discovers and understands himself, and discovers and understands others. This is essential for his success and realizing goals and ambitions. When it is deeply sincere, the normality will be very clear. When it is surficial, either more takes the form of shouting or less, it will lead to neurosis. If there is no communication, one will die on the psychological level, psychosis. (Wagdi Zedan 1998, Hamid Zahran 2005, Chris kaul 2010 translated).
Anxiety is the main axis of the psychological studies in general and the psychological health in particular. It is a pivotal variety in all the psychological disorders and emotional and behavioral problems, and a vital variety in the psychological health and the consistency on all ages (Bashir Maamaria 2009:140).
The social anxiety is one of the anxiety types which are related to the personality varieties such as: underestimation, negative ideas, performance disorder, avoidance behavior, distortion of conceptual aspects, less affirmation, lack of self-confidence (Al-Naggar, et al., 2013: 1-2).
According to the psychological heritage,many studies referred to the rise in the social anxiety for the university students, reached (40%) in MaysaAnnial study, the percentage was (15 – 20%) in the study of both: Adel Albanna (2002), Ammari (2005), (15%) in Bashir Maamaria (2009), (50%) in WardaBelhessini (2011), (52%) in AlNaggar et al (2013), and (23%) in Lverach&Rapee (2014).
These percentagesconfirmed the importance of the problem, since the problem has to be properly faced with an effectivemedicament.
The medicament of Eye Movement Desensitization andReprocessing (EMDR) is a new medicament discovered by Francis Shapiro in the late 1980s and early 1990s in the last century, especially in 1989 which deal effectively with the shocking situations. This medicament is used on a wide scale in curing a wide variety of problems, psychological disorders, shocking situations and painful remembrances that the individual encounters in life (Walid Khaled 2013, 2014 Aslani, et al).
This medicament consists of three main aspects: 1. The remembrances behind the current problem 2. The current positions and the positive situations which have to make the patient go to the case of psychological health 3. Store the data again and positively in the memory so that it will suit the consistent behavior in the future (Lipike, 2000).
This medicament depends upon that the eye movement is one of activating components for activating the customer’s data, and realizing the effects of medicament.Since the eye movement right and left, up and down, by moving an activator (stick, light and finger) in front of the patient, the patient should follow this movement with his eye. This movement causes visual stimulation of the retina. Such stimulation makes the individual liberated from the emotional experiences related to the shocking situations stored in nervous system. When the individual suffers from shocking situation or painful remembrances,all the relevant sounds, ideas, emotions, persons and odors in this situation are stored by the brain. The medicament depends on stimulation of these shocking situations to float on the surface and through drawing the patient’s attention away from the painful remembrances relevant to the shocking situation and the cadential eye movements. This helps the patient cope up with the painful remembrances and emotions and makes him more aware of selecting the reaction to these experiences. The curer stores such information again and more positively so that he can speak positively about the shocking situation after the therapy sessions and to be free from the emotional experiences stored in the nervous system. So it will get rid of the concerns and emotions(Shapiro 2001).
This kind of medicament consists of complete components in many medicaments, it includes the techniques of the psychodynamic treatment, cognitive behavioral therapy, body treatment, treatment of the person, exposure therapy, in addition to the eye movement similar to the spontaneous eye movements (Shapiro &Maxfield 2002).
Shapiro (2001)indicates that the Eye Movement Desensitization andReprocessing is an integral psychological medicament relies on a group of cognitive, emotional and behavioral techniques. These techniques are as follows:
Exposure, Relaxation, Reinforcement, self-assertiveness, distraction, systematic Desensitization, Modeling, Role playing, Role Reversal, Debating, Emotional Abreaction (Catharsis), Self-Presentation, Imagination, Cognitive Restructuring and include the logical persuasion, learning the model of ABC, Stop Thinking (Tought Stopping), Self Talking, Problem Solving Approach, Self-control.
All of: TaisirShawwash (no date), Lipike 2000, JonghBroeke 2009, Walid Khalid (2011), Greyber et al 2012, indicate that the effective medicament of the anxiety, personality disorders, phobia, eating disorders, depression, post-traumatic stress disorders, schizophrenia, obsessive disorder, Attention Deficit Hyperactivity and learning difficulties.
Also, both of Jongh&Broeke (1998), Floey& Spates 2001, Feener 2004, Roos&Jongh 2008, Aslani et al 2014, agree about the effectiveness of medicament of improving the eye movement and reprocessing (EMDR) for reducing the social anxiety of the university students. Nakano (2013) refers to the effectiveness of curing the painful remembrances. And Neal (2001) refers to its effectiveness in curing the phobia. Also, both of SChurmans (2007), Roos&Jongh (2008) agree about the effectiveness of medicament (EMDR) in reducing the social phobia.Gaureau&Bouchard (2008) referred to the effectiveness of curing the generalized anxiety disorder.
According to the knowledge of the researcher, there is scarcity in Arabic studies that tackled (EMDR)in reducing the social anxiety of the university students, though it is important, and many foreign studies confirmed its effectiveness. This motivated the researcher to perform the current study trying hardly to recognize the effect of this therapy on reducing the social anxiety of the university students.
Problem of the study:
Social Anxiety is considered one of the problems of the personality varieties such as: underestimation, lack of self-confidence, negative ideas, performance disorder, distortion of conceptual aspects, less affirmation, avoidance behavior. This negatively affects the social, psychological, and academic conformity of the individual. Most university students suffer from social anxiety as confirmed by many studies in the psychological heritage such as: MaysaAnnial (1996), Adel Albanna (2002), Ammari (2005), BeshirMaamaria (2009), WardaBelhessini (2011), Al-Naggar et al (2013), Lverach&Rapee (2014).
The medicament by adjusting the Eye Movement Desensitization andReprocessing is considered one of the new medicaments that affirmed its effectiveness in curing the social anxiety and the relevant remembrances and the shocking situations encountered by the individual in his childhood. Both of Floey (1999), Floey& Spates (2001), Scott (2001), Feener (2004), Story (2004), Gaureau& Bouchard (2008), Aslani et al (2014) agreed about the therapy effectiveness of adjusting the Eye Movement Desensitization andReprocessing (EMDR) for reducing the social anxiety of the university students. According to the knowledge of the researcher, there is scarcity in Arabic studies that tackled (EMDR) in reducing the social anxiety of the university students. This motivated the researcher to use such therapy to know its effect on reducing the social anxiety of the university students and paved the way for researchers to search in this field. The problem of the study can be crystalized in answering the following questions:
1. Is the therapy by adjusting the Eye Movement Desensitization andReprocessing effective in reducing the social anxiety of the university students?
2. Does the therapeutic program extend to reduce the social anxiety for the study sample a short period after the end of the therapy “follow up”?
The Study Importance:
First: The Theoretical Importance:
1.According to the knowledge of the researcher, there is scarcity in Arabic studies that tackled (EMDR) in reducing the social anxiety of the university students. This affirms the importance of the study theoretically.
2. Trying to enrich the Arabic library of the theoretical framework of Eye Movement Desensitization andReprocessing (EMDR).
Second: The Practical Importance:
To set upthe medical program based on the Eye Movement Desensitization andReprocessing (EMDR) for reducing the social anxiety of the university students which largely contributes to the realization of the psychological, social and academic adjustment of the students.
Objectives of the study:
The current study aims at:
1. Exploring the theoretical framework of the Eye Movement Desensitization andReprocessing (EMDR).
2. Identifying the extent of the therapeutic effectiveness of the Eye Movement Desensitization andReprocessing (EMDR) in reducing the social anxiety.
The Study Terms:
Social anxiety:
It is a constant and remarkable fear, a stressed anxiety for the individuals in the social interaction and general performance situations. Their behavior will be noticeable by others either it is supposed or real, and evaluating negatively by others in these social situations. So, they suffer from frustration and grief, and they feel ashamed and confused where some symptoms appear such as: swear, face reddishness, speaking difficulty and the negative knowledge. The man with the social anxiety avoids the social situations, and raises the level of anxiety.The fear and avoidance contradict with the social, family, professional and academic functions of the individual (TahaAbdelAzim, 50: 2009).
The researcher temporarily adopts this definition till he defines the social anxiety, and accurately translates the problem of the study. It includes a group of dimensions defined by the researcher in the light of reading the frameworks of the social anxiety in the psychological field.
The social anxiety is procedurally defined through the degree obtained by the student in the social anxiety scale (prepared by the researcher).
Eye Movement Desensitization and Reprocessing (EMDR):
It is one of the complementary psychological therapy that depend on the eye movement as an effective means, for calling the experiences and shocking situations, the relevant information, sounds, ideas, emotions, persons, odors, … etc. and reprocessing and storing it again more positively. This helpsone be free from emotional experiences related to these experiences and reducing the anxiety, tension and the emotional frustration Shapiro (2001), Shapiro &Maxfield (2002).
Carrigan&Levis (1999) defines: it is one of the complementary psychological therapy that considers the eye movement a means for activating the processing system for customer data, and rebuilding it well after it is coded in memory.
The researcher defines the therapy program by adjustingEye Movement Desensitization and Reprocessing (EMDR): it is a number of the procedures and steps that stems from the cognitive, behavioral and psychodynamic that includes a number of the (cognitive, behavioral and emotional) techniques, in addition to the style of eye movement from the two sides (right and left), up and down, for recalling the experiences and the shocking situations, reprocessing it, and stored it memory more positively. This is an attempt to help the university students with the social anxiety disorder for encountering the social situations and the performance situations positively. This helps reduce the social anxiety disorder.
The study hypotheses:
1. There are statistical differences between the means of the experimental group grades and control group grades of the social anxiety scale after performing the therapy program for the sake of the experimental group.
2. There is a statistical difference between the means of the two scales grades before and after the experimental group of the social anxiety scale for the sake of the after scale.
3. There is no statistical difference between the grades of the two scales: the after scale, and what is after following the experimental group of the social anxiety scale.
The study limitations:
A. methodological limitations:
The sample study:
The sample study consists of (20) student out of the faculty of education, Benah University, they are from (19 - 20) years. They are divided into two groups: an experimental group of (10) student, and a control group of (10) student.
The study tools:
1. The social anxiety scale (prepared by the researcher).
2. The data collection form (prepared by the researcher)
3. Wechsler scale – for the intelligence of adults and adolescents (Arabized and applied by Mohamed EmadEddin and Luis Mleika 1996).
4. The therapy program of adjusting the Eye Movement Desensitization and Reprocessing (EMDR) for reducing the social anxiety of the university students (prepared by the researcher).
Methodology:
The experimental method with the dual experimental design is used, it is the design between the groups (experimental - control), and in the groups (before and after).
The statistical methods:
The following statistical methods are used:
1. Analyzing the simple contrast of the two groups, attempting to make sure of the conformity of the study groups: experimental and control before the application of the therapeutic program.
2. Mann Whitney test of the statistical significance of the independent samples.
3. Wilcoxon test of the statistical significance of the relevant samples.
B- Time limits:
This time limit is defined as the time in which the therapeutic program of the sample study, and it is also the time that it takes for the application of the therapeutic program of the sample study with two sessions a week.
C. Spatial limits:
The sample study is selected from the students of the faculty of education, Benha University. The therapeutic program will be applied to them in one of the faculty of education rooms.
The procedural steps of the study:
1. The social anxiety scale is applied (prepared by the researcher) –after make sure of the psychometric properties (truth - certainty)– of a big random sample of the students of the faculty of education, Benha University.
2. The students who got the highest degrees are selected in the social anxiety scale.
3. The researcher cares about the diagnostic criteria of the social anxiety as mentioned in the fifth statistical and diagnostic manual of the mental disorders, and the exclusion of the non-applicable cases of these diagnostic criteria.
4. The researcher divides the selected study sample into two groups: experimental (10 students), control one (10 students).
5. The researcher conforms between the experimental and control group before the application of the therapeutic program according to: age, intelligence, their grades on the social anxiety scale grades (prepared by the researcher).
6. The therapeutic program is applied to the experimental sample individuals.
7. The social anxiety scale is applied (prepared by the researcher) after the direct application of the therapeutic program (the post evaluation)on the group studies: experimental and control one.
8. The social anxiety scale is applied after (prepared by the researcher) two months after the application of the therapeutic program (follow up) of the experimental group individuals to make sure of the continuity of the effectiveness of the therapeutic program in reducing the social anxiety of the university students.
9. The suitable statistical styles are used for the access to the study results, and the results are explained in the light of the theoretical framework and the literature review.
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