The Impact of Reality Therapy on Distress Tolerance and Action Flexibility in Adolescents Afflicted with Coagulation Disorders

Introduction: Adolescents with coagulation disorders, such as hemophilia, often face significant psychological challenges due to the chronic and unpredictable nature of their condition. Enhancing their psychological resilience is essential for improving their quality of life. This study examines the effectiveness of Reality Therapy in increasing distress tolerance and cognitive flexibility among these adolescents. Method: This semi-experimental study used a pre-test, post-test design with a control group and a three-month follow-up. The statistical population included all adolescents (۱۳-۱۸ years old) with blood coagulation disorders, members of the Iranian Hemophilia Center. A sample of ۳۲ participants was selected using a convenient sampling method, with simple random assignment to experimental (n=۱۶) and control (n=۱۶) groups using the method of assigning random spheres. The intervention consisted of weekly ۹۰-minute sessions over ۱۲ weeks. Outcomes were measured using the Distress Tolerance Questionnaire (DTQ) and the Connor–Davidson Resilience Scale (CD-RISC). Data analysis was performed using SPSS software, version ۲۳. Results: According to findings, Reality Therapy significantly improved distress tolerance in the experimental group compared to the control group (p < ۰.۰۰۱), with an effect size of ۰.۴۲. Cognitive flexibility also showed a significant increase (p < ۰.۰۰۱) with an effect size of ۰.۸۸. These improvements were maintained during the three-month follow-up period. Subscale analysis indicated significant gains in stress regulation, personal competence, trust in personal impulses, and skillfulness in the intervention group. Conclusion: Reality Therapy effectively enhances distress tolerance and cognitive flexibility in adolescents with coagulation disorders. These findings suggest that Reality Therapy is a valuable therapeutic approach for improving psychological resilience in this population.

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Keywords: Adolescents , Coagulation disorders , Reality Therapy , Distress tolerance , cognitive flexibility