Methods
anger, 28).Social dysfunction, anxiety, insomnia, depression
DISORDERS
This study was a randomized clinical trial. The target population was 10th grade female high school students in the age group of 15–16 years old in Isfahan city in the center of Iran in 2019. There are two types of schools in Iran, public and non-profit schools.The students in public schools  usually live in the same neighborhood as the school is located.Since the researchers wanted to choose a public school for girls from an area with moderate socioeconomic status in the city of Isfahan, by referring to the Regional Organization of Education, 3 school were introduced to us with the  same characteristics we wanted. Among these three schools, we randomly selected one. In this school, 96 students were studying in the 10th grade. All students were included in the study by census sampling. In order to perform random allocation, first the researchers received the student numbers of the 10th grade students from the school's executive director and then entered these numbers into the SPSS software, and then using this software, the students were allocated in two groups of 32 and 64 people (32 in intervention group and 64 in the control group). The researchers reported the numbers extracted from the software to the executive director of the school and thus, the names of the students in each group were determined. ( Flow diagram of the study was given in Fig. Research flow-diagram (Based on Consort 2010 flow diagram. The inclusion criteria were informed consent to participate in the study by the students and their parents. Exclusion criteria were as follows:Participation in other psychological programs during the intervention course.History of psychological medicine use or any mental disorders.Absence for at least two sessions of training classes for the intervention group.The place where educational sessions were held and assessed was the school hall. There was no stopping guidelines for the protocol in this research. Since designed trainings were provided  in the intervention group, and the control group only received routine school training, and also both groups were in the same school, there was no possibility of blinding the participants. Only the person who entered the data and performed the statistical analysis was unaware of the studied groups.Six 90-min sessions were considered for problem-solving and assertiveness skill training which included lectures, question and answer, movie displaying, brainstorming and role-play. The role-plays were accompanied by rehearsals at home and assignments for the next session. In the second session, the students were given a pamphlet about life skills for further study. At the end of every session, homework was assigned based on the topics discussed. Reviewing the assignments at the beginning of every session, answering the question and giving feedback were also a part of each session. Empathy was used as one of the most important factors of communication with students in all sessions. The content of the sessions (shown in Table Teaching methods and contents of every sessionExplaining the goals of taking part in the group, displaying media content affective on motivation of the target group, using simple and creative methods like preparing a notebook for solving problems from today until the rest of their lives (for creative naming and problem-solving)Using balloons and writing down fears on them, then bursting them in order to eliminate the fearStablishing sincere relationships by involving class members in expressing their dreams and goalsEnhancing students’ self-confidence by hanging motivational sentences in the classroomAttempting to change the mental model of members from “I cannot” to “I can” using age-appropriate storiesDefining assertive and unassertive behavior by describing and comparing it using two different storiesPracticing critical thinking and expressing opinions using plays designed by studentsPracticing assertiveness by involving each of the class members in discussionsTeaching problem defining as the next step in problem-solving skillTeaching body language using role-play and explaining its importance in a simple wayExplaining individual rights and using visual contents in the classConsidering anger management as a method of reaching a suitable solution to the problems aheadTeaching brainstorming method as the next step in problem-solving and practicing it in classPromoting self-confidence by emphasizing on satisfaction with individual differences and physical features by telling informative storiesTeaching how to understand individual rights and express opinions by involving participants in discussionsUsing positive imagination and storytelling for motivationTeaching If–Then technique as the next step in problem-solving process and using decision-making tables techniqueRebuilding the issues that they have had encountered with at home and at school during these sessions by role-playingPracticing how to reject unreasonable requests by expressing students’ experiences in the classroomAccepting individual and physical differences and expressing dreams in public as a technique to enhance assertivenessEmphasizing on consulting in order to reach the right solution to problemsManaging stress as an important issue and by mentioned methods, and brainstorming solutions designed by studentsSaying goodbye and encouraging students to continue the practices by hanging the sentence “I should learn the skill of problem-solving and assertiveness in order to reach my dreams” on the class boardTwo questionnaires (CSEI questionnaire and GHQ 28) were completed by the students.Before starting the interventions, the students were given the questionnaires and the researchers helped the students complete them, and their questions were answered. After one month from the beginning of the intervention, the questionnaires were completed again by the students under the supervision of the researchers.The Coopersmith Self-Esteem Inventory (CSEI): We used the CSEI questionnaire (1967) in order to assess the self-esteem of the participants. This questionnaire has been widely used in several studies. Form A (the school form for adolescents age 8 to 16 years) consists of 58 items which eight of them are lie detectors. If the person scores more than four from those eight lie scale items, it means that the validity of the test is low and they have attempted to make themselves look better than they really are. The scoring method of this test is zero—one. The total 50 items are divided into four scales, representing different aspects of self-esteem including general self, social self-Peers, home parents and school academic. These scales, in addition to four other subscales, yield an overall score. The minimum score of general-self subscale will be zero with a maximum score of 26. The other three subscales will have a minimum score of zero and a maximum of eight. The maximum score possibly obtained is obviously 50 and the minimum is zero, and higher scores represent higher self-esteem levels. According to the scoring of this questionnaire, a total score of 26 or less indicates poor self-esteem, between 27 to 34 marks average and above 44 is considered strong self-esteem [General Health Questionnaire (GHQ 28): The main form of the questionnaire was developed by Goldberg and Hillier in 1970 and its reliability and validity have been investigated many times since then [The GHQ questionnaire divides into four subscales as follows:Somatic symptoms: Including items about how people feel about their health, feeling tired along with physical symptoms (Question 1–7 in GHQ 28).Anxiety/Insomnia: Including items related to insomnia and anxiety (Q 8–14 in GHQ 28).Social dysfunction: Evaluates people’s ability to cope with the demands and words and issues of daily life and reveals their feelings about coping with common life situations (Q 15–21 in GHQ 28).Severe depression: Including severe depression cases and suicidal tendencies (Q 22–28 in GHQ 28).All the parents of the students and the students themselves agreed to participate in the study and signed the consent form. During the intervention, 2 students were excluded from intervention group and 4 students were excluded from control group (shown in flow diagram of the study).In order to observe ethics in the research, a summary of the training program in the intervention group with pamphlets were also given to the control group after three months of intervention.The data was analysed using SPSS version 16.0. Chicago, SPSS Inc., Independent 