Intervention
cognitive distortions
DISEASE, SESSION, EVENTS, MUSCLE RELAXATION
The researcher conducted the group counseling in 8 sessions of 60–90 min weekly with 5–7 women in each group in a quiet room. All health and safety protocols were observed to prevent the spread of COVID-19. Online counseling was also available for whom wanted to participate due to pandemic conditions; it was provided in eight calls of 45 min weekly. Additionally, the counseling was conducted in the native language. The content of the sessions included mood screening, introducing cognitive-behavioral patterns, practicing skills, challenging thoughts, generalizing and maintaining, following up, and evaluating after the intervention. The content of the sessions was as follows:Session 1: The researcher attempted to establish a proper relationship with the participants. She explained the number and duration of each session, group rules, problem identification, cognitive-behavioral patterns, problem description, the concept of stress and its effects, objectives, and receiving feedback from counseling sessions.Session 2: Mood checking, presenting the progressive muscle relaxation and its practice, homework assignment: planning for progressive muscle relaxation twice a day, and receiving feedback.Session 3: Reviewing the cognitive-behavioral pattern according to the problem, mood checking, asking the participants to explain their issues, introduction of imagery practice, homework assignment: progressive muscle relaxation, and imagery practice.Session 4: Mood checking, reviewing the imagery practice, introduction of the first three columns of the thought record sheet (situation – automatic thoughts - emotions and mood) and the concept of hot thoughts, practicing the sheet using one of the events of last week, homework assignment: imagery practice, and receiving feedback.Session 5: Mood checking, discussing the treatment process, reviewing the homework, introducing cognitive distortions, completing the three columns of thought record sheet (situation - automatic thoughts - emotions and mood), identification and challenging hot thoughts, homework assignment: completing the three columns of thought record sheet, and receiving feedback.Session 6: Mood checking, reviewing the homework, presenting thought challenging and the seven-column thought record sheet (situation – automatic thoughts - emotions and mood - confirming evidence - rejecting evidence - alternative thinking - re-evaluating), completing the columns during the session, introducing the concept of challenging hot thoughts, homework assignment: relaxation techniques, and receiving feedback.Session 7: Mood checking, reviewing the homework, completing the seven-column thought record sheet, homework assignment: completing the seven-column thought record sheet, and receiving feedback.Session 8: Mood checking, reviewing the homework and treatment process (cognitive behavioral techniques), prevention, introducing self-management sessions, homework assignment: self-management practice.The validity of the intervention program (CBT sessions) was reviewed and approved by the research consultant professor (third author as a psychologist) and the reviewer of the research project (another psychologist). The control group received routine drug treatments related to the disease. After the intervention, STAI, BDI, and PCOSQ questionnaires were completed again by both groups.