IAHRW International Journal of Social Sciences © 2021 Indian Association of Health, Research and Welfare

Review, 2021, 9(3), 192-196 ISSN-2347-3797

Development and Implementation of Self-determination Focused

Today adolescent depression is a huge public health concern around the world. Among adolescents, depression is a
highly prevalent and severe mental health issue that often leads to suicide, school dropout, antisocial behavior, drug
abuse, cognitive vulnerability, and severe disability, resulting in their low psychological well-being. Perceiving this
scenario, the researcher aimed to develop an intervention to reduce the level of depression and increase the PWB of
adolescents, and to pilot test its viability and usability in the clinical practice. The study made use of the Beck
Depression Inventory (BDl-11) and Ryff's Psychological Well-being scales (RPWB) in measuring the research
variables. For a better understanding of the situation, the researcher conducted a need-assessment survey, in-depth
interviews, and focus group discussions. Based on these assessment procedures, the researcher developed an eight-
modular intervention program. The pilot was tested among ten adolescents who were in a moderate level of
depression and poor PWB. The pilot study's findings revealed a significant reduction in depression and a significant
improvement in the participant’s PWB.

Keywords: adolescents, depression, psychological well-being, self-determination focused acceptance bibliotherapy (SAB)

Depression is the most prevalent mental illness in all cultures and age attention available for cognitive tasks, difficulties in attention, lack
groups worldwide (Geraei, 2018). According to the World Health of motivation and interest, poor attendance, and physical health
Organization (2017), survey, depression is the single leading cause issues such as headaches and fatigability. These factors have an
of global disability, impacting around 322 million people globally. impact on students' academic performance (Chowdhury &
Depression has become a rising social issue among adolescents as Chakraborty, 2017). There is evidence that peer relationship issues,
well as, a major public health concern that is affecting an expanding peer rejection, and loneliness are risk factors for adolescent
number of countries. According to the National Mental Health depression growth (Arseneault, 2018). Due to their symptoms, they
Survey of India (2016), depressive episodes almost tripled from 4 to may reduce their participation in school activities and remain to
11 percent during adolescence. In India, in recent years the experience low psychological well-being (Maslow, 2015).
prevalence of depression is alarmingly high and has become one of According to Self-Determination Theory (Deci & Ryan, 2000)
the most serious national illnesses (Sinha et al., 2020). Depression is addressing basic psychological needs increased motivation, which
a severe mental disorder, often adversely impacted the social in turn addressed the three universal essential and psychological
functioning, family relationships, and academic performance of aspects of autonomy, competence, and relatedness. The
adolescents (Moeini et al., 2019). The obvious consequences of improvement of motivation created adolescents' greater well-being.
depression in adolescents are increased academic difficulties, poor The failure to experience adequate psychological need satisfaction
academic engagements, and performance. It also strained their often diminished motivation and increased the risk of depression
relationships with friends, teachers, and family members, and often (Tang et al., 2020). The Acceptance and commitment therapy (ACT)
withdrew from healthy positive social engagements. It is also model is adapted to understand that the discrete employment of
characterized by significant impairment of function in psychological various mindfulness exercises would be effective in facilitating
well-being among adolescents (Maslow, 2015). Adolescent students flexibility and improving the necessary skills to address the signs of
with depression symptoms are predisposed to concentrating their depression effectively and improve PWB of adolescents
attention on interfering, irrelevant thoughts, leaving little constant (Moghanloo et al., 2015). While Bibliotherapy is integrated into
Author Note SAB to help adolescents gain insights into their dysfunctional
behaviors and identify apt strategies to avoid potential difficulties,
Sherin Joseph, The Graduate School, University of Santo Tomas
overcome various problems in both group and individual settings,
Manila, Philippines
and reduce depressive symptoms. It can also help promote problem
Rosalito De Guzman, The Graduate School, University of Santo
solving, understanding, self-awareness, and providing more
Tomas, Manila, Philippines
opportunities for insight and behavioral change. Thus, the
We have no known conflict of interest to disclose
intervention SAB was preparing the adolescents to attain cognitive
Correspondence concerning this article should be addressed to
diffusion through the right awareness and insights, leading them to
Sherin Joseph, The Graduate School, University of Santo Tomas
make conscious choices and decisions to address the psychological
Manila, Philippines
needs of autonomy, competence, and psychological relatedness,
E-mail: [email protected]
 IAHRW International Journal of Social Sciences Review, 2021, 9(3), 192-196 193

helping them reduce their depression and improve their Ryff's Psychological Well-being (RPWB) Scale: In terms of
psychological well-being. development and growth, Carol Ryff, who studied PWB,
While combining Self-determination theory with the constructed a self-report scale of six core PWB measurements
Bibliotherapy and Acceptance commitment therapy model, the (RPWB, 1989). This assesses a person's well-being at a given time in
researcher was focused on improving the factors of well-being, each of the six dimensions. It was made up of 42 statements that
which can motivate adolescents through various activities. Self- described six areas of psychological well-being: autonomy,
realization is a central definitional aspect of well-being and focuses environmental mastery, personal growth, healthy interpersonal
mainly on factors that can contribute to well-being. These activities relationships, life purpose, and self-acceptance. It took 10 minutes to
have to strengthen adolescents' coping strategies, thus reducing the have this instrument administered. The current version will employ
level of depression and improving their well-being. The self- the shorter overall version of 42 items, with7 items in each
determined, sense that adolescents have the autonomy and flexibility dimension. The individual evaluates himself on a 6-point Likert
to make decisions that shape their future, is essential for each scale (1-Strongly disagree, 2-Moderately disagree, 3-Slightly
individual's well-being. This awareness, acceptance, and motivation disagree, 4-Slightly agree, 5-Somewhat agree, 6-Strongly disagree).
will lead adolescents to improve their PWB. This readiness can lead The negatively scored items are reversed during the final scoring
to good decision-making in their life. Thus the theories incorporated procedures, such that high marks reflect high self-ratings on the
in the intervention was helped to reduce the level of depression and calculated measurements. Greater scores on each of the subscales
prevent their recurrence by helping adolescents with depression reflect the individual's greater well-being in that dimension, and the
recognize and test their destructive cognitions, improve alternative, lower scores reflect the individual's distress in that particular
flexible, and positive ways of thinking, and practice new cognitive dimension. Internal consistency for each aspect ranged from 0.86
and behavioral reactions. and 0.99 indicating that the scale has a greater level of validity
(Sagone & De Caroli, 2014).
Method
Procedure
The research was conducted among adolescent students from the
The research was conducted in two phases. In phase I, the research
Southern part of India who is studying in higher secondary schools
participants include the following: 1). During the program
with a moderate level of depression were measured by BDI-II and
development phase, the researcher, identified the problems of the
low PWB, 10 adolescents at the ages bracket of 14 to 18 were
adolescents through the problem study, related review of literature,
selected to participate in the pilot study of the current research. The
exploration of relevant theoretical basis. 2). The need assessment
pilot study's participants were chosen at random from a pool of
was done through BDI-II & RPWB scales. 3). Participants-those
potential participants. They were randomly chosen based on the
fulfills the inclusion criteria were randomly assigned to interview,
following inclusion criteria: (a) Adolescents currently enrolled in
focused group discussion (FGD), and pilot study. Phase 2, testing the
schools situated in the state of Kerala, India; (b) Adolescents who are
efficacy of the SAB program through experimental evaluation. Pre-
staying/living with biological parents/guardians; (c) Adolescent
experimental, experimental, post-experimental stages are used to
boys and girls under the ages bracket of 14 to 18. The experimental
collect data in this phase. During the pre-experimental stage, the
study was approved out in respect of ethical issues and a license was
researcher was administered pre-test- BDI-II and RPWB for
obtained from the UST Graduate School Ethics Review Committee.
adolescents who fulfilled the inclusion criteria and later researcher
The measures used in this study are as follows:
randomly selected the participants with low RPWB scores and
Instruments moderate levels of depression. These derived data were analyzed
Personal Data Sheet: The personal data sheet provides important both qualitatively and quantitatively. The participants of the study
information describing the socio-demographic profile of the were a total of 400 adolescent students from different schools in
respondents. It will facilitate gathering relevant information and Kerala, India. After prior consultation with the school authorities,
help in the inclusion and exclusion of the participants. It will they were selected through the purposive sampling technique. After
promote the identification of pertinent information and help obtaining informed consent from each participant and their parents
participants to be included and excluded. The personal data sheet or local guardian, Personal Data Sheet, BDI-II, and RPWB scales
examines personal and professional information such as name, age, were administered to the participants. Wilcoxon Signed-Rank Test
gender, nationality, religion, number of siblings, educational status was used to compare the mean difference between the pretest and
of the parents, name of the school, and history of physical and mental posttest of the pilot study.
health. included. The informed consent of the participants shall also Results
be part of the demographic information form.
Beck Depression Inventory-II (BDI-II): Beck developed the Beck The intervention SAB program was carried out in two phases:
Depression Inventory in 1961 and revised it in 1979 with DSM-IV- program development and expert validation. Data gathering
TR-based symptoms of depression (Rehm, 2010). It is a self-report procedures during the program development involved studying the
list of 21 items for assessing depression symptoms. It took 10 problem, deriving insights from the existing literature, and exploring
minutes to have this instrument administered. BDI II was a 21-item relevant theories. The current situation was then assessed using the
questionnaire used to determine the severity of depression in BDI II and PWB scales, as well as interviews and focus group
adolescence and adults. It was a frequently used tool in clinical discussions to get first-hand evidence from the participants,
psychology and psychiatry for determining the severity of parents/legal guardians, and mental health specialists on important
depression in psychiatric patients as well as detecting probable concerns and probable resolutions. The program was then themed
depressions in normal populations. based on these issues and structured into modules. The creation of
194 JOSEPH AND GUZMAN/ DEVELOPMENT AND IMPLEMENTATION OF SELF-DETERMINATION

the modules followed a logical flow starting with introducing the Module 7: Foster personal insight-To enhance self-understanding by
SAB and its objectives to the adolescents, engaging the participants valuing personhood, and to increase the knowledge and accuracy of
to open up and accept their thoughts and emotions, liberation oneself self-perceptions. To help the participant to recognize and find new
from dysfunctional thought, promote self-advocacy, enhancing solutions for the problems he/she is confronting. Help them to focus
competence and relatedness, foster personal insight and on what is good, speak encouraging words to themselves, and be
empowering them to master and gain control over their thoughts mindful of how they carry themselves. Ready to enrich and empower
with strong determination with the result of achieving their set goals within them.
when they entered the program. Module 8: Determination to Succeed-Participants capable to
persevere in the face of adversity to achieve a challenging goal. To
SAB modules and its objectives
enable participants to form a clear vision and strong determination
Module 1: Be acquainted with each other-Participants to be familiar occurs before achieving their goals, as well as to motivate behavior
with one another and to build group unity by introducing SAB. To that will assist them to achieve their goal. At the end of the session,
provide information regarding the importance of the SAB program, participants were able to make a successful and hopeful thought in
attending every session, structure, and norms of the program. To their minds.
promote a positive transaction through introductory activities. to The SAB was then evaluated by a team of experts which will be
promote positive bonding, explore expectations, and set ground consisted of three practicing clinical psychologists, a psychiatrist, a
rules. counseling psychologist, and a 1iterary expert. The experts
Module 2: Acceptance of one's own emotions and thoughts-To employed the standard evaluation procedures which were an
recognize and become aware of the depressive symptoms. Allow adapted version of the tool created and used by USAID. The experts
participants to relieve or outlet their repressed emotions through unanimously gave the program an 'A' graded after the extensive
reading literature. Monitor the specifics of the participant's evaluations, confirming the SAB's soundness, relevance, and
responses, emotional expression, and release and increase the self- viability. The SAB was shown to be consistent and reliable in an
acceptance through cognitive restructuring. Participants able to inter-rater reliability test of expert evaluations. The inter-rater
learned to focus on their unpleasant feeling and becoming aware of dependability was calculated as a coefficient of .78. The experts'
and learning to direct their emotional states and able to recognize validation resulted in the assurance that the program is reliable and
negative emotions. has predicted a high probability of being effective in bringing about
Module 3: Liberation oneself from dysfunctional thought- Aims to positive changes. For the test of feasibility, a pilot study was carried
assist the participants to attain mastery over their dysfunctional out and was completed with a group of 10 adolescents as participants
thoughts through cognitive diffusion such as willingness to let go of and used the pre and post-test pilot intervention design. The
the attachment and identification with thoughts that cause suffering. 'Wilcoxon signed-rank test was employed to examine the pre and
To teach the participants about how thought affects the mood. post-test scores of the adolescents for statistical analysis. The result
Exploring and modifying the positive cognition and help the of the statistical analysis is shown in Table 1. The findings of the
participants to transform destructive self-talk into positive. To allow study revealed that the intervention program modules are reliable,
the participants to bring their attention to the moment and allow feasible, and efficacious when tested on a larger base of adolescents
distracting thoughts to move away. To help the participants with a moderate level of depression.
restructure the distressing thoughts with positive activities and The pre-test and post-test mean scores and standard deviation
thoughts. values of the pilot study participants in terms of BDI II and PWB are
Module 4: Promote Self Advocacy-To build positive self-esteem; shown in Table 1. The results show a decrease in the adolescents'
become self-reliant, and accomplished making self-decisions based level of depression and increase in PWB level after the feasibility
on set individual values. And also improve the purpose in their life. It test as indicated by the mean score of the post-test; and that there is a
helps the participants to able to manage the opportunities for significant change in the pre-test and post-test scores of both BDI II
fullness and able to be independent to make decisions. Participants and PWB. Lastly, participants' feedback was obtained. Ten
can make their feelings of self-worth and self-like brightening up adolescents participated in the four-week-long pilot testing of the
their life. eight module intervention program, and positively agreed,
Module 5: Enhancing self-Autonomy-To help participants learn expressed fulfillment and appreciation for the program. Mostly, they
how to make decisions without relying on others and to be informed having less the level of depressive symptoms and
independent. To be able to evaluate self by personal standards improved levels of concentration and increased psychological well-
includes providing choices, meaningful rationales for learning being. One said, “Through this intervention program I have
activities, granting participants feelings, and lessening stress and learned a lot, especially the importance of having a positive
control. Give emotional support, a sense of hope, emotional outlook. I got new insights through reading literature. The
understanding. methods and techniques learned were helpful to me to reduce
Module 6: Enhancing competence and relatedness-Encouraging stress. It helped me to improve my concentration, reduce my
participants to accept more responsibility for their learning, provide negative feelings, and promote self-determination.” Another
freedom, and identify what they want. Includes providing structured participant said, “After attending the program, I am getting a lot of
guidance, provide optimal challenges, and positive and constructive relaxation in my mind. I was able to understand the positive and
feedback. Participants become more insightful to become clear negative energy within me. I have learned to be kinder to myself, and
about self-acceptance capacity and to build a positive relationship have replaced negative self-talk with positive. This intervention
with others. program enabled me to accept the realities of life and enhanced my
self-confidence”.
 IAHRW International Journal of Social Sciences Review, 2021, 9(3), 192-196 195

Table 1
Wilcoxon signed-rank test results before and after the treatment (n=10) wilcoxon
signed ranks test result of the pilot study participants
Scale Domains Pretest Posttest z-value p-value
Mean(SD) Mean(SD)
BDI II Depression 24.4(1.26) 7(1. 06) -2.821 0.005
RSPW AUT 9.8(1.13) 25.4(1.34) -2.842 0.004
EM 10.2(0.08) 22(0.82) -2.844 0.004
PG 10.0(0.94) 20.3(1.15) -2. 831 0.005
PR 10.1(1.28) 24.9 (1.19) -2.829 0.005
PL 10.4(0.96) 23.7(0.67) -2.848 0.004
SA 10.1(0.99) 19.8(1.39) -2.821 0.005
Note: Level of significance p<0.05, Legend: BDI II; PWB-Psychological Well-Being; AU-
Autonomy; EM-Environmental Mastery; PG-Personal Growth; PR-Positive Relations; PL-
Purpose in Life; SA-Self-Acceptance.

Table 1 depicts the Pre-test, Post-test, mean score, and standard were able to embrace self-acceptance, develop autonomy and gain
deviation values of the pilot study participants in terms of depression self-mastery through the Self- determination focused acceptance
measured by BDI II and psychological well-being measured by Bibliotherapy intervention. Hence, have shown a positive change in
RPWB scales. The results show a decrease in the level of depression their overall behavior and have expressed high hopes for a brighter
and an increase in well-being after the intervention program. It also future and real-life engagements.
shows the Wilcoxon Signed rank test result of the variables. The Through the study, adolescents were able to gain insight into their
program elicited a statistically significant change in the level of challenges and to develop positive strategies to improve their lives
depression and psychological well-being among the pilot study by providing information, support, and guidance to address the most
participants. There was a significant change in the pre-test and the concerning issues. The intervention helps the adolescents to attain
post-test scores of both BDI II and PWB. cognitive diffusion through the right awareness and insights, leading
them to make conscious choices and decisions to address the
Discussion psychological needs of autonomy, competence, and psychological
The development of the SAB program embraced the concepts of relatedness, helping them reduce their depression and improve their
acceptance and cognitive restructuring to improve the PWB of psychological well-being. The research findings of Anastasiades and
adolescents and reduce their level of depression and its symptoms. colleagues (2016) revealed that self-determination is helped to
The result of the experiment statistically supported and validated the learning new skills, learning engagement, enhancing interpersonal
effect and efficacy of the four-week execution of the SAB as an relationships, and participating in adaptive behaviors. The use of
intervention program. The pilot study conveys a strong implication autonomy, competence, and related Self-determination theory
that the concepts of the Self-determination theory, ACT, and components will then have the greatest effect in resolving
Bibliotherapy are efficacious and have achieved the program depression.
objectives. The study validation with 10 adolescents was completed These positive changes reflected in the significant increase in
in four weeks to ascertain the program's feasibility and efficacy on a post-test scores on each element of psychological well-being
larger population. The results of the pilot study are consistent with specifically: autonomy, environmental mastery, positive relations,
the validation and evaluation performed by the experts proving that purpose in life, personal growth, and self-acceptance.Boosting
the researcher-developed SAB is reliable to positively influence internal protective factors like self-awareness and knowledge of
change in PWB of the adolescents. In line with the findings, the study self-worth apart from their difficulties can achieve a deeper
conducted by Grant and his colleagues (2013) indicates that more understanding of themselves and can provide positive perspectives
significant depressive symptoms were associated with lower well- in describing the events they face. It helps the participants grasp
being. In particular, the study found that individuals who reported cognitive abilities, strengths, weaknesses, and goals better
lower baseline well-being showed substantial increases in symptom (Sadeghinejad et al., 2017). Before this pilot test, the researchers
scores of depression over time. Study shows that during this stage, carefully examined the research conditions and the demographic
they notice that there is a lack of experience of autonomy, profile of the participants to ensure homogeneity. The SAB, as an
environmental mastery, positive relationships, and life meaning intervention program, was designed and implemented as a group
among adolescents. As a result, depression is a significant problem activity. However, it can also be implemented on an individual basis.
among adolescents. Studies show that bibliotherapy has excellent The primary goal of using SAB as an intervention program was to
effects on the prevention programs on the depressive symptoms of address the depression's functioning and symptoms. The findings of
adolescents (Rohde et al., 2016).The skills and perceptions that the study conducted by Nock and his companions (2013) proved that
comprised the psychological well-being of adolescents showed that it is a turbulent time that can impact several factors, such as
they are capable of growth, fulfillment, and satisfaction by developmental issues, low academic performance, familial and
promoting their inherent potentials (Rashid, 2015). The adolescents social instability, poor physical health, hormonal changes, and
196 JOSEPH AND GUZMAN/ DEVELOPMENT AND IMPLEMENTATION OF SELF-DETERMINATION

psychosocial stressors. This study suggests that other factors that than meets the eye. Journal of Family Medicine and Primary Care, 6(2), 169-170.
https://doi.org/10.4103/jfmpc.jfmpc
may contribute to the deterioration of psychological well-being of
Gautham, Sukumar, M., Gururaj, G., Varghese, M., Benegal, V., Rao, G.N., Kokane, A.,
adolescents leading them to depression and need to be carefully Chavan, B.S., et al. (2020). The national mental health survey of India (2016):
explored, reflected, and analyzed such as broken family issues, Prevalence, socio-demographic correlates and treatment gap of mental morbidity.
presence of a dominant personality that is negatively influencing the International Journal of Social Psychiatry, 66(4), 361-372. https://doi.org/10.11
77/0020764020907941.
individual, and relationship issues among others. To maximize the
Geraei, E., Fereshteh, S., & Elaheh, M. (2018). Depression: Detecting the historical
benefits of the SAB, it may be further tested on a larger base of roots of research on depression prevention with reference publication year
individuals with extensive planning and among different cultures. spectroscopy. International Journal of Preventive Medicine, 9(1) 53-59.
https://doi.org/10.4103/ijpvm.IJPVM_308_17
The results in Table 1 (Wilcoxon signed-rank test result of the
Grant, F., Guille, C., & Sen, S. (2013). Well-being and the risk of depression under stress.
variables) show that the 3 week-long SAB elicited a statistically PLoS , 8(7), 16. https://doi.org/10.1371/journal.pone.0067395
significant change in the level of depression and psychological well- Maslow, G. R., Dunlap, K., & Chung, R. J. (2015). Depression and suicide in children
being among the participants. This indicated that the SAB had an and adolescents. Pediatrics in Review, 36(7), 299-310. https://doi.org/10.154
impact on the participants' life and it was an effective program to 2/pir.36-7-299
Moeini, B., Bashirian, S., Soltanian, A. R., Ghaleiha, A., & Taheri, M. (2019).
reduce the level of depression and improve the PWB. The result of
Prevalence of depression and its associated socio-demographic factors among
the pilot study is consistent with the expert validation and evaluation Iranian female adolescents in secondary schools. BMC Psychology, 7(1), 1-11.
are given by the team of experts and thus proves that the researcher- https://doi.org/10.1186/s40359-019-0298-8
developed SAB is reliable and can positively impact the lives of Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A.
M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime
adolescents with depressive symptoms.
suicidal behavior among adolescents: Results from the national comorbidity survey
replication adolescent supplement. JAMA Psychiatry, 70(3), 300-310. https://doi.
Conclusion org/10.1001/2013.jamapsychiatry.55
Rashid, T. (2015). Positive psychotherapy: A strength-based approach. Journal of
As a remedy, the SAB has been tested as an effective program to
Positive Psychology, 10(1), 25-40. https://doi.org/10.1080/17439760.2014.920411
decrease the level of depression among adolescents and to improve Rehm, L. (2010). Depression. Cambridge: Hogrefe.
their overall psychological well-being. Adolescents' self-awareness, Rohde, P., Stice, E., Shaw, H., & Gau, J.M. (2016). Pilot trial of a dissonance-based
decision-making skills, self-regulation, and goal-setting abilities cognitive-behavioral group depression prevention with college students. Behaviour
were all improved as a result of the intervention, which encouraged Research and Therapy , 82, 21-27. Doi:10.1016/j.brat.2016.05.001
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of
the development of stronger self-determination. The study found intrinsic motivation, social development, and well-being. American Psychologist,
that the program's concepts and the structure of the program are 55(1), 68-78. https://doi.org/10.1037/0003-066X.55.1.68
consistent, practicable, and effective when tested on a larger group of Sadeghinejad, S., Bakhtiyarpour, S., Heidari, A., & Makvandi, B. (2017). The effect of
adolescents at risk of developing depressive symptoms. self-determination skills training of on primary school student's depression. Iranian
Journal of Educational Sociology, 1(5), 29-36.
Acknowledgments and funding Sagone, E., &Caroli, M. E. De. (2014). Relationships between psychological well-being
and resilience in middle and late adolescents. Procedia-Social and Behavioral
The researchers have not received any financial support from any Sciences, 141(August), 881-887. https://doi.org/10.1016/j.sbspro.2014.05.154
Sinha, S., Patil, M. S., Viveki, R. G., & Halki, S. (2020). Prevalence of depression among
institution or sources. The researchers are affiliated with the
school-going adolescents in an urban area of Karnataka, India: A cross sectional
University of Santo Tomas, Manila, Philippines. There are no study. International Journal of Community Medicine and Public Health, 7(5), 1790-
conflicts of interest whatsoever in the conduct of this study. The 1793.
authors would like to thank all those who kindly participated in this Tang, M., Wang, D., & Guerrien, A. (2020). A systematic review and meta-analysis on
basic psychological need satisfaction, motivation, and well-being in later life:
study.
Contributions of self-determination theory. PsyCh Journal, 9, 533. https://doi.org
/10.1002/pchj.293
References Vahid, A.Mo., Moghanloo, R.A., & Moazezi, M. (2015). Effectiveness of acceptance
Anastasiades, M. H., Gupton, O. A., Anastasiades, M. H., Gupton, O. A., & Fritz, Y. A. and commitment therapy for depression, psychological well-being and feeling of
(2016). Research article depression and nonadherence: Exploring diabetes, guilt in 7 - 15 years old diabetic children. Iranian Journal of Pediatrics, 25, 4.
hopelessness as a meditating factor: A preliminary study. Mental Health in Family Https://doi.org/10.5812/ijp.2436.
Medicine, 12, 241-247. World Health Organization (2017). Maternal, newborn, child and adolescent health.
Arseneault, L. (2018). Annual research review: The persistent and pervasive impact of Adolescents and mental health. Available from: http://www.who.int/maternal_
being bullied in childhood and adolescence: Implications for policy and practice. child_adolescent/topics/ adolescence/mental_health/en/, accessed on July 15.
The Journal of Child Psychology and Psychiatry, 4, 405421. https://doi.org/10.1 Received August 7, 2021
111/jcpp.12841 Revision received August 11, 2021
Chowdhury, S., & Chakraborty, P. (2017). Universal health coverage: There is more to it
Accepted August 31, 2021
Copyright of IAHRW International Journal of Social Sciences Review is the property of
Indian Association of Health, Research & Welfare and its content may not be copied or
emailed to multiple sites or posted to a listserv without the copyright holder's express written
permission. However, users may print, download, or email articles for individual use.