Discussion
The burden and effects of COVID‐19 are felt all around the world, and
this is likely to cause fear and anxiety.32 This study
was conducted with the aim of examining the effects of online SFBT
applied to parents with high levels of anxiety during the COVID 19
pandemic. As a result of the study, it was determined that online SFBT
was an effective method in reducing the state anxiety levels of parents
with high anxiety levels.
In studies conducted with different sample groups in the COVID 19
pandemic, it has been reported that the epidemic significantly increases
the anxiety level of children and parents.7,32 In this
study, the anxiety levels of the parents of children aged 3-6 who had to
spend most of their time at home by leaving the nursery, school and many
social environments due to the pandemic were evaluated and it was
determined that the pre-test anxiety levels of the parents were quite
high in the intervention and control groups. In a study conducted in
China (n = 2446), it was stated that the participants had a high level
of anxiety and approximately 80% of them scored above 40 in both STAI-S
and STAI-T subscales.33 In the study conducted by Lee
et al., it was determined that parents’ anxiety levels were high and
parental anxiety caused an increase in the anxiety level of
children.7 In the study conducted by Saddik et al., it
was determined that most of the participants experienced mild or severe
anxiety due to the pandemic. In the same study, the participants stated
that the measures taken by the government to prevent the pandemic
increased their anxiety.34 In another study conducted
with 1069 participants, it was stated that having a child is one of the
reasons that increase anxiety during the COVID 19
pandemic.3 All these studies and our study findings
show similarities in the sense that parental anxiety is high during the
pandemic.
The COVID 19 pandemic places a wide range of stressors on young
children, including its invisibility, the danger of infection,
frustration and boredom, inadequate information, lack of face to face
contact with family members, classmates, friends and teachers, and lack
of personal space at home. Stress levels of children directly or
indirectly cause stress and anxiety on their
parents.35 In this study, more than half of the
parents stated that their children’s being away from the nursery and
being constantly isolated at home made them aggressive and worsened
their mental health. Sudden changes in the routines of children, who
previously attended a nursery or nursing facility, events they cannot
understand in a home-oriented life environment and many other factors
can play a role in increasing the stress and anxiety levels of children
and parents.
It has been reported that correct information about the virus has a
negative and significant correlation with individuals’ anxiety
levels.36 In this study, almost all of the parents
stated that they had access to information about COVID 19 via television
(44.2%) and social media (37.8%). In the study conducted by Malesza
and Kaczmarek, more than 80% of the participants stated that they had
access to COVID information through television while 70% of the
participants acquired information via the internet. However, only 20%
of the participants had access to information through health
authorities. When these findings are interpreted together with the high
anxiety levels of the parents, it is thought that reaching the
information from the right source may also have an effect on the anxiety
level.
The global COVID-19 pandemic is a stressor that originated outside of
the family system but given the novelty and uncertainty concerning this
disease, it is likely to be perceived as a significant stressor for many
parents and children.11 Individuals use different
methods in order to cope with the anxiety experienced in the pandemic.
When the coping behaviours of parents are examined; It is seen that they
use different methods such as spending time with the family, trying not
to think about the pandemic, cleaning, spending time by watching
television and using telephone and praying. However, the high anxiety
score averages of the parents indicate that these coping methods are not
very effective in the pandemic process, which has very devastating
effects.
It has been reported that the COVID 19 pandemic negatively affects the
mental health of both parents and children and significantly reduces
their psychological well-being.8,37 In our study,
majority of the parents stated that they will continue to take measures
even if the pandemic decreases and they believe that there will be new
pandemic. These findings are important in terms of suggesting that
parents experience anxiety about their future lives.
The effectiveness of SFBT in literature has been evaluated in many
studies.14,24,38–40 Studies have shown that SFBT is
effective in individuals with social anxiety
disorder,13 reduces depression and
anxiety,12,15 improves quality of
life14, affects mindfulness and psychological
well-being41 and is effective in solving mental
problems by contributing to the development of all areas of mental
health.40 In the study conducted by Novella, Ng and
Samuolis, SFBT was applied to university students with mild and moderate
anxiety simultaneously with two different methods using face-to-face and
online programmes. As a result of the study, it was determined that both
methods significantly reduced students’ anxiety levels and there was no
significant difference between the effectiveness of the two
methods.23 The use of video teleconferencing platforms
is important in terms of providing a suitable alternative for continuity
of care in times of social, economic and health-related problems, and
provides more flexibility and access opportunities than face-to-face
therapy.42 In our study, SFBT was applied through the
online video-conference method due to the restrictions and precautions
during the pandemic and it was found to be an effective method in
reducing anxiety.
In order to reduce the anxiety level of individuals in the COVID 19
pandemic, different interventions were implemented and their
effectiveness was evaluated. Internet-based integrated intervention
focusing on relaxation, self-care, and raising sense of security applied
to individuals diagnosed with COVID 19 with psychological problems was
found to have a significant pleasing effect on mild and moderate
depression and anxiety symptoms.43 In a study
conducted, it was determined that informing via teleconference was
effective in reducing the anxiety levels of mothers with chronic
diseases during the pandemic period.32 In the study
conducted by Chen (2020), it was aimed to administer 2-4 sessions of
online solution focused brief therapy to adolescents who showed anxiety
symptoms in the COVID 19 pandemic. It was hypothesized that participants
who are randomly assigned to Solution Focused Brief Therapy would have
betterclinical outcomes, lower depression levels, and increased coping
strategies in dealing with distress during the COVID 19
pandemic.25 In our study, SFBT was applied to parents
who had high levels of anxiety and it was found that the state anxiety
levels of the parents were significantly reduced. In the model
established in SEM analysis, it was determined that the SFBT
intervention had a significant effect on anxiety (Fig. 2). After SFBT,
the state and trait anxiety mean scores of the intervention group
decreased compared to the pre-intervention mean scores. While this
difference between state anxiety scores was statistically significant,
the difference between trait anxiety scores was not statistically
significant. This result can be related to the fact that the state
anxiety level is a result of the individual’s direct psychological
reactions related to negative events while the trait anxiety is related
to the tendency to exhibit personal anxiety and it is relatively stable.
This finding can be considered as an expected result, since the change
in the state anxiety level must gain continuity in order for the trait
anxiety level to change. However, it is noteworthy that the state
anxiety score in the intervention group is still high (over 40) even in
the post-test. It is anexpected result that the anxiety does not
decrease to the desired level due to the continuation of the pandemic.