EFFECT OF COGNITIVE BEHAVIOURAL AND SELF- MANAGEMENT THERAPIES ON PSYCHOLOGICAL DISTRESS AMONG IN-SCHOOL ADOLESCENTS WITH HEARING IMPAIRMENT IN OYO STATE, NIGERIA

Abstract

Psychological distress is usually exhibited among in-school adolescents with hearing impairment as a result of their inability to communicate and relate effectively with their hearing counterparts especially in Oyo State, Nigeria. The consequences of hearing impairment are withdrawal from peer relationship, low performance in school, anxiety and at times suicidal ideation. Past studies have concentrated more on factors predicting psychological distress among adolescents with hearing impairment than on the therapies for the management of psychological distress among these adolescents. This study was, therefore, carried out to investigate the effects of Cognitive Behavioural Therapy (CBT) and Self-Management Therapy (S-MT) on psychological distress among in-school adolescents with hearing impairment in Oyo State, Nigeria. The moderating effects of onset of hearing impairment (before and during birth: congenital impairment; and after birth: acquired impairment) and self-esteem were also examined. Beck’s Cognitive Behavioural and Rehm’s Self-control theories of depression were used as the framework. The pretest-posttest control group quasi-experimental design with a 3x2x2 factorial matrix was adopted. Three secondary schools (Methodist Grammar School, Bodija Ibadan; IMG Grammar School, Agodi Ibadan and Durbar Grammar School, Durbar Oyo) from Oyo South and Central senatorial districts having units for students with hearing impairment were conveniently selected. Sixty-nine adolescents with hearing impairment were selected after screening using Kessler Psychological Distress Scale and students with the index scores of 19 and above were included in the study. The schools were randomly assigned to CBT (31), S-MT (16) and Control (22) groups. Instruments used were Kessler Psychological Distress Scale (r=0.73), Clinical Outcomes in Routine Evaluation (r=0.71) and Rosenberg Self-esteem Rating (r=0.78) scales instructional guides. The treatment lasted 10 weeks. Data were analysed using Analysis of covariance and Scheffe post-hoc test at 0.05 level of significance. The participants’ age was 18.542.36 years. 54.0% were male. More than half (56.0%) of the participants had acquired hearing impairment (after birth), while 44.0% had congenital hearing impairment (before or at birth). The participants’ self-esteem was low (36.4%). The treatment had a significant main effect on the management of psychological distress (F (2, 57) =107.38; partial η2=0.79). The participants in CBT had the most reduced psychological disress (6.35), followed by those in S-MT (7.02) and control (16.35) groups. There were no significant main effects of onset of hearing impairment and self-esteem on the management of psychological distress. The two-way and three-way interaction effects of treatment and onset of hearing impairment, treatment and self-esteem, onset of hearing impairment and self-esteem, treatment, onset of hearing impairment and self-esteem respectively were not significant on the reduction of psychological distress. Cognitive behavioural and self-management therapies were effective in reducing psychological distress among in-school adolescents with hearing impairment in Oyo State, Nigeria, regardless of the onset of hearing impairment and self-esteem. Special educators, councellors and clinical psychologists should adopt these therapies for the management of psychological distress among adolescents with hearing impairment.