1- PhD Student in Counseling, Aras International Campus, University of Tehran, Tehran, Iran
2- Department of Counseling, Faculty of Psychology, University of Tehran, Tehran, Iran ,asayesh@ut.ac.ir
3- Department of Counseling, Faculty of Humanities and Social Sciences, Ardakan University, Yazd, Iran
2- Department of Counseling, Faculty of Psychology, University of Tehran, Tehran, Iran ,
3- Department of Counseling, Faculty of Humanities and Social Sciences, Ardakan University, Yazd, Iran
Abstract: (19 Views)
Objective: The present study aimed to design and validate the content of a Reality Therapy group protocol for adolescents with GAD.
Methods: A developmental study utilizing a sequential exploratory mixed-methods design was conducted in three stages: First, five mechanistic themes were extracted by integrating Choice Theory literature with theoretical and empirical evidence regarding adolescent anxiety and rumination. Second, a preliminary version of the protocol was designed based on these themes and the five components of Choice Theory (basic needs, total behavior, quality world, self-evaluation, and planning), structured as eight weekly 90-minute sessions. Third, this version was refined by an expert panel using the modified Delphi method and validated using the Content Validity Ratio (CVR), Content Validity Index (CVI), and Kappa coefficient.
Results: The protocol was organized around five mechanistic themes (unmet needs, worry-driven total behavior, the gap with the "Quality World," lack of self-evaluation, and low frustration tolerance) and structured into eight sessions (introduction and the concept of choice; basic needs; total behavior and responsibility; the Quality World; evaluating current behaviors; self-evaluation and responsible choice; frustration tolerance and coping strategies; consolidation and termination). Fifteen experts participated in the validation phase; in the first round, 38 out of 44 items simultaneously met the CVR and I-CVI criteria.The S-CVI/Ave value for the entire form was 0.91, and the S-CVI/UA value was 0.84. Additionally, the mean modified kappa was 0.83, and Fleiss' kappa (κ) was 0.79 (p = 0.001). Based on the Landis and Koch (1977) criteria, this coefficient indicates almost perfect agreement.
Conclusions: The proposed protocol—focusing on education regarding needs, self-evaluation, and frustration tolerance—demonstrates favorable content validity according to expert consensus; however, its clinical effectiveness requires testing in feasibility and controlled trials involving adolescents.
Methods: A developmental study utilizing a sequential exploratory mixed-methods design was conducted in three stages: First, five mechanistic themes were extracted by integrating Choice Theory literature with theoretical and empirical evidence regarding adolescent anxiety and rumination. Second, a preliminary version of the protocol was designed based on these themes and the five components of Choice Theory (basic needs, total behavior, quality world, self-evaluation, and planning), structured as eight weekly 90-minute sessions. Third, this version was refined by an expert panel using the modified Delphi method and validated using the Content Validity Ratio (CVR), Content Validity Index (CVI), and Kappa coefficient.
Results: The protocol was organized around five mechanistic themes (unmet needs, worry-driven total behavior, the gap with the "Quality World," lack of self-evaluation, and low frustration tolerance) and structured into eight sessions (introduction and the concept of choice; basic needs; total behavior and responsibility; the Quality World; evaluating current behaviors; self-evaluation and responsible choice; frustration tolerance and coping strategies; consolidation and termination). Fifteen experts participated in the validation phase; in the first round, 38 out of 44 items simultaneously met the CVR and I-CVI criteria.The S-CVI/Ave value for the entire form was 0.91, and the S-CVI/UA value was 0.84. Additionally, the mean modified kappa was 0.83, and Fleiss' kappa (κ) was 0.79 (p = 0.001). Based on the Landis and Koch (1977) criteria, this coefficient indicates almost perfect agreement.
Conclusions: The proposed protocol—focusing on education regarding needs, self-evaluation, and frustration tolerance—demonstrates favorable content validity according to expert consensus; however, its clinical effectiveness requires testing in feasibility and controlled trials involving adolescents.
Keywords: Reality Therapy, Choice Theory, Generalized Anxiety Disorder, Adolescents, Rumination, Frustration Tolerance
Type of Study: Original |
Subject:
Evolutionary Psychology
Received: 2026/02/14 | Accepted: 2026/08/15
Received: 2026/02/14 | Accepted: 2026/08/15
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