Introduction: The aim of this study was to determine the effectiveness of positive, mindfulness, and cognitive-behavioral mindfulness therapy on rumination and psychological well-being of depressed students in the Rehabilitation Faculty of Jundishapur University.
Method: The quasi-experimental design was pre-test-post-test and follow-up in a three-group randomized controlled trial (two experimental groups and one control group). From the statistical population of all undergraduate students in the Faculty of Rehabilitation, Jundishapur University of Shahr-e Ahvaz (1300-1499), 30 depressed students were selected by available sampling method and randomly divided into two experimental groups during 12 group sessions (under positive mindfulness treatment program). N = 10 axis and underwent cognitive-behavioral therapy program (n = 10) and control group (n = 10). The Ruminant Questionnaire (RRS), Nolen-Hoxma and Marlowe (1991), and the Reef Psychological Well-Being Questionnaire (2008) were administered to them.
Findings: The results of repeated measures analysis of variance showed that both treatment groups had a significant effect on the improvement of rumination and psychological well-being (p <0.01).
Conclusion: Positive mindfulness and cognitive-behavioral mind therapy is an effective way to reduce rumination and increase psychological well-being in the treatment of people with depression.
The Effect of Positive Mindfulness Therapy and Cognitive-Behavioral Therapy on Rumination and Psychological Well-Being of Depressed Students in Rehabilitation School
Introduction: The challenges of the college student period stemming from the existing social, economic and cultural environment of the country which can provide sources of anxiety and stress for students, and eventually cause their depression. Kuyken, Byford, Taylor, Watkins, Holden, White, et al., (2016) found in a research that almost half of the students suffered from psychological problems, especially depression, which leads to wasting half of their studies.
One of the important factors in the activation of these fundamental beliefs is the ruminating-response style. Rumination is repetitive, resistant, recurring and uncontrollable thoughts that divert people's attention from the desired topics and current goals. During this period, people face many stressful factors that can be a threat to their healthy growth and well-being. Therefore, paying attention to the psychological well-being of students is the great importance.
New findings showed that unique aspects of psychological well-being should improve academic performance in undergraduate courses, therefore, psychological interventions in this field can be very effective.  One of the therapeutic interventions that has been shown to be effective in various fields in many recent studies is a cognitive-behavioral therapy group.
In the last decade, researches have emphasized the effectiveness of cognitive behavioral therapy on the recovery of depressed patients. However, the new perspectives of psychology, in contrast to the traditional attention and focus on pathology, have focused on health and well-being from a positive aspect to seek and to explain the psychological nature of well-being.
One of the most recent of these integrated approaches is Positive Mindfulness Based Therapy. Positive mindfulness-based therapy is a combined intervention study based on mindfulness, which was created by combining two methods of positive psychotherapy program and mindfulness interventions.
In this treatment method, clients will learn to be more optimistic with more stable of its therapeutic changes. Cebolla, Enrique, Alvear, Soler & García-Campayo (2017) have shown that mindfulness itself is a positivist construct by integrating with other positive therapies provides the possibility of benefiting from the capacity of both mindfulness and positive therapies.
Numerous studies indicated the usefulness of mindfulness in clinical situations such as emotional regulation, emotional states and emotional capital, rumination.
The importance of students' health and the various statistics that have been reported on the prevalence of depression among students have received a lot of attention; and also considering the importance of effectiveness research in generalizing the results to society and situations of real therapy; although, it caused numerous researches about the importance of rumination and psychological well-being in students with different psychological structures, however, no research has been conducted on comparing the effectiveness of positive mindfulness-based and cognitive-behavioral therapies on rumination and psychological well-being. This vacuum itself has been one of the most important reason for the necessity and importance of studies about the current research type at the professional and specialized level. Therefore, in order to fill the existing gap, the current research aimed to provide a scientific answer to the question: "Which of the positive mindfulness-based treatments and cognitive behavioral therapy reduced rumination and increased psychological well-being in depressed students of the rehabilitation faculty after treatment would be more effective?", and it was designed and implemented.
Method: This research was conducted in a quasi-experimental design, and during a three-group randomized controlled trial (two experimental groups and one control group), a three-stage study with a pre-test and follow-up design. From the statistical population of all undergraduate students of the Faculty of Rehabilitation, Jundishapur University of Ahvaz (1400-1399), 30 depressed students were selected based on inclusion criteria by available sampling method and randomly and equally in the two experimental groups ( They were subjected to a positive mindfulness group therapy program (n = 10) and under a cognitive-behavioral group therapy program (n = 10 during 12 group sessions) and the control group (n = 10: did not receive any intervention during this period). All participants completed the Nolen-Hooksma and Marlowe (RRS) Ruminant Questionnaire (RRS) and the psychological well-being of Riff et al. (2008) in all three groups, before and after the intervention and one month after the intervention.
Results: The results of repeated measures analysis of variance showed that there was a significant difference between the positive groups of mindfulness-oriented mind and cognitive-behavioral therapy in rumination scores and psychological well-being in post-test and follow-up compared to pre-test and both treatments had a significant effect on recovery. These two components had (p<0.05). The results also showed that both treatment groups (positive mindfulness-based treatment group and cognitive-behavioral therapy group) had a significant effect on the autonomy component and no significant difference was observed between the two treatment groups (p <0.01). But the effect of positive mindfulness group therapy on the components of personal growth, purpose in life and self-acceptance was significant (p<0.05). However, the effect of cognitive-behavioral group therapy on the components of personal development, purpose in life and self-acceptance was not significant (p<0.05). According to the results of this study, positive mindfulness-based group therapy and cognitive-behavioral therapy is an effective way to reduce rumination and increase psychological well-being in the treatment of people with depression.
Discussion and conclusion: The results of this research show that there was no significant difference between the two methods of implementing the two treatment methods in improving rumination and psychological well-being, and the follow-up results also showed that the intervention has maintained its lasting effect.This finding in the present study was in line with the results of previous studies that somehow supported the effectiveness of positive mindfulness-based therapy and cognitive-behavioral group therapy, and also it was consistent to the reteaches including the studies of Golperor and Tabatabainejad (2017), which was the only research conducted in relation to the design and implementation of positive mindfulness-based therapy in Iranian society. Various studies show that mindfulness-based treatments have a positive effect on a variety of variables related to mental health.
Mindfulness by using techniques such as teaching relaxation, non-judgmental acceptance of the existing situations, and being aware of oneself, which is one of the fundamental concepts of this approach, has led to the awareness of the present moment and, as a result, the reduction of students' anxiety and rumination. Moreover, mindfulness is associated with increased life satisfaction, happiness, optimism and psychological well-being. In positive mindfulness exercises, depressed students learned to live in the present, to pay attention to their emotions and thoughts, and to accept the reality of problems. Mindfulness also prepares the mind for cognitive changes by teaching depressed students the concept that thoughts are just views that come and go.
According to the findings of the present study, cognitive and behavioral therapy compared to the control group along with positive mindfulness therapy significantly had reduced rumination and increased psychological well-being, and also the results had showed the effectiveness of this therapy among depressed students. Moreover, the results confirmed the findings of the studies in the effectiveness of cognitive and behavioral therapy.
As the last outcome of this research, it stated that positive mindfulness therapy had a greater effect on reducing rumination vise versa increasing psychological well-being and its components among depressed students than cognitive and behavioral therapy.
the most important differences between positive mindfulness and cognitive behavioral therapy was that it focused on the strengths and capabilities of depressed students at the same time as release thinking from automatic negative habits. This lead to made differentiation of positive mindfulness therapy being more effective than cognitive behavioral therapy on reducing rumination and increasing psychological well-being and its components in depressed students.