نوع مقاله : مقاله پژوهشی
عنوان مقاله English
نویسندگان English
This study was conducted to evaluate the impact of a spiritual health educational program on depression and anxiety among first-period secondary school students. Given the increasing prevalence of mental disorders among adolescents, this research aimed to investigate practical strategies for reducing symptoms of depression and anxiety through strengthening the spiritual dimensions of health.
The present study was a quasi-experimental design with a pre-test/post-test and unequal control group. The study population consisted of all first-period secondary school students in Razavi Khorasan Province during the academic year 1403 (2024–2025). Using random cluster sampling, one school was selected, and 30 students with the highest scores on depression and anxiety measures (15 in each group) were randomly assigned to experimental and control groups. The experimental group received spiritual health education over 10 two-hour sessions spanning two months, while the control group received no intervention. Instruments included the Beck Depression Inventory (Beck, 1961) and the Beck Anxiety Inventory (Beck et al., 1988). Data were analyzed using descriptive statistics and analysis of covariance (ANCOVA) with SPSS version 24.
The results indicated a significant difference between the two groups in depression scores (p < 0.05), demonstrating the positive role of the spiritual health educational program in reducing depressive symptoms. Additionally, a significant difference was observed in anxiety levels between the experimental and control groups (p < 0.05), confirming the effectiveness of this intervention in alleviating anxiety among students.
Spiritual health education significantly reduces depression and anxiety in first-period secondary school students. These findings can serve as a foundation for designing educational programs and psychological interventions in schools.
کلیدواژهها English
Extended Abstract
1. Problem statement
Adolescence, particularly during the early years of secondary school, represents one of the most sensitive and challenging stages of human development, characterized by extensive biological, cognitive, and social changes. Within this context, the mental health of adolescents serves as a vital national asset and a foundation for the future of society. However, global and national statistics indicate a concerning prevalence of mental disorders among teenagers; depression is recognized as one of the most disabling disorders, and anxiety is identified as a primary cause of academic and social maladjustment. Research suggests that the prevalence of psychological issues in secondary school students varies between 15% and 25%. These disorders not only threaten the quality of life and academic performance of students but can also serve as a breeding ground for chronic problems in adulthood. In response to these challenges, traditional treatment approaches have often focused on pharmacological interventions or cognitive-behavioral psychotherapies. However, in recent decades, researchers' attention has shifted toward the fourth dimension of health: "spiritual health." From a theoretical perspective, spiritual health—which encompasses a harmonious relationship between the individual, the self, others, nature, and a higher power—can act as a defensive shield against stress by fostering a sense of purpose, meaning, and resilience. Theories such as Viktor Frankl’s "Logotherapy" and Pargament’s "Spiritual Coping" explain how the inability to find meaning leads to an existential void and ultimately depression, whereas religious and spiritual beliefs can reduce psychological burden by reinterpreting stressful events. Given that most previous studies have focused on adults and considering the rich spiritual-Islamic culture of Iran, investigating the effectiveness of spiritual health-based interventions in female first-period secondary school students is both a necessary and innovative endeavor. The present study was formulated to answer this fundamental question: Can the implementation of a structured spiritual health educational program significantly reduce levels of depression and anxiety in female first-period secondary school students?
2. Method
This research is applied in purpose and quasi-experimental in nature, utilizing a pre-test-post-test design with an unequal control group. The statistical population of the study included all female first-period secondary school students in the academic year 1403 (2024-2025) in Razavi Khorasan Province. To select the sample, random cluster sampling was employed. One school was selected from among the target schools, and after administering screening questionnaires, 30 students with the highest scores for depression and anxiety were selected. Participants were randomly assigned to two groups: experimental (15 participants) and control (15 participants). Inclusion criteria included being female, studying in grades 7 to 9, and willingness to participate. Measurement instruments included the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI), both of which have confirmed validity and reliability within the Iranian population. The experimental group received a spiritual health education intervention over 10 two-hour sessions spanning two months (one session per week). The educational content was designed based on localized models and the psychology of religion literature, structured around four main dimensions: connection with God (trust, prayer, supplication), connection with self (self-awareness, purposefulness), connection with others (forgiveness, maintaining family ties), and connection with nature/the world. Sessions were conducted interactively using teaching methods such as group discussions, parables, and practical exercises (including meditation and spiritual journaling). The control group received no intervention during this period. At the end of the educational course, both groups were reassessed in the post-test phase. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (Analysis of Covariance or ANCOVA) using SPSS version 24 software. To verify the assumptions of ANCOVA, the Shapiro-Wilk test (for normality) and Levene's test (for homogeneity of variances) were utilized, and all assumptions were confirmed.
3. Findings and Results
The results of the data analysis indicated that the distribution of scores for the dependent variables was normal in both groups and that variances were homogeneous. The results derived from the Analysis of Covariance (ANCOVA), after controlling for the pre-test effect, demonstrated a significant difference between the experimental and control groups in both studied variables. Regarding depression, the adjusted mean post-test score in the experimental group (36.65) was significantly lower than that of the control group (43.31). The F-value was calculated at 8.62 with a significance level less than 0.01, indicating the high effectiveness of the intervention. Furthermore, the effect size (Eta Squared) for depression was found to be 0.44, suggesting that 44% of the variance in changes in depression scores could be attributed to participation in the spiritual health education program. Similar results were obtained for the anxiety variable. The adjusted mean anxiety score in the experimental group (25.31) showed a significant decrease compared to the control group (32.23) (F=9.13, P<0.005). The effect size for anxiety was reported at 0.35, indicating that 35% of the changes in students' anxiety could be ascribed to this intervention. Overall, descriptive findings also revealed that while no significant changes were observed in the control group, a substantial reduction in symptoms of depression and anxiety was observed in the experimental group.
4. Conclusion
The findings of this research confirm that spiritual health education can function as an efficient and effective intervention in reducing depression and anxiety among female first-period secondary school students. These results are consistent with numerous domestic and international studies that have reported an inverse relationship between spirituality and psychological disorders. The mechanisms of this intervention's impact can be examined across several dimensions: First, strengthening the connection with God and practices such as prayer and trust (Tawakkul) helps teenagers experience a sense of support and reliance on a higher power when facing problems, which directly reduces anxiety stemming from uncertainty. Second, focusing on self-awareness and purposefulness assists students in reaching a deeper understanding of life beyond daily issues and academic pressures, which is associated with reduced feelings of emptiness and related depression. Third, relational components such as forgiveness and maintaining family ties contribute to mental health by improving interpersonal relationships and reducing feelings of loneliness. From a theoretical standpoint, these findings support Frankl’s theory regarding the necessity of finding meaning for mental health. Moreover, the results demonstrated that this intervention can be utilized as a complementary and cost-effective treatment within schools. Given that adolescence is a period of identity formation, integrating spiritual education into the school curriculum can play a preventive role against social and psychological harms. It is recommended that future research be conducted with larger samples, long-term follow-ups, and on male students to further examine the generalizability of the findings. Ultimately, this study emphasizes that attention to the spiritual dimension of the human being is not only compatible with the indigenous culture of Iranian society but also represents a scientific strategy for raising a healthy, vibrant, and resilient generation.
5. Acknowledgement & Funding
· The manuscript did not receive a grant from any organization.
6. Conflict of Interest
· The authors declare no conflict of interest.
7. Author contribution
All authors share equal responsibility for the content of this paper.
1. Leila Javadi Elmi; Email: lielajavadielmi@gmail.com; ORCID: https://orcid.org/0000-0002-9790-7594
2. Fateme Rasayi; Email: rasayi062@gmail.com
3. Seyed Aghil Nasimi; Email: mailto:sa.nasimi@cfu.ac.ir; ORCID: https://orcid.org/0000-0001-7873-2269
References
Bazargan et al. (2023). Prevalence of depression among Iranian children and adolescents: An updated systematic review and meta-analysis. Health Science Reports, 6(10), e1584.
Aggarwal et al. (2023). Religiosity and spirituality in the prevention and management of depression and anxiety in young people: A systematic review and meta-analysis. BMC Psychiatry, 23(۱), 29.
Koenig (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry.
Pargament (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. Guilford Press.
