Att Thy & Suicide New

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EFFECTIVENESS OF ATTITUDINIZE PSYCHOTHERAPY

IN ENHANCING SELF ESTEEM AND

DIMINISHING SUICIDAL IDEATION AMONG ADULTS IN PAKISTAN

Dr. Linah Askari

Assistant Professor, Psychology

College of Business Management

Institute of Business Management, Karachi

Email: [email protected]

ABSTRACT

The Attitudinize Psychotherapy; an Intervention of the New Millennium, is a complete

psychotherapy dealing effectively with all the six vital aspects concerning an emotional problem of a

human being.

In order to test the five hypotheses, the sample comprised of NO THERAPY GROUP; the Fifty-

two Male and Twenty-three Female Adult Students on which NO Attitudinize Psychotherapy would be

conducted, and for ATTITUDINIZE THERAPY GROUP; Fifty-four Male and Twenty-three Female Adult

Students on which Attitudinize Psychotherapy would be conducted. The data was collected from the

Adult students between the ages of 18–25 belonging to Iqra University, Karachi. In the Initial Phase of

BEFORE THERAPY All the Male and Female students were administered; a) Dysfunctional Attitude Scale

(Therapy Form) (Modified by Dr. Linah Askari 2003), b) Queendom’s Self–Esteem Test (2003) and c)

Adult Suicidal Ideation Questionnaire (William & Reynolds, 2005). In the Final Phase of AFTER

THERAPY, Attitudinize Therapy was conducted for fourteen weeks (75 minute session, twice a week)

on the ATTITUDINIZE THERAPY GROUP only. At the completion of this phase the whole sample was Re-

administered All the three Scales, to both the adults of NO THERAPY GROUP and the adults of

ATTITUDINIZE THERAPY GROUP. The purpose was to relate the effectiveness of the Attitudinize

Therapy with the Enhancement of Self – Esteem and Diminishing of Suicidal Ideation within the Adult

to build their lives successfully.

The results of statistical analysis reveal that (i) In Before Therapy Phase: the adults within NO

THERAPY GROUP have Mean Scores of Dysfunctional Attitude = 303.40, Self-Esteem = 51.78 &

Suicidal Ideation = 149.25 whereas ATTITUDINIZE THERAPY GP have Mean Scores of Dysfunctional

Attitude = 304.83, Self-Esteem = 50.50 & Suicidal Ideation = 150.35 (ii) In After Therapy Phase: theadults within NO THERAPY GROUP have Mean Scores of Dysfunctional Attitude = 309.26, Self-Esteem

= 50.33 & Suicidal Ideation = 153.41 whereas ATTITUDINIZE THERAPY GP have Mean Scores of

Dysfunctional Attitude = 103.94, Self-Esteem = 124.15 & Suicidal Ideation = 60.15 providing evidence

that Ultimately, Attitudinize Psychotherapy would be the BEST CHOICE.

Key words: Attitude, Self-Esteem, Suicidal Ideation, Attitudinize, Psychotherapy, Pakistan.

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The roots of personality grow within the concept of Self Esteem. Each individual has a unique

identification, distinct traits, separate innovative ideas, exceptional comprehending skills and

extraordinary way of understanding the reality. When these qualities are polished with confidence,

trust and encouragement within the environment, they produce a successful Individual. Every person

struggles for the survival and reputation of its name or identification. For each and every

action/behavior there is an Attitude/Intention behind it. As it is beautifully said in the First Hadith

(Preachings of the Holy Prophet PBUH): “Innamal Aamaal-u- Binniyaat” means “All Behaviors arise

from Attitudes/Intentions.” It means that the bases of every human action and reaction are the

attitude/intention. After the arousal of a positive or a negative attitude (intention) to particular stimuli

or situation, the person starts thinking on those terms, beliefs due to his/ her past experiences arise

accordingly and hence the behavior in the connection is framed.

Bartleby (2000) defines, “Attitudinize means to assume an affected attitude; Practice or adopt

attitudes especially for effect.” When Parents, Teachers or other important people within the circle of

an individual develop a positive vision for the success of that individual, all of them struggle within

their own roles, at each developmental phase and on all stages to guide and mentor the person

towards their set goals for the positive achievements. In fact, the individual makes a mindset to prove

oneself and come up to the mark for the expectations demanded by himself and others for his success.

Webster (2003) defines, “Attitude is a complex mental state involving beliefs, feelings, values

and dispositions to act in certain ways. In addition, “Attitude is a psychological tendency expressed by

an evaluative response that can be overt or covert, cognitive, affective or behavioral.”

Kamradt and Kamradt (1999) define, “Attitude is a psychophysical structure that stores related

bits of affective, cognitive, and psychomotor learning in a manner that allows instantaneous,

subconscious access by its owner (p. 570). They view attitude as the fundamental unit of learning.”

Figure1: Components and Structure of a Discrete Attitude

(Kamradt & Kamradt, 1999).

Attitude makes a difference every hour, everyday, in everything that one does for the entire

life. Anything done with a positive attitude will work beneficially, whereas anything done with a

negative attitude will work harmfully. If one has a positive attitude, a person looks for ways to solve

the problems that one can solve, and let go off things, over which one has no control. One can develop

a positive attitude by emphasizing the good, by being tough-minded and by refusing defeat. The

greatest discovery of any generation is that human beings can alter their lives by altering the

attitudes of their minds (Schweitzer, 2002).

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change the patterns of thinking, beliefs and behavior toward psychological self,

environment and the world around.”

2. Terminological: The training within the terminological aspect of the emotional problem

includes, “Changing of the abusive / invective attitudes and behaviors; altering

verbal and non-verbal maladaptive communications, through altering the language-

expression toward self, environment and the world around.”

3. Spiritual: The training within the spiritual aspect of the emotional problem includes,

“Changing of dysfunctional / maladaptive attitudes toward Allah (the Divine Being),

Reducing guilt and fear, and Inculcating the belief of attaining perfect justice for

self and others.”

4. Physiological: The training within the physiological aspect of the emotional problem includes,

“Changing of maladaptive attitudes toward physiological self, through deep

breathing exercise to keep oxygen balance in the body, to maintain balanced diet

consumption and control the water intake and output to stabilize the body fluids.”

5. Neuro-hormonal: Neuro-hormones are the body's chemical messengers; these hormones

stimulate the cells they are attached to. The training within the terminological aspect of the

emotional problem includes, “Inculcating an attitude that Neuro-hormonal Regulation

of one’s own body can be easily controlled through muscle relaxation exercises and

massage of pressure points of your body.”

6. Time Management: The training within the ‘time management’ aspect of the emotional

problem includes, “Changing of maladaptive attitudes toward time management and

to become positively creative and remain relaxed for most of the time in your life-

time.”

Burns (1999) proposed the Development of Better Self – Esteem inferring that, “Most

people's feelings and thoughts about themselves fluctuate somewhat based on their daily experiences.

The grade you get on an exam, how your friends treat you, ups and downs in a romantic relationship -

all can have a temporary impact on your wellbeing.” Your self-esteem, however, is something more

fundamental than the normal "ups and downs" associated with situational changes. For people with

good basic self-esteem, normal "ups and downs" may lead to temporary fluctuations in how they feel

about themselves, but only to a limited extent. In contrast, for people with poor basic self-esteem,

these "ups and downs" may make all the difference in the world.

Before you can begin to improve your self-esteem you must first believe that you can change

it. Change doesn't necessarily happen quickly or easily, but it can happen. You are not powerless!

Once you have accepted, or are at least willing to entertain the possibility that you are not powerless,

there are three steps proposed by Burns (1999) that a person can take to begin to change their self-

esteem:

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Step 1: Rebut the Inner Critic: The first important step in improving self-esteem is to begin

to challenge the negative messages of the critical inner voice. For example: When the Inner Critic's

Voice Catastrophizes: "She turned me down for a date! I'm so embarrassed and humiliated. No one

likes or cares about me. I'll never find a girlfriend. I'll always be alone." So Your Rebuttals to Become

Objective: "Ouch! That hurt. Well, she doesn't want to go out with me. That doesn't mean no one does.

I know I'm an attractive and nice person. I'll find someone."

Step 2: Practice Self-Nurturing: Rebutting your critical inner voice is an important first

step, but it is not enough. Since our self-esteem is in part due to how others have treated us in the

past, the second step to more healthy self-esteem is to begin to treat oneself as a worthwhile person.

Start to challenge past negative experiences or messages by nurturing and caring for yourself in ways

that show that you are valuable, competent, deserving and lovable. There are several components to

self-nurturing such as: Practice Basic Self-Care, Plan Fun & Relaxing Things For Oneself, Reward

Yourself For Your Accomplishments, Remind Yourself of Your Strengths & Achievements, Forgive

Yourself When You Don't Do All You'd Hoped and Self-Nurture Even When You Don't Feel You Deserve

It.

Step 3: Get Help from Others: Getting help from others is often the most important step a

person can take to improve his or her self-esteem, but it can also be the most difficult. People with low

self-esteem often don't ask for help because they feel they don't deserve it. But since low self-esteem

is often caused by how other people treated you in the past, you may need the help of other people in

the present to challenge the critical messages that come from negative past experiences. Here are

some ways to get help from others such as: Ask for Support from Friends, Get Help from Teachers &

Other Helpers and Talk to a Therapist. Sometimes low self-esteem can feel so painful or difficult to

overcome that the professional help of a therapist or counselor is needed. Talking to a counselor is agood way to learn more about your self-esteem issues and begin to improve your self-esteem. Hence

Attitudinize Psychotherapy would be the BEST CHOICE.

Reinherz, Tanner, Berger, Beardslee and Fitzmaurice (2006) studied across a wide variety of

indicators, with adolescent and adult subjects for suicidal ideation. It was reported that

significantly poorer functioning was found by subjects at age 30 for those having suicidal ideation in

adolescence as compared to their peers without suicidal ideation in adolescence. Interviewers rated

subjects with suicidal ideation as having significantly lower levels of global functioning and social and

occupational functioning than subjects without suicidal ideation. Self-reported coping and self-esteem

were lower in subjects with suicidal ideation; interpersonal problems and reports of needing social

support were higher for this group.

Therefore, Adolescent Suicidal Ideation was Predictive of Psychopathology, Suicidal Behavior, and

Compromised Functioning at Age 30, in adulthood. Research Findings underscore the importance of

considering suicidal ideation in adolescence as a marker of severe distress and a predictor of

compromised functioning, indicating the need for early identification and continued intervention.

Additional factors that point to an increased risk for suicide in depressed individuals are:

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Anxiety, agitation, or enraged behavior

Isolation, segregation and seclusion from the environment

Drug and/or alcohol use or abuse

History of physical or emotional illness

Feelings of hopelessness or desperation

Ultimately, Attitudinize Psychotherapy would be the BEST CHOICE.

Literature Review

The meaning of high self-esteem is currently under close empirical scrutiny. High self-esteem

is typically viewed as beneficial for individuals due to its association with markers of psychological

adjustment (Diener, 1984; Kaplan, 1975; Robins, Hendin, & Trzesniewski, 2001; Tennen & Affleck,

1993). Secure high self-esteem, which can be traced to the work of Carl Rogers (1959, 1961), reflects

positive attitudes toward the self that are realistic, well-anchored, and resistant to threat.

So what degree of self-esteem do people have that never even graduated high school? A study

conducted at the University of Maine (McCaul, Donaldson, Colodarci, & Davis, 1992) examined just

that. The high school and beyond data base was used to investigate the experiences of drop outs and

high school graduates (control group), four years after the projected date of graduation. Specifically,

dropouts and graduates with no post-secondary education were compared on the following: Self-

esteem, satisfaction at work, political/social participation measures, and number of jobs. Multiple

regression analyses were used to determine the degree to which dropping out explained variance in

these measures. Dropouts differed from graduates on every personal and social adjustment measure.

Differences on these measures were much more significant in males (dropouts vs. graduates), than in

females (dropouts vs. graduates).

In the article published by Goliath (2005), large number of studies has been accumulated

within this concern. Adolescent / Adult suicide is a worldwide problem, but it is of particular concern in

highly industrialized nations such as the United States (Conner, Duberstein, Conwell, Seidlitz, & Caine,

2001); Kurtz & Derevensky, 1993). The suicide rate in the United States has tripled since 1960, making

it the third leading cause of death among adolescents and the second leading cause of death among

the college-age population (National Mental Health Association, 1997). Although it is estimated that

approximately 14 adolescents in the United States commit suicide each day, the actual number is two

to three times higher (American Psychiatric Association, 1996; 1998). Understandably, these alarming

statistics have stimulated great concern in the public at large and have led social scientists to warn of

an impending rise in the number of suicides and suicidal attempts among adolescents (Berman &

Jobes, 1994; Griffiths, Farley, & Fraser, 1986; Watt & Sharp, 2002). Much of the research literature

appears to be focused on suicide per se. However, professionals are increasingly paying attention to

the antecedent behaviors. According to Bush and Pargament (1995), suicidal behavior is often

preceded by thoughts, threats, and unsuccessful attempts at suicide. Similarly, Cole, Protinsky, and

Cross (1992) noted that suicide was the completed process of a continuum that began with suicidal

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ideation, followed by an attempt at suicide, and finally completed suicide. Suicidal ideation is a

preoccupation with intrusive thoughts of ending one's own life (Cole, Protinsky, & Cross, 1992; Harter,

Marold, & Whitesell, 1992) while suicide is the completed act of taking ones life (National Mental

Health Association, 2002). Because of this progression from thought to action, it is fitting that

researchers explore the notion of suicidal ideation in greater depth. (Studies referred from Goliath,

2005).

This study examined the phenomenological relationship among stress, self-esteem, and

suicidal ideation in adolescents. Much of the research to date has focused on the associations of stress

and self-esteem to actual suicide but not to ideation. Moreover, the majority of studies have examined

the relationships in clinical populations. Thus, we know little about the associations of these processes

in non-clinical populations. The present study investigated the relationship among cumulative negative

life experiences (stress), self-esteem, and suicidal ideation in a non-clinical population of college

students. Selye (1974) defined stress as a response of the human body to any stimulus that disrupts

the individual's homeostasis. Because these responses are unavoidable, individuals are faced with the

constant urge to maintain internal balance. Accordingly, any experience that affects one's homeostasis

is considered to be stress (Rice, 1992). Social scientists have expanded Hans Selye's notion of

physiological stress to include social, cognitive, and psychological or mental stress. Mullis, Youngs,

Mullis, and Rathge (1993) proposed that stress is a function of an individual's appraisal of a life

stressor and therefore, a cognitive process. Similarly, Lazarus (1993) contended that the extent to

which individuals experience stress is determined by their subjective evaluations of their experiences.

Therefore, if individuals appraise an event as traumatic, they will experience more stress from the

experience than will individuals who appraise the event as non-significant. Researchers (e.g., Bartle-

Haring, Rosen, & Stith, 2002; Ferrer-Wreder, Lorente, Kurtines, Briones, Bussell, Berman, & Arrufat,

2002) have noted the importance of reducing stress by helping youth develop positive perceptions of the self in order to avoid catastrophic socioemotional outcomes such as suicidal behavior. Indeed,

exposure to stress by youth has been linked to severe emotional and psychological problems (Bartle-

Haring, Rosen, & Stith, 2002; Gonzales, Tein, Sandler, & Friedman, 2001), a known precursor to suicide

(Teen suicide, 1998). (Studies referred from Goliath, 2005).

Mc Gee, Williams and Nada-Raja (2001) examined the longitudinal relationship between family

characteristics in early childhood, self-esteem, hopelessness and thoughts of self-harm in the mid-

childhood years, and suicidal ideation at ages 18 and 21. Path analysis was used to establish separate

models for boys and girls. The results suggested different pathways to later suicidal ideation for boys

and girls. For boys, suicidal ideation seemed to have stronger roots in childhood, with significant pathsfrom low self-esteem and hopelessness to early thoughts of self-harm and thence to later ideation. For

girls, self-esteem had a small but significant direct effect on later suicidal ideation. The findings

provide support for the idea that individual characteristics such as feelings of hopelessness and low

self-esteem act as generative mechanisms, linking early childhood family characteristics to suicidal

ideation in early adulthood.

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Hong, Li, Fang, Wai, and Xiong (2007) proposed, China accounts for nearly a half of the

suicides in the world, but little is known about the risk factors of suicidal ideation among general

Chinese population. This study examines the association between stressful life events, self-esteem and

suicidal ideation among three community-based samples in China: rural residents, rural-to-urban

migrants and urban residents. Representative samples of rural-to-urban migrants (n=1006) and urban

residents (n=1000) were recruited in Beijing. The sample of rural residents (n=1020) was recruited

from 8 provinces from where 75% of migrant sample originated. All participants completed a cross-

sectional survey. Multivariate logistic regressions were employed for data analyses. The Results

evidenced that Approximately 9.2% of total participants had suicidal ideation in the past 6 months,

and the rate was slightly higher among urban residents and females. A significant dose-response

relationship was observed between the number of stressful life events and suicidal ideation. In

multivariate regression model, both stressful life events and self-esteem were significantly associated

with elevated risk of suicidal ideation among three groups of participants. No moderating effect of self-

esteem was observed in the relationship between stressful life events and suicidal ideation. It was

concluded that Stressful life events and self-esteem were two significant risk factors for suicidal

ideation among Chinese population. Appropriate intervention and education programs that aim at

reducing suicide risks need to consider these two important factors.

Sterud, Hem, Lau, and Ekeberg (2008) produced the first paper on suicidal ideation and

attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and

suicide attempts among ambulance personnel, and to identify important correlates and the factors to

which ambulance personnel attribute their serious suicidal ideation. In conclusion, ambulance

personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious

suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-

related factors like emotional exhaustion and bullying may be of importance which greatly lowers theself-esteem.

Wagner, Rouleau, and Joiner (2000) conducted this study to determine whether there are

changes in the cognitive factors of attributional style, hopelessness, and self-esteem when suicidal

ideation fades in psychiatrically hospitalized children and adolescents. The cognitive factors of

attributional style, hopelessness, and self-esteem were assessed in subjects aged 7–17 years (50 with

and 50 without suicidal ideation) at admission and discharge from a psychiatric hospital. The results

revealed: For subjects with suicidal ideation, attributional style became significantly more positive and

hopelessness was decreased from admission to discharge, by which time suicidal ideation had faded.

There was no association between self-esteem and suicidal ideation after control for depression. Thesechanges in cognitive factors were not seen in the group without suicidal ideation. There were no

significant differences between children and adolescents in the pattern of results. It was concluded

that Change in attributional style was shown to be a factor significantly related to the resolution of

suicidal ideation in children and adolescents. This cognitive style could be specifically addressed in

psychotherapy with depressed children and adolescents as a means of reducing suicidal ideation.

These results may have an implication for reducing the length of psychiatric inpatient stays.

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Although low self-esteem has been associated with suicidal ideation in adolescents (De Man &

Leduc, 1995), after control for depression in our study, there were no significant changes in the level of

self-esteem when suicidal ideation was resolved. Since self-esteem is a depressive symptom, this

finding is not particularly surprising. This result is consistent with the findings of Marciano and Kazdin

(1994), who reported that self-esteem did not discriminate between children with and without suicidal

ideation when depression was controlled for.

The cognitive model of psychopathology described by Beck (1976) has led to characterization

of the negative thinking that typifies depressed individuals (Beck, 1991). A negative cognitive shift

occurs in which a person disregards positive information and focuses on negative information. This

results in negative beliefs and assumptions. Beck, Steer and Brown (1993) have examined these

dysfunctional attitudes and their relationship to suicidal ideation in adult psychiatric outpatients. They

found that although dysfunctional attitudes such as a need for approval were related to suicidal

ideation, they were not as significantly related as a history of a suicide attempt and the degree of

hopelessness about the future. Pinto and Whisman (1996) reported that negative views of oneself and

others led to negative affect and suicidal ideation in a sample of psychiatrically hospitalized

adolescents.

Attitudinize Psychotherapy Technique includes Motivational Interviewing

elaborated by Group Health Centre for Health Promotion (2003) “client-centered, directive method for

enhancing intrinsic motivation to change by exploring and resolving ambivalence.” The Attitudinize

therapy can be learned by the person / client. The person then needs to take what has been learned,

practice it at home (when they are alone and not feeling self-conscious, for approximately thirty

minutes a day), and through means of repetition, and get that “new learning” down into the brain over

and over again. Just like learning at school or an institution. It enables you to begin believing, feeling

and acting, differently. This takes persistence, practice, and patience, but when a person sticks with

this therapy, and does not give up, noticeable progress begins to occur.

Persistency is the next key. These solutions must be practiced every day for three months or

longer. It is essential that the brain receive these new, rational, forward moving messages so that

attitude can be changed. The neural pathways in the mind "absorb" the attitudinize therapy and it

begins to become a part of the person allowing permanent change to occur. After granting the

intricacies, the mastery of these concepts is needed for treating the emotional problems successfully.

Method

Sample of the present study comprised of 106 Male and 46 Female Adult Students of Iqra

University, Karachi. It was selected through Random Sampling Technique.

Procedure of the study comprises of Two phases. In order to test the hypotheses, the sample

comprised of NO THERAPY GROUP; the Fifty-two Male and Twenty-three Female Adult Students on

which NO Attitudinize Psychotherapy would be conducted, and for ATTITUDINIZE THERAPY GROUP;

10



Fifty-four Male and Twenty-three Female Adult Students on which Attitudinize Psychotherapy would be

conducted. The data was collected from the Adult students between the ages of 18–25 belonging to

Iqra University, Karachi. In the Initial Phase of BEFORE THERAPY All the Male and Female students were

administered; a) Dysfunctional Attitude Scale (Therapy Form) (Modified by Dr. Linah Askari 2003), b)

Queendom’s Self–Esteem Test (2003) and c) Adult Suicidal Ideation Questionnaire (William & Reynolds,

2005). In the Final Phase of AFTER THERAPY, Attitudinize Therapy was conducted for fourteen weeks

(75 minute session, twice a week) on the ATTITUDINIZE THERAPY GROUP only. At the completion of

this phase the whole sample was Re-administered All the three Scales, to both the students of NO

THERAPY GROUP and the students of ATTITUDINIZE THERAPY GROUP. The purpose was to relate the

effectiveness of the Attitudinize Therapy with the Enhancement of Self – Esteem and Reduction of

Suicidal Ideation within the Adult students.

Statistical Analysis of the obtained scores revealed the significance of differences for the

Enhancement of Self – Esteem through the application of Attitudinize Psychotherapy between the TWO

Groups after completion of the Therapy and No Therapy. The Means, Standard Deviations, Pearson

correlation coefficients, one sample t-test, One Way ANOVA were computed along with Mean-plots,

Mean Graphs, Pie-Charts and Percent Count Graphs for data analysis.

Results

The data was statistically analyzed among the following groups. BTNODAS – “Before Therapy,

No Therapy Group, Dysfunctional Attitude Scale”. BTNOSET – “Before Therapy, No Therapy Group,

Self-Esteem Test”. BTNOASI – “Before Therapy, No Therapy Group, Adult Suicide Ideation

Questionnaire”. BTATZDAS – “Before Therapy, Attitudinize Therapy Group, Dysfunctional Attitude

Scale”. BTATZSET – “Before Therapy, Attitudinize Therapy Group, Self-Esteem Test”. BTATZASI –

“Before Therapy, Attitudinize Therapy Group, Adult Suicide Ideation Questionnaire”.

ATNODAS – “After Therapy, No Therapy Group, Dysfunctional Attitude Scale”. ATNOSET –

“After Therapy, No Therapy Group, Self-Esteem Test”. ATNOASI – “After Therapy, No Therapy Group,

Adult Suicide Ideation Questionnaire”. ATATZDAS – “After Therapy, Attitudinize Therapy Group,

Dysfunctional Attitude Scale”. ATATZSET – “After Therapy, Attitudinize Therapy Group, Self-Esteem

Test”. ATATZASI – “After Therapy, Attitudinize Therapy Group, Adult Suicide Ideation Questionnaire”.

The following Hypotheses proved their significance through the statistical analysis, and the

summarized results are presented below:

1) There is More Positive Correlation between scores of Dysfunctional Attitudes and Suicidal

Ideation, i.e., The Higher the Dysfunctional Attitudes the Higher will be the Suicidal Ideation,

and Vice Versa.

2) There is More Negative Correlation between scores of Dysfunctional Attitudes and Self-Esteem,

i.e., The Higher the Dysfunctional Attitudes the Lower will be the Self-Esteem, and Vice Versa.

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3) After the Therapy; the scores of Dysfunctional Attitudes are Lower within the adults of

ATTITUDINIZE THERAPY GROUP as compared to the scores of Dysfunctional Attitudes within

the adults of NO THERAPY GROUP.

4) After the Therapy; the scores of Self-Esteem are Higher within the adults of ATTITUDINIZE

THERAPY GROUP as compared to the scores of Self-Esteem within the adults of NO THERAPY

GROUP.

5) After the Therapy; the scores of Suicidal Ideation are Lower within the adults of ATTITUDINIZE

THERAPY GROUP as compared to the scores of Suicidal Ideation within the adults of NO

THERAPY GROUP.

Descriptive Statistics

75 221.00 355.00 303.4000 48.0824

75 36.00 75.00 51.7867 11.7947

75 122.00 169.00 149.2533 13.340777 222.00 355.00 304.8312 47.6780

77 37.00 73.00 50.5065 11.5001

77 123.00 170.00 150.3506 13.2196

75

BTNODAS

BTNOSET

BTNOASIBTATZDAS

BTATZSET

BTATZASI

Valid N (listwise)

N Minimum Maximum Mean Std. Deviation

Descriptive Statistics

75 228.00 365.00 309.2667 49.9509

75 35.00 74.00 50.3333 11.4104

75 125.00 176.00 153.4133 13.2951

77 60.00 160.00 103.9481 27.0024

77 110.00 141.00 124.1558 7.8925

77 35.00 80.00 60.1558 12.9372

75

ATNODAS

ATNOSET

ATNOASI ATATZDAS

ATATZSET

ATATZASI

Valid N (listwise)

N Minimum Maximum Mean Std. Deviation

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One-Sample Statistics

75 303.4000 48.0824 5.5521

75 51.7867 11.7947 1.3619

75 149.2533 13.3407 1.5405

77 304.8312 47.6780 5.4334

77 50.5065 11.5001 1.3106

77 150.3506 13.2196 1.5065

75 309.2667 49.9509 5.7678

75 50.3333 11.4104 1.3176

75 153.4133 13.2951 1.5352

77 103.9481 27.0024 3.0772

77 124.1558 7.8925 .8994

77 60.1558 12.9372 1.4743

BTNODAS

BTNOSET

BTNOASI

BTATZDAS

BTATZSET

BTATZASI

ATNODAS

ATNOSET

ATNOASI

ATATZDAS

ATATZSET

ATATZASI

N Mean Std. Deviation

Std. Error

Mean

One-Sample Test

54.466 74 .000 302.4000 291.3372 313.4628

37.290 74 .000 50.7867 48.0729 53.5004

96.240 74 .000 148.2533 145.1839 151.3228

55.919 76 .000 303.8312 293.0096 314.6528

37.775 76 .000 49.5065 46.8963 52.1167

99.137 76 .000 149.3506 146.3502 152.351153.446 74 .000 308.2667 296.7740 319.7593

37.443 74 .000 49.3333 46.7080 51.9586

99.280 74 .000 152.4133 149.3544 155.4723

33.455 76 .000 102.9481 96.8193 109.0768

136.926 76 .000 123.1558 121.3645 124.9472

40.124 76 .000 59.1558 56.2195 62.0922

BTNODAS

BTNOSET

BTNOASI

BTATZDAS

BTATZSET

BTATZASI ATNODAS

ATNOSET

ATNOASI

ATATZDAS

ATATZSET

ATATZASI

t df Sig. (2-tailed)Mean

Difference Lower Upper

95% ConfidenceInterval of the

Difference

Test Value = 1

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Correlations

1.000 -.901** .912** -.085 -.879** .876**

. .000 .000 .469 .000 .000

75 75 75 75 75 75

-.901** 1.000 -.852** .132 .970** -.831**

.000 . .000 .259 .000 .000

75 75 75 75 75 75

.912** -.852** 1.000 -.120 -.811** .965**

.000 .000 . .303 .000 .000

75 75 75 75 75 75

-.085 .132 -.120 1.000 .079 -.102

.469 .259 .303 . .500 .385

75 75 75 75 75 75

-.879** .970** -.811** .079 1.000 -.841**

.000 .000 .000 .500 . .000

75 75 75 75 75 75

.876** -.831** .965** -.102 -.841** 1.000

.000 .000 .000 .385 .000 .

75 75 75 75 75 75

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

BTNODAS

BTNOSET

BTNOASI

ATNODAS

ATNOSET

ATNOASI

BTNODAS BTNOSET BTNOASI ATNODAS ATNOSET ATNOASI

Correlation is significant at the 0.01 level (2-tailed).**.

14



Correlations

1.000 -.909** .912** .030 .242* .183

. .000 .000 .798 .034 .112

77 77 77 77 77 77

-.909** 1.000 -.862** -.030 -.192 -.138

.000 . .000 .795 .094 .231

77 77 77 77 77 77

.912** -.862** 1.000 .074 .296** .205

.000 .000 . .520 .009 .074

77 77 77 77 77 77

.030 -.030 .074 1.000 .335** .515**

.798 .795 .520 . .003 .000

77 77 77 77 77 77

.242* -.192 .296** .335** 1.000 .781**

.034 .094 .009 .003 . .000

77 77 77 77 77 77

.183 -.138 .205 .515** .781** 1.000

.112 .231 .074 .000 .000 .

77 77 77 77 77 77

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

Pearson Correlation

Sig. (2-tailed)

N

BTATZDAS

BTATZSET

BTATZASI

ATATZDAS

ATATZSET

ATATZASI

BTATZDAS BTATZSET BTATZASI ATATZDAS ATATZSET ATATZASI

Correlation is significant at the 0.01 level (2-tailed).**.

Correlation is significant at the 0.05 level (2-tailed).*.

Oneway ANOVA

ANOVA

9983.087 52 191.982 13.559 .000

311.500 22 14.159

10294.587 74

12300.353 52 236.545 5.983 .000

869.833 22 39.538

13170.187 74

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

BTNOSET

BTNOASI

Sum of

Squares df Mean Square F Sig.

15



Means Plots

BTNODAS

354.00

351.00

348.00

344.00

340.00

337.00

333.00

328.00

322.00

315.00

305.00

255.00

247.00

243.00

235.00

230.00

226.00

221.00

M e a n o f B T N O S E T

80

70

60

50

40

30

BTNODAS

354.00

351.00

348.00

344.00

340.00

337.00

333.00

328.00

322.00

315.00

305.00

255.00

247.00

243.00

235.00

230.00

226.00

221.00

M e a n o f B T N O A S I

180

170

160

150

140

130

120

110

Oneway ANOVA

ANOVA

9876.413 55 179.571 21.569 .000

174.833 21 8.325

10051.247 76

12500.366 55 227.279 6.110 .000

781.167 21 37.198

13281.532 76

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

BTATZSET

BTATZASI

Sum of


Means Plots

BTATZDAS

354.00

351.00

348.00

344.00

340.00

337.00

334.00

330.00

325.00

317.00

313.00

303.00

254.00

248.00

244.00

236.00

231.00

227.00

222.00

M e a n o f B T A T Z S E T

80

70

60

50

40

30

BTATZDAS

354.00

351.00

348.00

344.00

340.00

337.00

334.00

330.00

325.00

317.00

313.00

303.00

254.00

248.00

244.00

236.00

231.00

227.00

222.00

M e a n o f B T A T Z A

S I

180

170

160

150

140

130

120

16



Oneway ANOVA

ANOVA

6444.333 49 131.517 1.031 .481

3190.333 25 127.613

9634.667 74

9664.853 49 197.242 1.444 .161

3415.333 25 136.613

13080.187 74

Between GroupsWithin Groups

Total

Between Groups

Within Groups

Total

ATNOSET

ATNOASI

Sum of


Means Plots

17



ATNODAS

364.00

360.00

357.00

353.00

348.00

345.00

340.00

335.00

328.00

315.00

265.00

256.00

251.00

243.00

237.00

233.00

228.00

M e a n o f A T N O S E T

80

70

60

50

40

30

ATNODAS

364.00

360.00

357.00

353.00

348.00

345.00

340.00

335.00

328.00

315.00

265.00

256.00

251.00

243.00

237.00

233.00

228.00

M e a n o f A T N O A S I

180

170

160

150

140

130

120

Oneway ANOVA

18



ANOVA

3967.963 55 72.145 1.977 .044

766.167 21 36.484

4734.130 76

10540.463 55 191.645 1.846 .062

2179.667 21 103.794

12720.130 76

Between Groups

Within Groups

Total

Between Groups

Within Groups

Total

ATATZSET

ATATZASI

Sum of


Means Plots

ATATZDAS

155.00

145.00

141.00

135.00

128.00

120.00

115.00

110.00

106.00

102.00

97.00

93.00

89.00

84.00

80.00

75.00

71.00

66.00

60.00

M e a n o f A T A T Z S E T

150

140

130

120

110

100

ATATZDAS

155.00

145.00

141.00

135.00

128.00

120.00

115.00

110.00

106.00

102.00

97.00

93.00

89.00

84.00

80.00

75.00

71.00

66.00

60.00

M e a n o f A T A T Z A S I

90

80

70

60

50

40

30

19



Graphs

A T A T Z A S I

A T A T Z S E T

A T A T Z D A S

A T N O A S I

A T N O S E T

A T N O D A S

B T A T Z A S I

B T A T Z S E T

B T A T Z D A S

B T N O A S I

B T N O S E T

B T N O D A S

M e a n

400

300

200

100

0

ATATZASI

ATATZSET

ATATZDAS

ATNOASI

ATNOSET

ATNODAS

BTATZASI

BTATZSET

BTATZDAS

BTNOASI

BTNOSET

BTNODAS

M e a n

400

300

200

100

0

20



ATATZASI

ATATZSET

ATATZDAS

ATNOASI

ATNOSET

ATNODAS

BTATZASI BTATZSET

BTATZDAS

BTNOASI

BTNOSET

BTNODAS

A T N O S E T

B T A T Z S E T

B T N O S E T

A T A T Z A S I

A T A T Z D A S

A T A T Z S E T

B T N O A S I

B T A T Z A S I

A T N O A S I

B T N O D A S

B T A T Z D A S

A T N O D A S

C o u n t

160000

140000

120000

100000

80000

60000

40000

20000

0

P er c en t

100

50

077399316111941126511506

227552281223195

Discussion

The Means, Standard Deviations, correlation coefficients, one sample t-test, and one way

ANOVA were computed shown in Tables 1, 2, 3, 4, 5, 6, 7, 8, 9 & 10 and ALL THE GRAPHS, MEAN

PLOTS, PERCENT COUNT & PIE-CHART to examine the relationship between application of Attitudinize

Psychotherapy and improvement of Personality within the self – Esteem, reduction of dysfunctional

attitudes and diminishing of suicidal ideation.

21



Hypothesis 1: There is More Positive Correlation between scores of Dysfunctional Attitudes and

Suicidal Ideation, i.e., The Higher the Dysfunctional Attitudes the Higher will be the Suicidal Ideation,

and Vice Versa.

a) BTNODAS vs. BTNOASI; Mean BTNODAS = 303.40 & Mean BTNOASI = 149.25, r = 0.912 **

b) ATNODAS vs. ATNOASI; Mean ATNODAS = 309.26 & Mean ATNOASI = 153.41, r = - 0.102

c) BTATZDAS vs. BTATZASI; Mean BTATZDAS = 303.40 & Mean BTATZASI = 150.35, r = 0.912 **

d) ATATZDAS vs. ATATZASI; Mean ATATZDAS = 103.94 & Mean ATATZASI = 60.15, r = 0.515 **

e) One way ANOVA Between & Within Groups for BTNODAS vs. BTNOASI; F = 5.983 at 0.000 Sig.

f) One way ANOVA Between & Within Groups for ATNODAS vs. ATNOASI; F = 1.444 at 0.161 Sig.

g) One way ANOVA Between & Within Groups for BTATZDAS vs. BTATZASI; F = 6.110 at 0.000

Sig.

h) One way ANOVA Between & Within Groups for ATATZDAS vs. ATATZASI; F = 1.846 at 0.062

Sig.

(For Pearson Correlation Coefficient r, ** means correlation is significant at the 0.01 level 2-

tailed

& * means correlation is significant at the 0.05 level 2-tailed)

The person having higher level of dysfunctional attitudes does not seem to analyze the

situation out of the box. Continuous hurt to the self-esteem provides destructive thoughts in all the

situations being experienced. The solution for such a person seems to take refuge in gaining sympathy

from the people around and flight from the situations by thinking of ending up their lives.

Smith, Alloy and Abramson (2006), In order to advance the detection and prevention of

suicide, focused recent research on predictors of suicidal ideation and behavior such as negativecognitive styles, dysfunctional attitudes, hopelessness, and rumination. In this study the relationships

among these risk factors in the context of the Attention Mediated Hopelessness (AMH) theory of

depression are examined. One hundred and twenty-seven undergraduates in the Cognitive

Vulnerability to Depression (CVD) project were followed for 2.5 years. The CVD project followed initially

non-depressed freshmen, at either high or low cognitive risk for depression, in order to predict onsets

and recurrences of depressive disorders. The presence and duration of suicidal ideation were predicted

prospectively by rumination and hopelessness, and hopelessness partially mediated the relationship

between rumination and ideation and fully mediated the association between rumination and duration

of suicidality. Further, rumination mediated the relationship between cognitive vulnerability and

suicidal ideation.

Hypothesis 2: There is More Negative Correlation between scores of Dysfunctional Attitudes

and Self-Esteem, i.e., The Higher the Dysfunctional Attitudes the Lower will be the Self-Esteem & Vice

Versa.

a) BTNODAS vs. BTNOSET; Mean BTNODAS = 303.40 & Mean BTNOSET = 51.78, r = - 0.901 **

b) ATNODAS vs. ATNOSET; Mean ATNODAS = 309.26 & Mean ATNOSET = 50.33, r = 0.079

22



c) BTATZDAS vs. BTATZSET; Mean BTATZDAS = 304.83 & Mean BTATZSET = 50.50, r = - 0.909 **

d) ATATZDAS vs. ATATZSET; Mean ATATZDAS = 103.94 & Mean ATATZSET = 124.15, r = 0.335 **

e) One way ANOVA Between & Within Groups for BTNODAS vs. BTNOSET; F = 13.559 at 0.000

Sig.

f) One way ANOVA Between & Within Groups for ATNODAS vs. ATNOSET; F = 1.031 at 0.481 Sig.

g) One way ANOVA Between & Within Grps for BTATZDAS vs. BTATZSET; F = 21.569 at 0.000 Sig.

h) One way ANOVA Between & Within Grps for ATATZDAS vs. ATATZSET; F = 1.977 at 0.044 Sig.

Ashby and Rice (2002) in their study examined the association between adaptive and

maladaptive dimensions of perfectionism and self-esteem. Confirmatory factor analysis and structural

equations modeling were used to develop and test a model derived from theoretical links between

perfectionism and self-esteem. Path models revealed that adaptive perfectionism was positively

associated with self-esteem and maladaptive perfectionism was negatively associated with self-

esteem. Implications of discriminating between adaptive and maladaptive perfectionism in counseling

research and practice are discussed.

Hypothesis 3: After the Therapy; the scores of Dysfunctional Attitudes are Lower within the

adults of ATTITUDINIZE THERAPY GROUP as compared to the scores of Dysfunctional Attitudes within

the adults of NO THERAPY GROUP.

a) ATNODAS vs. ATATZDAS; Mean ATNODAS = 309.26 & Mean ATATZDAS = 103.94

b) ATNODAS vs. ATATZDAS; ATNODAS one sample t = 53.44 & ATATZDAS one sample t = 33.45

at 95% Confidence Interval of the Difference & at Significant level 0.000 (2 – tailed).

Dr. Hamamci (2006) proposed for Integrating psychodrama and cognitive behavioral therapy

to treat moderate depression. The aim of the study is to compare the effects of psychodramaintegrated with cognitive behavioral therapy and cognitive behavioral group therapy in the treatment

of depression. Thirty-one university students with moderate depression participated in this study. After

the participants were randomly assigned to and control groups, group therapies were conducted for 11

sessions over a period lasting nearly 3 months. The control group received no treatment. The Beck

Depression Inventory (BDI), the Automatic Thoughts Questionnaire (ATQ) and the Dysfunctional

Attitude Scale (DAS) were administered to the participants at three different occasions: pre-treatment,

post-treatment, and 6-month follow-up. A 3 × 3 ANOVA was used to examine the effectiveness of the

treatments. The results indicated that both psychodrama integrated with cognitive behavioral therapy,

and cognitive behavioral group therapy alone, led to reduction in the level of depression, negative

automatic thoughts, and dysfunctional attitudes of participants. However, there were no significant

differences between the two treatments in terms of their effectiveness.

Hypothesis 4: After the Therapy; the scores of Self-Esteem are Higher within the adults of

ATTITUDINIZE THERAPY GROUP as compared to the scores of Self-Esteem within the adults of NO

THERAPY GROUP.

a) ATNOSET vs. ATATZSET; Mean ATNOSET = 50.33 & Mean ATATZSET = 124.15

23



b) ATNOSET vs. ATATZSET; ATNOSET one sample t = 37.44 & ATATZSET one sample t = 136.92

at 95% Confidence Interval of the Difference & at Significant level 0.000 (2 – tailed).

Powell, Newgent and Lee (2006) in this study on Group cinema therapy proposed for using

metaphor to enhance adolescent self-esteem. It examines the effectiveness of a cinema therapy

intervention at enhancing the perceived self-esteem of 16 youth with a serious emotional disturbance.Participants completed the Rosenberg Self-Esteem Scale (RSE) at pre-, post-, and 1-week follow-up

within a 6-week coping skills group in which a brief cinema therapy intervention is introduced to a

treatment and delayed treatment group. A control group was used, which only received the coping

skills training. Results of a split-plot analysis of variance (ANOVA) with one between-groups factor and

one repeated-measures factor revealed no significant differences within or between groups, however,

meaningful differences between the three groups were found. Implications for counselors and

therapists are discussed.

Hypothesis 5: After the Therapy; the scores of Suicidal Ideation are Lower within the

adults of ATTITUDINIZE THERAPY GROUP as compared to the scores of Suicidal Ideation within theadults of NO THERAPY GROUP.

c) ATNOASI vs. ATATZASI; Mean ATNOASI = 153.41 & Mean ATATZASI = 60.15

d) ATNOASI vs. ATATZASI; ATNOASI one sample t = 99.28 & ATATZASI one sample t = 40.12 at

95% Confidence Interval of the Difference & at Significant level 0.000 (2 – tailed).

Schwenk (2004) studied upon Reducing Suicidal Ideation in Elders, stating it is Possible, but

Expensive. Primary care-based interventions to reduce suicide risk in older patients are appealing but

are relatively unstudied. Researchers enrolled 598 elders (age, >60) with depression diagnoses from

20 primary care practices in the U.S. in a 1-year trial of a primary care-based intervention. Practices

were randomized to provide usual care or intervention. The intervention consisted of physician

education (with algorithmic approaches to depression treatment); trained care managers with mental

health expertise who provided treatment recommendations, clinical monitoring, and frequent follow-

up; and financial support for medication (citalopram, supplied by the manufacturer) and

psychotherapy. Results reveal, In the intervention group, the prevalence of suicidal ideation dropped

from 29% at baseline to 17% at 8 months and to 15% at 12 months. In the usual-care group, the

prevalence dropped from 20% at baseline to 19% at 8 months and to 13% at 12 months. Given the

higher baseline prevalence in the intervention group, the decline at 8 months was significantly greater

in the intervention group than in the usual-care group. Compared with usual care, intervention yielded

significantly larger declines in depression severity (measured by questionnaire scores) at 4, 8, and 12

months; number of patients in remission at 8 or 12 months was similar in both groups. Actual suicide

attempts were too uncommon to evaluate (one in each group). The statistical significance of the

decline in the suicidal ideation rate with intervention derives mostly from an unexplained higher

baseline rate in the intervention group than in the usual-care group. Intervention costs were not

calculated, but clearly this approach was expensive and probably could not be supported in usual

practice. We would have learned more from this study if medication and psychotherapy had been

provided at no cost to both groups.

24



Statistically significant results reveal that Attitudinize Psychotherapy employs a positive,

active, educational approach that focuses on how to change the attitudes and on seeking solutions

rather than just simply talking about the past or “exploring” ones feelings and problems. Attitudinize

Psychotherapy is typically provided within an emotionally supportive, empathic relationship, giving

opportunity to express feelings and receive caring in addition to working directly on positive attitude

change in thinking and lifestyle. The treatment is often short term because it is based on a clear

attitude conceptualization that guides the treatment process. Attitudinize Psychotherapy emphasizes a

collaborative relationship between the therapist and the client wherein they work together to specify

goals and to implement the treatment strategies. Each client is assisted in using strategies /

techniques that will help in resolving current areas of difficulty as well as learning skills that will be

useful in preventing relapse and in dealing with future life challenges.

Attitudinize Psychotherapy directly teaches specific ways to examine and correct dysfunctional

thinking patterns or beliefs, those that are causing or contributing to problems in ones life within the

personality. Behavioral strategies are often used with Attitudinize Psychotherapy to develop skills such

as assertiveness or problem solving. Often we need “reality experiments” to prove to ourselves that

what we fear really is not true, or that we could cope with particular circumstances, or that we are

capable of changing certain habits, or that we can easily delete our own low self – esteem and lack of

confidence, by learning and practicing an effective personality improving strategy. The results of this

type of therapy may include a sense of freedom from old patterns, greater opportunity to pursue new

life opportunities, improve personality to a maximum level, reduce distress, and enhance a greater

sense of confidence and self-esteem.

Ramakrishna was born with congenital cataract. By the age of 22, he was totally blind.

Today he is General Manager with the Industrial Development Bank of India. He credits his

mathematical ability and technology as the two most important pillars of his success. We will let his

words do the talking and reflect on his journey to success. Ramakrishna (2007) says:

“I often question myself, did I really succeed? If so what is the success formula? What is that I

would like to share with those who want to succeed? Well, I believe success is a journey, not a

destination. I invented a secret recipe of success, which unlike the three or so routine courses of meal,

has eight courses to taste and dwell on. These are: vIsion, Dream, focUs, dirEction, mind Tuning,

Toughness, perseverAnce and sTruggle. Now collect the capitalized letters of these eight steps and

reshuffle them to form the mantra of my success ‘ATTITUDE’.”

Conclusion

It is imperative to constantly keep a check on ones attitudes (cognition/thought, feeling and

behavior) in all the six dimensions i.e., Physiologically, Psychologically, Terminologically, within Time

Management, Neuro-harmonically and Spiritually. Evidence is provided that attitudinize psychotherapy

25



enables the individual for Self-Conditioning constantly for turning all the dysfunctional attitudes into

positive/adaptive attitudes. Once the individual is determined to keep one self tuned into the adaptive

attitudes most of the time, towards self, environment and the world around them, enhances the self

esteem of the individual to a higher level most of the time and the self identity, meaning of life, worth

of life remains intact, boosts the ego and keeps the person motivated enthusiastically for life ahead.

Cannon (2003) proposes, Hopelessness is a significant predictor of suicidality, but not all

depressed patients feel hopeless. If clinicians can predict hopelessness, they may be able to identify

those patients at risk of suicide and focus interventions on factors associated with hopelessness. In

this study, we examined potential predictors of hopelessness in a sample of depressed outpatients.

Methods: In this study, we examined potential demographic, diagnostic, and symptom predictors of

hopelessness in a sample of 138 medication-free outpatients (73 women and 65 men) with a primary

diagnosis of major depression. The significance of predictors was evaluated in both simple and

multiple regression analyses. Results were Consistent with previous studies, we found no significant

associations between demographic and diagnostic variables and greater hopelessness. Hopelessness

was significantly associated with greater depression severity, poor problem solving abilities as

assessed by the Problem Solving Inventory, and each of two measures of dysfunctional cognitions (the

Dysfunctional Attitudes Scale and the Cognitions Questionnaire). In a stepwise multiple regression

equation, however, only dysfunctional cognitions and poor problem solving offered non-redundant

prediction of hopelessness scores, and accounted for 20% of the variance in these scores. These

findings, identifying clinical correlates of hopelessness, provide clinicians with potential additional

targets for assessment and treatment of suicidal risk. In particular, clinical attention to dysfunctional

attitudes and problem solving skills may be important for further reduction of hopelessness and

perhaps suicidal risk.

The findings are statistically modest and provide an insight to the effectiveness of the

Attitudinize Psychotherapy. Friedenberg and Gillis (2006) in an experimental study reveal that a

frequent goal in psychotherapy is the modification of low self-esteem. While such modification is

accomplished most often in an indirect manner, it is possible to apply attitude change techniques

directly to this purpose. In this study, 36 college students who had scored poorly on a standardized

measure of self-esteem were exposed to a videotaped counter-attitudinal message under conditions of

either high or low credibility; controls did not view the videotape. Results were consistent across

several esteem measures and demonstrated significant positive changes in esteem for Ss exposed to

the high credibility communication. The possibilities of adapting attitude change techniques to

psychotherapy are considered.

Eland (2005) conducted research on Self Esteem Improvement, to know ‘What Does It Takes

and How Important Is It?’ The researcher proposes, “To be honest, it probably takes less than most

people would ever believe. Your desire, commitment and consistency are the most important success

factors - and last but not least good tools to accomplish the task of improving your self esteem and

confidence. Only one can tell how important it is. Self-esteem is fundamental. It is related to your self

26



worth and how you value yourself. Thus, building self-esteem is basic for your happiness and a good

life. Low self-esteem causes mental illness like depression and anxiety. Other people's desires can

seem more important than yours. The Inner, nagging voice of disapproval makes you powerless even

minor challenges seem impossible to overcome. This is a condition you don't have to stay in a minute

longer!

Then, how can I get out of it and really develop a high self-esteem, reduce dysfunctional

attitudes and diminish suicidal ideation you may ask? The first is to admit and accept your fear -

stop denying your bad self image - face it and from there start working with yourself. Then, set your

goal as precisely as you can. Commit to your goal. Then follow a plan containing a set of self-

esteem building activities to reach it; acceptance of dysfunctional attitudes can greatly help to work

for diminishing your suicidal ideation. Be nice to yourself. Reward yourself when you have reached a

sub-goal or a milestone. Give yourself a teaser from time to time. This is considered a vital part of

the knowledge of how to build self-confidence. Just know that your desire and commitment for

improving your self-esteem, reducing dysfunctional attitudes and diminishing suicidal ideation are

most important. If you really don't want an improvement, no program or self esteem exercise can

help you. But can I get help to develop my desire and commitment, you may ask? Yes, you can.

This is a major element in every quality program for improving your self-image, reducing

dysfunctional attitudes and diminishing suicidal ideation.

ACKNOWLEDGMENT

Dr. Linah Askari deeply thanks Almighty Allah Pak for the completion of the research. The

President - Mr. Shahjehan S. Karim, Executive Director Admissions – Ms. Sabina Mohsin, Executive

Director Academics – Mr. Talib S. Karim, Dean CBM – Dr. Javed Akbar Ansari and Administration

Personnel of Institute of Business Management, and my family & colleagues for their guidance and

Cooperation, in conducting and compiling the research. And the committee of SELF, Fifth Self Biennial

International Conference - UAE University for the opportunity granted for paper presentation.

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27



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