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PROPOSAL Topic : Relative Effective of Rational Emotive Behavioural Therapy and Humour Therapy on Among Depressed Patient in Delta State. Background to the Study The normal ups and downs of life mean that everyone feels sad or has "the blues" from time to time. But if emptiness and despair have taken hold of an individual life and won't go away, that person may have depression. Depression makes it tough to function and enjoy life like one once did. Just getting through the day can be overwhelming. But no matter how hopeless one feel, one can get better. Understanding the signs, symptoms, causes, and treatment of depression is the first step to overcoming the problem. According to Salmans (2013), Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being. People with depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed or restless. They may lose interest in activities that were once pleasurable, experience overeating or loss of appetite, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present. Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms a person have, the stronger they are, and the longer they’ve lasted—the more likely it is that an individual is dealing with depression. When these symptoms are overwhelming and disabling, that's when it's time to seek help. Murray , Buttner, and Price (2012 ), posits that Depressed mood is a feature of some psychiatric syndromes such as major depressive disorder, but it may also be a normal reaction to life events such as bereavement, a symptom of some bodily ailments or a side effect of some drugs and medical treatments. Depression is a common condition in the some individuals that negatively affects numerous parts of their lives. The prevalence of depressive disorder among those over 65 years was 10.99% to 16.7% in Korea,2,3 approximately 2.3% to 15.8% in the USA.4,5 Recent studies have reported that untreated depression is related to the increase of illness and disability, suicide and mortality. 6 It also places a substantial burden on family caregivers as well as health and social services. Recent studies have reported that untreated depression is related to the increase of illness and disability, suicide and mortality. 6 It also places a substantial burden on family caregivers as well as health and social services. Depressed mood may not require only professional treatment, and may be a normal reaction to certain life events, a symptom of some medical conditions, or a side effect of some drugs or medical treatments. A prolonged depressed mood, especially in combination with other symptoms, may lead to a diagnosis of a psychiatric or medical condition, e.g. of a mood disorder. Treatment of depression shall not be limited to medical approach only but psychological measure could help to reduced depression in patients. This study will attempt to use rational emotive behavioural therapy and laughter (Humour) therapy in treating patient with depression in delta central senatorial central hospitals, delta state. Laughter, in its basic form, is a psychophysiological response to a stimulus that leads to the production of muscle contractions, facial expressions, and other neurophysiological processes (Bennett & Lengacher 2008; Mora-Ripoll 2010; Mora-Ripoll & Garcia-Rodera 2008). In her review of the benefits of laughter, Mora-Ripoll (2010) concluded that the physiological benefits include improved respiration, general muscle relaxation, and enhanced mental functioning. The physiological changes were accompanied by psychological benefits, including increased positive mood and decreased depression. Typically, laughter has been investigated in terms of its ability to reduce negative emotions like anxiety, stress and depression (Houston, McKee, Carroll & Marsh 1998; Mora-Ripoll 2010; Papousek & Schulter 2008; Shahidi et al. 2011). This property was used to propose a stressbuffering hypothesis by Kuiper & Martin (1998), following their revelation that individuals who reported more frequent laughter experienced less negative affect during stress. In confirmation, Ko & Youn (2011) reported that laughter therapy reduced depressive symptoms and increased sleep quality in a group of elderly people with high rates of depressive vulnerability. On the other hand, Rational Emotive Behavior Therapy (REBT) is the first form of cognitive behavior therapy (CBT) and was created by Dr. Albert Ellis in 1955. According to the REBT model, people experience undesirable activating events, about which they have rational beliefs (RBs) and irrational beliefs (IBs). These beliefs then lead to emotional, behavioral, and cognitive consequences. Rational beliefs (i.e., helpful/effective beliefs) lead to functional consequences, while irrational beliefs (i.e., unhelpful/negative beliefs) lead to dysfunctional consequences. Clients who engage in REBT are encouraged to actively dispute their IBs and to assimilate more efficient, adaptive and rational beliefs, with a positive impact on their emotional, cognitive, and behavioral responses (Ellis, 1962; 1994; Walen et al., 1992). Thus, REBT is a psychological theory and a treatment consisting of a combination of three different types of techniques (cognitive, behavioral, and emotive) you can use to help yourself feel better physically and emotionally, and to engage in healthier behaviors. According to the cognitive theory, the effect that our thoughts can have on our physical, behavioral and emotional responses to a particular situation can be illustrated using the following diagram: A = Activating event or situation that we experience B= Beliefs or thoughts regarding the situation C = Consequence: How we feel or act based on these beliefs Let’s illustrate this model using an example: REBT Depression Manual/Protocol – BBU, David et al., (2004) Example 1: Person 1: A (Activating Situation) = A friend does not return your phone call B (Beliefs/Thoughts) = “I must have done something to upset them. I am such a horrible person.” C (Consequence/Effect) = Anxious, upset, depressed Person 2: A (Activating Situation) = A friend does not return your phone call B (Beliefs/Thoughts) = “They’re probably just really busy, and haven’t had time to get back to me yet.” C (Consequence/ Effect) = Content, neutral • The above example shows how two people may experience the same situation (e.g., having a friend not return one’s telephone call), but have very different reactions to the event based on how they interpret and evaluate the situation according to their thoughts and beliefs. Aims and Objectives/Purpose The purpose of this study will be to determine the effectiveness of laughter therapy and rational emotive behaviour therapy on depression in delta central senatorial district. Specifically the study will seek to: 1. Determine the effects of assertive laughter therapy in enhancing depression. 2. Determine the effects of rational emotive behaviour therapy in enhancing depression. 3. Determine the relative effectiveness of laughter therapy and rational emotive behaviour therapy in enhancing depression. 4. Determine the relative effectiveness of laughter therapy and rational emotive behaviour therapy in enhancing depression with respect to gender. 5. Determine the relative effectiveness of laughter therapy and rational emotive behaviour therapy in enhancing depression with respect to age. Methodology The design for this study will be true experimental design. The design is called true experimental because subjects were randomly assigned to groups. Because of the control they provide, they are the mostly highly recommended designed for experimentation in education. In the randomized subjects, pre-test and post test control group design; one randomly assigns subjects to the experimental and control groups and administer a pre test to both groups (dependent variable). The treatment is introduced only to the experimental subjects, after which the two groups are measured. Expected Outcomes The expected outcome will be based on either the hypotheses for the study will be upheld or not. References Bennett, M. P. & Lengacher, C. (2008). ‘Humour and laughter may influence health – III: Laughter and health outcomes’. Evidence-based Complementary and Alternative Medicine 5, pp. 37–40. Mora-Ripoll, R. (2010). ‘The therapeutic value of laughter in medicine’. Alternative Therapies in Health & Medicine 16, pp. 56–64. Mora-Ripoll, R. & Garcia-Rodera, N. C. (2008). ‘Therapeutic value of laughter in medicine’. Med Clin (Barc) 131, pp. 694–698. Houston, D. M., McKee, K. J., Carroll, L. & Marsh, H. (1998). ‘Using humour to promote psychological well-being in residential homes for older people’. Aging & Mental Health 2, pp. 328–332. Kuiper, N. A. & Martin, R. A. (1998). ‘Laughter and stress in daily life: Relation to positive and negative affect’. Motivation and Emotion 22, pp. 133–153. Lee Y, Choi K, Lee YK. Association of comorbidity with depressive symptoms in communitydwelling older persons. Gerontology 2001; 47: 254–262.