Introduction
Parents of children with intellectual and developmental disorders face challenges and problems that expose them to high levels of stress and negative psychological consequences. Meanwhile, because of their traditional role of care, mothers take on more responsibilities towards their disabled children, resulting in more psychological problems [4].
Psychological well-being is defined as a positive feeling and general satisfaction with life in various areas of life. People with a high level of well-being evaluate life events positively and experience more positive emotions. In contrast, people with a low level of well-being evaluate their life events negatively and unpleasantly and experience most negative emotions such as anxiety and anger [6, 7].
Meaning in life means having a set of values, beliefs, and positive attitudes toward the world and the divine source that provide psychological well-being in life [12]. The presence of meaning in life as a stimulus leads people to experience positive emotions and the experience of positive emotions helps people find meaning in their lives more easily [13].
One of the important concepts to prevent self-criticism and embarrassment is self-compassion. Neff (2009) considers self-compassion as a three-component construct that includes kindness to oneself versus self-judgment, human sharing versus isolation, and awareness versus extreme imitation. Using this construction in the atmosphere of compassion-focused therapy sessions can reduce the self-criticism and shame of mothers of mentally-retarded children and thus improve their psychological well-being [26].
Compassion-focused therapy acts as a positive emotion regulation style, which reduces negative emotions and replaces them with positive ones. It seems that because of this emotional self-regulation, the person’s shame and self-criticism are reduced [55]. On the other hand, Irons and Lad (2017) believed that with the help of compassion-focused therapy, a person becomes more courageous and can challenge the vicious cycle of self-criticism and high-level expectations of self, and with a new and compassionate attitude towards oneself, redesign realistic standards and achievable expectations that do not require hardship and harassment [53].
This study aimed to determine the effectiveness of compassion-focused therapy on psychological well-being and meaning in the life of mothers of children with intellectual and developmental disorders living in Ahvaz City, Iran.
Methods
The research method was experimental with a pretest-posttest design and a control group. The statistical population of this study consisted of all mothers of children with intellectual and developmental disorders living in Ahvaz in the academic year 2018-2019. Among whom, 30 mothers whose psychological well-being scores and meaning in life were one standard deviation lower than the mean of the prototype were selected using a simple random sampling method and assigned to the experimental (n=15) and control groups (n=15). To analyze the collected data, the multivariate analysis of covariance was performed using SPSS v. 22 software.
Scales of psychological well-being (SPWB)
 This scale was designed by Reef (1980) [41]. In this research, the 84-item form of this questionnaire was used. This scale has six components of positive communication with others, self-acceptance, autonomy, overcoming of the environment, purposefulness in life, and personal growth. This test is scored on a 6-point scale from “strongly disagree” to “strongly agree” [42]. In the present study, the instrument’s reliability was obtained at 0.85 by calculating the Cronbach α value.
Meaning in life questionnaire (MLQ)
 The meaning in life scale was provided by Stiger (2006) [47] to evaluate the existence of meaning and attempt to find it. In this study, a 10-item form was used. In this questionnaire, the answers were scored on a 5-point Likert scale from “strongly agree” to “strongly disagree.” In the present study, the instrument’s reliability was obtained at 0.73 by calculating the Cronbach α. In the research phase, after randomly assigning the participants to the experimental and control groups, the pretest was implemented. Then, the experimental group was treated with compassion-focused therapy for eight 90-min sessions, and again the research questionnaires were administered to all participants in the posttest and follow-up phase (with 30 days intervals). Compassion-focused therapy package was designed based on the research activities of Gilbert and Irons (2004) and Gilbert (2009, 2010) [5, 51, 52]. The content validity of this package was confirmed by consulting with three clinical psychologists who were familiar with the third-wave therapies regarding the description of the sessions and the objectives of each session. In addition, treatment sessions were performed twice a week for one month.
Results
In this study, multivariate analysis of covariance was used to evaluate the effectiveness of treatments. The results of Levene’s test on the homogeneity of variance of the scores of the pretest stage of the psychological well-being (P<0.40, F=0.74) and the variable of meaning in life (P<0.07, F=4.33) indicate the variances’ homogeneity. Given that the P (P>0.05) and Levene’s test were not significant, using the analysis of covariance was justified.
Multivariate analysis of covariance in the experimental and control groups shows that these groups were significantly different in at least one of the dependent variables. F statistics of univariate analysis of covariance for psychological well-being (F=48.32, P≥0.001) and meaning in life (F=51.32, P≥0.001) were obtained in the pretest. In addition, the F statistics of univariate analysis of covariance were obtained for the psychological well-being variable (F=45.61, P≥0.001) and meaning in life (F=33.60, P≥0.001) in the post-test. Therefore, a significant difference was observed in the dependent variables (psychological well-being and meaning in life) between the experimental and control groups in the post-test and follow-up stages.
Discussion
The results of this study showed that the compassion-focused therapy package improves psychological well-being and enhances meaning in the life of mothers with children with intellectual and developmental disorders. A four-week follow-up period also showed constant treatment changes. Therefore, this therapy can be a successful treatment to improve psychological well-being and meaning in life and thus promote the mental health of these mothers. The results of this study can be helpful for teachers of mentally-retarded children, school counselors, and any individuals or institutions (welfare institution) that interacts directly with these children and their parents. Therefore, it is suggested that psychologists and counselors in rehabilitation centers for children with special needs (especially mentally retarded children) benefit from the therapeutic components of a compassion-focused approach to reduce psychological problems and increase the mental health of parents of children with mental retardation.

Ethical Considerations
Compliance with ethical
In a briefing session (before the treatment program), the importance of the study was  explained to the participants. Observing the ethical issues in research guarantees the quality of research and helps the researcher perform the whole process with double accuracy. Therefore, in the present study, all the ethical standards governing research, including obtaining informed consent and keeping information confidential, were fully observed (Code of ethics: EE/99.3.02.45002/scu.ac.ir).

Funding
This research is a part of Akbar Taheri's master's thesis, which was carried out in collaboration with Seyed Ali Marashi as a supervisor and author Najmeh Hamid and Kiyomarth Beshledeh as a consultant. This research has been financially supported by Shahid Chamran University of Ahvaz (research number: SCU.EP99.191).

Authors contributions
Designing the general framework, content collection, content analysis, and submitting and correcting the article: Akbar Taheri; General framework design, selection of approaches, final review, comparison of approaches and conclusion: Seyed Ali Marashi; Designing the general framework and summarizing: Najmeh Hamid and Kiyomarth Beshlideh.

Conflicts of interest
The authors declared no conflict of interest.


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