جستجوی مقالات مرتبط با کلیدواژه « طرح واره درمانی » در نشریات گروه « روانشناسی »

The present study was conducted to compare the effectiveness of schema therapy and metacognitive therapy on the emotional expression of conflicted women. The research method was semi-experimental with a pre-test-post-test design and a control group with a three-month follow-up period. The statistical population of the present study included all conflicted women who were referred to counseling clinics and psychological services in the 1st district of Tehran in 2023, from which 45 women were selected using the available sampling method and were randomly assigned to two experimental groups and one control group. The measurement tools included the Sanai Marital Conflict Questionnaire (MCQ, 2000) and King and Emmons's Emotional Expression Questionnaire (EEQ, 1990). The intervention based on schema therapy and metacognitive therapy was implemented in 8 two-hour sessions, twice a week, as a group for the first and second experimental groups. Analysis of variance with repeated measurements was used for data analysis. The findings showed that there was a significant difference between the pre-test and post-test averages of the three groups in emotional expression (positive emotion expression, negative emotion expression, and intimacy expression) at a significance level of P<0.05, and in addition, there was a significant difference between the post-test and follow-up at the P<0.05 level was not observed. Also, there was a significant difference between the post-test and follow-up averages in the two test groups at the P<0.05 level. From the above findings, it can be concluded that schema therapy is more effective than metacognitive therapy.

This study aimed to compare the effectiveness of schema therapy and therapy based on acceptance and commitment to increasing the emotional processing and self-efficacy of people with rheumatoid arthritis. The present research method was semi-experimental with a pre-test-post-test design and a control group with a three-month follow-up period. The statistical population of this research was all people with rheumatoid arthritis in 2022-2023 from Loqman Hospital in Tehran. 60 people, as a sample, were randomly selected in 3 groups of 20 people (two experimental and one control group) using the purposeful sampling method. The emotional processing scale (EPS, Baker et al, 2007) and the general self-efficacy scale (GSE, Scherer et al., 1982) were used to collect data, as well as the 12-session protocol of schema therapy and the 11-session protocol of acceptance and commitment therapy were used for the intervention. The data were analyzed using variance analysis with repeated measures and Tukey's post hoc test. The findings showed that the schema therapy and acceptance and commitment groups significantly increased emotional processing and self-efficacy compared to the control group (p<001), and the schema therapy group performed significantly better in two dependent variables than the acceptance and commitment group (p<001). Therefore, using schema therapy and acceptance and commitment therapy can help to increase the emotional processing and self-efficacy of people with rheumatoid arthritis.

The present study aimed to compare the effectiveness of schema therapy and emotional therapy on the quality of marital relationships in women affected by infidelity. The method of the present study was semi-experimental with a pre-test-post-test design and a control group with a three-year follow-up period. The statistical population of the present study consisted of all women affected by the infidelity of their husbands who were referred to psychological clinics in the 1st district of Tehran in the first half of 2023. 45 people were selected purposefully and randomly assigned to two experimental groups and one control group. The instrument of this research was Busby et al's Revised Dyadic Adjustment Scale (RDAS, 1995). The emotion-based intervention of Johnson's educational package (2004) and Young et al.'s schema-based protocol (2003) were implemented in 9 sessions of 120 minutes twice a week for the first and second experimental groups. The data were analyzed using mixed analysis of variance. The results of the variance analysis showed that there was a significant difference between the groups in the post-test and follow-up of the quality of marital relationships (P<0.05), and the results showed that there was no significant difference between the effectiveness of schema therapy and emotion-oriented therapy in improving the quality of marital relationships. (P>0.05). It can be concluded that schema therapy and emotional therapy are two effective methods for the acceptance of spouses of couples with marital differences.

This study aimed to compare the effectiveness of two therapeutic approaches, schema therapy and mindfulness, on early maladaptive schemas in students.

This quasi-experimental study utilized a pretest-posttest control group design. The statistical population consisted of second-grade high school students in Tehran, from which 45 students were selected through convenience sampling and randomly assigned to two experimental groups (15 students each) and a control group (15 students). The experimental groups participated in either schema therapy (8 sessions of 120 minutes each over 8 weeks) or mindfulness therapy (7 sessions of 90 minutes each over 7 weeks). The research instrument used was the Young Schema Questionnaire (1998), administered in both the pretest and posttest phases.

Analysis of covariance revealed that both therapeutic approaches led to a significant reduction in early maladaptive schemas compared to the control group. However, schema therapy was found to be more effective than mindfulness in improving these schemas, particularly in components such as emotional deprivation, abandonment, mistrust, social isolation, and defectiveness/shame.

Based on the findings, it can be concluded that schema therapy, with its deeper focus on the cognitive and emotional roots of schemas, is more effective than mindfulness in improving and modifying early maladaptive schemas. Schema therapy can be considered a valuable approach for treating psychological disorders associated with early maladaptive schemas.

This research aims to evaluate the effectiveness of Schema Therapy on cognitive emotion regulation and Emotional Behavior Regulation in mothers with children with learning disabilities. Based on purpose the research was applied with a semi-experimental design with pre-test, and post-test. The statistical population of the study was mothers of children with learning disabilities in Tehran in the first six months of 1400. The sample consisted of 30 mothers who were selected as the final sample by purposive sampling method and were randomly divided into two groups of experiments and control (each Group 15 mothers). Cognitive Emotion Regulation Questionnaire by Garnefski and Kraaij (2002) and Emotional Behavior Regulation by Garnefski and Kraaij (2019) were used. The experimental group received eight sessions of mindfulness-based cognitive therapy and the control group received no therapy. The results of covariance analysis showed that the Perceived Stress and Emotional Behavior Regulation was significantly different in the experimental group (P0.01). So Schema Therapy can be used effectively on cognitive emotion regulation and Emotional Behavior Regulation in mothers with children with learning disabilities.

The purpose of this study was to investigate the effectiveness of group schema therapy on self-concept and impulsivity in people with post-traumatic stress disorder. This research was practical in terms of purpose and was carried out in the form of semi-experimental research and within the framework of a pre-test and post-test design with a control group. The statistical population included all the people who referred to the two counseling centers of Arak City in the fall of 2022, from which 30 people were selected by the available sampling method and randomly by lottery in two experimental groups (15 people) and Control (15 people) were replaced. The experimental group was subjected to group schema therapy intervention during 8 sessions of 90 minutes and answered impulsivity questionnaires (Barat et al., 1998) and the self-concept of Rogers (1957). The data were analyzed using multivariate and univariate analysis of covariance and using SPSS-26 software. The results showed that schema therapy was able to have a significant effect in reducing impulsivity (components of unplanned, cognitive, and motor components) and increasing self-concept in the participants of the experimental group (P<0.01). schema therapy intervention can be used to reduce impulsivity symptoms and increase self-concept for people with post-traumatic stress disorder and benefit from it.

IntroductionHumans go through sensitive phases in their lives, and one of the critical and decisive phases is the issue of marriage and the formation of a common life, and more importantly, the efforts of each couple to maintain this common life so that they can reach their desired goals. Today, it is very important to expand the horizon of psychological treatments, especially to find more effective treatments. Also, comparing different treatments can be a priority among researchers to choose the most effective treatment that can be more cost-effective. Therefore, the current research seeks to investigate whether mindfulness and schema therapy have an effect on marital conflict, anger management, and quality of life. And which one has more influence on the components of marital conflict, anger management and quality of life? The aim of this study was to compare the effectiveness of mindfulness and schema therapy on anger management, marital conflict and quality of life. MethodThe method used in this study was quasi-experimental, in which the effect of two independent variables, namely schema therapy and mindfulness, on the dependent variables, namely marital conflict, anger management and quality of life, was examined. The pre-test-post-test design with the control group was used. The statistical population of this study consisted of all men and women who referred to counseling centers. To measure independent variables such as mindfulness in this study, the mindfulness package based on the package written by Bowen, Chaula and Marlat (2011) was used to measure anger management using the Spielberger anger control questionnaire, to measure quality of life from 36-item quality of life questionnaire (SF-36) and to measure conflict from Zakir and Barati questionnaire (2008) to analyze information from software. ResultsThe results showed that both therapeutic schemas and mindfulness training increased anger management, reduced marital conflicts and increased the quality of life of the experimental group compared to the control group. In addition, the results indicated that there is no difference in the mean total score of marital conflict, anger management and quality of life between the two groups of schema therapy and mindfulness, but between the control group and the two groups of schema therapy and mindfulness in all three conflict variables. There is a significant difference between marital, anger management and quality of life (P<0.001). Therefore, both types of treatment had the same effect on marital conflict, anger management and quality of life in couples with conflict. DiscussionIn comparing the effectiveness of schema therapy and mindfulness on anger management, marital conflict and quality of life in this study, it was observed that the training of both schema therapy and mindfulness groups increased anger management, reduced marital conflicts and increased quality of life in the experimental group compared to the control group was. Therefore, the training of both therapy groups is effective in increasing anger management and reducing marital conflicts, as well as increasing the quality of martial life. In addition, both types of treatment showed the same effect on marital conflict, anger management and quality of life in couples with conflict.

The purpose of the present study was to compare the effectiveness of schema therapy and acceptance and commitment therapy on improving emotion regulation strategies of depressed bereaved patients

The present study was a semi-experimental study with a pre-test-post-test design and follow-up with a control group. The statistical population included depressed patients with bereavement experience who referred to the Toos treatment and rehabilitation center in Mashhad in 2022, after screening and initial diagnosis, 45 people were selected by purposeful sampling and randomly divided into three groups of 15 people, including two An experimental and a control group were assigned. The purpose of data collection was emotional regulation questionnaire (ERQ). The first experimental group received schema therapy (8 sessions of 90 minutes) and the second experimental group received treatment based on acceptance and commitment (8 sessions of 90 minutes) once a week. The data were analyzed using variance analysis of repeated measurements and Ben Feroni post hoc test.

The results showed that in both experimental groups, the averages of cognitive reappraisal (P<0.001, F=206.26, etha square=0.98) and suppression (P<0.001, F=116.28, etha square=0.97) increased from pre-test to post-test and to follow-up and this effect was greater in the acceptance and commitment treatment group.

In general, the results show that both of these treatment methods can improve the emotional regulation of patients and play an important role in the treatment of bereavement

The present study aimed to comparison the effectiveness of cognitive therapy based on mindfulness and schema therapy on emotional regulation and distress tolerance of women with obsessive-compulsive symptoms. The present research method was semi-experimental with pretest, posttest and follow-up. The statistical population of the study included all women with obsessive-compulsive disorder who referred to the counseling centers of Mashhad in 2023-2024. Based on the inclusion and exclusion criteria, 48 people were selected by convenience sampling and randomly assigned to two experimental groups and one control group. The participants were evaluated using the emotion regulation questionnaire (Gross & John, 2003) and distress tolerance scale in the pretest, posttest and follow-up. Data were analyzed using SPSS 26 software and using descriptive and inferential statistics. The results of and analysis of variance with repeated measures showed that there is a significant difference between the experimental and control groups in emotion regulation and distress tolerance (P<0.05). Cognitive therapy based on mindfulness and schema therapy has led to improved emotion regulation and increased distress tolerance. Cognitive therapy based on mindfulness is more effective than schema therapy in improving emotion regulation.</div>

The present study was conducted with the aim of comparing the effectiveness of schema therapy and stress reduction based on mindfulness on emotional dyslexia, self-control and psychological well-being in Tehran. This research was semi-experimental with a pre-test-post-test waiting list group design. The statistical population included all women affected by domestic violence who referred to Menda Ara Psychology Clinic in 1402. In this study, 45 eligible patients were selected and the participants were randomly divided into three groups: behavioral therapy counseling (15 people), mindfulness-based stress reduction group (15 people) and control group (15 people). Strategies methods and techniques were taught to the groups for 8 sessions of 90 minutes. The groups were asked to take the Toronto Ataxia Questionnaire; Answer Tanji's self-control questionnaire and Rif's psychological well-being questionnaire. The results of the research showed that the experimental group of schema therapy and mindfulness-based stress reduction compared to the control group was able to more effectively change the scores of ataxia, self-control and psychological well-being at the level of P<0.001. The results showed that there is a significant difference between the experimental and control groups in reducing emotional dyslexia, and increasing self-control and psychological well-being.

The results showed that the use of schema therapy approaches and stress reduction based on mindfulness increases the self-control and psychological well-being of women affected by domestic violence and reduces their emotional ataxia. Therefore, schema therapy and mindfulness-based stress reduction approaches are recommended for women affected by domestic violence to increase self-control and psychological well-being and reduce emotional ataxia.

The aim of the present study was to investigate the effectiveness of the combined intervention of schema therapy and mindfulness on rumination and alexithymia in women with extramarital relationship experience in Tehran in 1402. The research method was semi-experimental with a pre-test-post-test design with a control group. The statistical population of the research included all the women with experience of extramarital relationship who referred to counseling centers and psychological services in Tehran, who were selected by available sampling method and were placed in two experimental (20 people) and control (20 people) groups. The experimental group underwent 10 90-minute sessions of schema therapy training based on mindfulness, and the control group remained waiting for treatment during this period. The method of data collection was based on the standard alexithymia questionnaire (Begby et al., 1994) and the standard rumination questionnaire (Nolen Hoeksma and Maro, 1991). The reliability of the questionnaire was calculated using the Cronbach's alpha method, and its value for the alexithymia questionnaire was 81. And rumination questionnaire was obtained above 0.7. Likewise, content validity was used to test the validity of the questionnaire, and for this purpose, the questionnaires were approved by the relevant experts. The analysis of the information obtained from the implementation of the questionnaires was done through SPSS24 software in two descriptive and inferential sections (covariance analysis). The results of the research showed that the schema therapy based on mindfulness reduced the "rumination" of women experiencing extramarital relationship. Also, the results showed that schema therapy based on mindfulness improved the alexithymia" of women with extramarital relationship experience. Therefore, the findings of the present study showed that schema therapy based on mindfulness is effective in reducing rumination and alexithymia in women with extramarital relationship experience.

This study's aim was to compare the effectiveness of Intensive short-term dynamic psychotherapy and schema therapy on depression and anxiety in mothers with autistic children.

The research method was quasi-experimental with pre-test-post-test design with control and follow-up group for three months and the statistical population included all mothers of autistic children in educational and rehabilitation centers in Tehran in 2020. 45 people were purposefully selected and randomly assigned to two experimental groups and one control group (15 people in each group). Intensive short-term dynamic psychotherapy sessions and schema therapy were held in 12 sessions of 60 minutes, individually, one session per week. Subjects completed Beck Depression Inventory (1996) and Beck Anxiety Inventory (1998) in the pre-test-post-test and follow-up stages. The data of the present study were analyzed using repeated measures analysis of variance.

The results showed that both intensive short-term dynamic psychotherapy and schema therapy had reduced depression and anxiety compared to the control group and this effect was stable in follow-up (P<0.01). But intensive short-term dynamic psychotherapy has further reduced depression compared to schema therapy. In contrast, the effect of the two treatments on anxiety at the level (P> 0.05) was not significant.

It was concluded that intensive short-term dynamic psychotherapy is a more effective method to reduce depression in mothers with children with autism compared to schema therapy.

Rheumatoid arthritis is the most common chronic inflammatory autoimmune disease. Social factors and prolonged stress have an effect on Rheumatoid arthritis. Limitation of movement in these patients can cause mental disorders, especially anxiety and depression. The purpose of this study is to compare the effectiveness of short-term dynamic psychotherapy, schema therapy, cognitive behavioral therapy with drug therapy in reducing pain and pain dimensions in patients with rheumatoid arthritis with anxiety, depression and coping strategies.The research method was semi-experimental with a pre-test and post-test design and follow-up with the control group. The statistical population was all patients with rheumatoid arthritis with anxiety and depression in Tehran, who referred to the rheumatology clinics of Imam Khomeini Hospital in Tehran in the spring of 2014. There are 60 volunteers selecting by purposive sampling technique. According to Cohen's table the sample were divided into groups of20 people. We use Standard Depression questionnaires (Beck et al., 1996), anxiety (Beck et al., 1990), Revised McGill pain questionnaire (McGill Durkin et al. 2009) for collecting data. Data analysis has been done by using multivariate analysis of variance with repeated measurement at a significant level of 0.05 through SPSS version 26. The results showed that psychotherapies are effective in reducing pain, and schema therapy was the most effective method in reducing cognitive pain and various pain in patients with rheumatoid arthritis who have anxiety and depression and inconsistent coping strategies The use of psychotherapies along with drug therapy can be more effective than drug therapy alone and can help reduce the pain of patients with rheumatoid arthritis by treating anxiety and depression and correcting coping strategies.

The present study was conducted with the aim of investigating the effectiveness of schema therapy on eating styles and happy child and healthy adults Modes modes in obese people with binge eating disorder. The design of the current research was semi-experimental with a single case structure of ABA type. The statistical population of the study included obese women suffering from binge eating disorder who referred to a slimming clinic in Tehran in 2014-2016. The study sample consisted of eight obese women according to the inclusion criteria. Data collection tools included the Dutch Eating Styles Questionnaire (1986), the Young Schema Modes Questionnaire (2008) and a semi-structured interview. Schema therapy was implemented in form of 20 90-minute group sessions and 4 additional 45-minute individual sessions. The participants were evaluated 3 times in the baseline phase, 10 times in the intervention phase, and 8 weeks after the intervention, they were followed up 4 times every 2 weeks using the measurement tool. In order to analyze the data, the participants' scores were collected individually during the three stages of baseline, ten stages of intervention and four stages of follow-up, and then by using the trend chart and interpreting the ups and downs of the scores. Participants were visually analyzed in different stages of baseline, intervention and follow-up. Then, by using the effect size indices, the percentage of non-overlapping data (PND), and the percentage of improvement and the valid change index (RCI), the effectiveness of the treatment was determined. The findings showed that in most of the participants, in the intervention stage compared to the baseline stage the scores of efficient modes; The happy child and healthy adult had an upward and increasing trend. For all the participants, The scores of emotional eating styles all people and external for most of them, and inhibited eating styles also had a downward and decreasing trend. Also, the RCI index scores indicated the stability of schema therapy results in the follow-up phase.

The aim of the present study was to compare the effectiveness of schema therapy based on enrichment programs and systemic-integrated couple therapy on interpersonal forgiveness of betrayed women. The method of the current research was semi-experimental with a pre-test-post-test design and a control group with a follow-up period of two months. The statistical population of the present study was made up of all the betrayed women who were referred to the counseling centers located in Rodhen City in 2022. 45 people were selected in a purposeful way and randomly assigned to two experimental groups and one control group. The instrument of this research was Pollard's interpersonal forgiveness questionnaire (IFS) (1998). Schema therapy intervention based on Lu and McKay's acceptance communication enrichment program (2012) and Feldman's (1990) system-integrated couple therapy protocol was implemented in 12 90-minute sessions twice a week for the first and second experimental groups. The data were analyzed using mixed analysis of variance. The results of the Varbans analysis showed that there is a significant difference between the groups in the post-test and follow-up of interpersonal forgiveness (P<0.05). The results showed that the schema therapy based on the communication enrichment program of acceptance compared to Feldman's systemic-integrated couple therapy had a significant effect on forgiveness The interpersonal relationship of betrayed women was more effective. A significant difference was observed between the two treatments (P<0.05). It can be concluded that there is a substantial difference between the two treatments of schema therapy based on the enrichment of acceptance communication and systemic couple therapy.

 The purpose of this research was to compare the effectiveness of the educational program based on the causal model of tendency to emotional divorce and schema therapy on marital vitality. 

The research was conducted with a semi-experimental design using a pre-test-post-test design with a control group. The statistical population of the research included all couples (regular households of men and women) in Kermanshah city in 2019. Purposive sampling, 30 couples were randomly assigned to 2 experimental and control groups. The data collection tools were Gutman's emotional divorce questionnaires (2008) and Tagrian's marital happiness questionnaires (2007). Data analysis was done using SPSS software and through covariance analysis model. 

 The results showed that schema therapy and educational program derived from the model are effective on couples' marital vitality (P<0.05). The results of the comparison between the two programs showed that the training program derived from the model with the control group was at the same level (P<0.01), the training program was derived from the model with the schema therapy program at the level (P<0.01) and between the schema therapy training program There is a significant difference with the control group at the level (P<0.01). 

 Based on the obtained results, the educational program based on the causal model of the tendency to divorce can be used in counseling and psychology centers.

obsessive-compulsive disorder is a debilitating anxiety disorder whose main feature is the occurrence of obsessions and compulsive actions. The purpose of this study is to compare the effectiveness of the schema therapy package based on psycho-social issues of obsessive-compulsive patients with cognitive-behavioral therapy on early maladaptive schemas and anxiety in patients with obsessive-compulsive disorder.

This article was a semi-experimental method, pre-test-post-test type with a control group and a 45-day follow-up period. The research population in this study included all patients with obsessive-compulsive disorder who referred to two psychotherapy clinics in Isfahan city. For the study, 45 people were randomly selected into two groups of schema therapy based on psychosocial issues (based on Yang, Kliusko and Wishar, 2003), cognitive-behavioral therapy (Struch et al., 2007) and a control group (each group). 15 people) were placed. Before and after the intervention and 45 days later (follow-up stage), the subjects responded to the short-form Young’s schema questionnaire (Young, 1994) and the anxiety questionnaire (Beck, 1989). The data was analyzed using the method of analysis of variance with repeated measurements and Spss.22 software.

The results of the study showed that there is a significant difference in the mean of early maladaptive schemas and anxiety in two experimental groups (schema therapy and cognitive-behavioral therapy) and evidence. In addition, based on the results of schema therapy compared to cognitive-behavioral therapy, in the reduction of early maladaptive schemas (F=33.06; P<0.001) and anxiety (F=11.26; P<0.001) Patients were more effective.

Compared to cognitive-behavioral therapy, schema therapy treatment based on psycho-social issues can play an effective role in reducing the early maladaptive schemas and anxiety of these patients.

Academic procrastination is a way to escape from living in the present and to postpone what we have decided to do to the future. The aim of this study was to evaluate the effectiveness of schema therapy on rumination and academic procrastination of Yasouj University students. The design of this study was a quasi-experimental pretest, post-test with a control group. The statistical population included all undergraduate students of Yasouj University. Thus, among the undergraduate students of Yasouj University, students who wished to participate in the project were registered and then they were asked to complete the consent form in the research. Out of 72 volunteers, 60 student were registered and assigned to two experimental and control groups. They completed the Nalin Hooksma and Murrow rumination Questionnaires and the Lee procrastination Scale. The subjects in the experimental group were trained in schema therapy for 8 sessions and the control group did not receive any training. Then both groups were re-evaluated by post-test. One month later, post-test was followed up from both groups. After the pre-test, data analysis was performed using ANKOA analysis method. The results showed that the post-test scores of procrastination were significantly different between the two groups; this means that the procrastination of the experimental group has decreased after training in schema areas. According to the results of the present study, it can be concluded that schema therapy has positively and significantly treated rumination and academic procrastination.

This research was conducted with the aim of comparing schema and cognitive behavioral therapy on the cognitive regulation of emotions in  girls adolescent of divorced.

The research was semi-experimental and repeated measurement type with a control group.The statistical population was all adolescent girls from divorced families, who were between the ages of 13 and 15 in Isfahan. A statistical sampl of 45 girls who were randomly assigned to the experimental group of schema therapy and cognitive behavioral therapy and control. experimental groups received group counseling schema and cognitive behavioral therapy for 20 sessions of 90 minutes, and the control group did not receive any training.The instrument used was the 36-question cognitive emotion regulation questionnaire (Granofsky,Kraij and Spinhaven,2002) (CERQ). In order to compare the test averages in each stage, was used of the method analysis of variance with repeated measurements and follow-up tests.

The results of the analysis of variance with repeated measurements showed experimental groups of schema therapy and cognitive behavioral therapy created a significant increase in the cognitive regulation of emotion (p<0.01). And these results remained in the two-month follow-up (p<0.01). The comparison between the two experimental groups showed that schema therapy is more effective than cognitive behavioral therapy in the cognitive regulation of emotion in both post-test (p<0.05) and follow-up (p<0.01) stages.

Based on this study, therapists in the field of children and adolescents are suggested to use schema therapy and cognitive behavioral therapy for emotional diagnosis.

Chronic renal failure is defined as the presence of at least three months of glomerular filtration rate less than 60 ml/min/1.73 m2 or structural/functional abnormalities of the kidney for more than three months (Lameire et al., 2021). Research showed that dialysis women suffer from a more negative body image than normal women (Dąbrowska-Bender et al., 2018). Body image is defined as individuals perception and attitudes towards their physical characteristics (Griffiths et al., 2018). Some studies have shown that body image dissatisfaction is directly related to a lack of self-confidence and self-esteem in sexual relations, more especially in women (Gillen & Markey, 2019). Sexual self-esteem is defined as individuals' overall desire to positively evaluate their capacity for participating in healthy sexual behaviors and experiences in a pleasurable and satisfying manner. Sexual self-esteem affects sexual behavior and includes emotional responses to thoughts and feelings (Akbari, 2017).Schema therapy and acceptance and commitment therapy are two different approaches, each of which looks at pathology with a different perspective. It seems that a combination of the two theraputic models can be a good complement to cover the shortcomings of each of them (Grecucci, 2018). Since no research has specifically compared the impacts of these approaches on psychological status of dialysis patients, it is important to investigate and compare the effectiveness of the acceptance and commitment therapy and schema therapy based on acceptance and commitment (AC-based schema therapy) on body image and sexual self-esteem of dialysis women.

This study was a semi-experimental research with a pretest-posttest and follow-up ‎control group design. The statistical population consisted of all married dialysis women who referred to Khorasan Razavi Dialysis Patients Support Association between January 2021 and June 2022. The sample included 45 married women undergoing dialysis. The participants were selected using convenience sampling method and were randomly assigned to three groups. The first group (15 people) received the therapeutic intervention based on acceptance and commitment, the second group (15 people) received the AC-based schema therapy intervention, and the third group (15 people) were placed on the waiting list to receive psychological treatment. The tools included the Body Image Concern Inventory (BICI) and Sexual Self-Esteem ‎Index for Woman-Short Form (SSEI-W-SF). The AC-based therapy sessions were held based on the treatment protocol of Gustafson (2020) during ten 120-minute weekly sessions. The AC-based schema therapy sessions were held according to the treatment protocol of McKay et al. (2012) for ten 120-minute weekly sessions. The data were analyzed using repeated measures analysis of variance and Bonferroni test.

The results of chi-square test demonstrated that the groups were homogeneous in terms of age (p=0.979, χ2=8.00), duration of marriage (p=1.000, χ2=5.267), and duration of dialysis (p=0.628, χ2=9.867). After checking that the assumptions were fulfilled, repeated measures analysis of variance was used. The results showed that body image scores in the within-group section (P=0.001, F=57.908), the interaction effect of group and repetition (P=0.001, F=23.243) and the between-group effect (P=0.035, F=3.640) are significant in the studied groups in three phases of measurement. Moreover, sexual self-esteem scores in the within-group section (P=0.001, F=25.429), the interaction effect of group and repetition (P=0.001, F=6.575), and the between-group effect (P=0.037, F=3.251) are significant in the studied groups in three phases of measurement (P<0.05). Considering the significance of F statistic, it seems necessary to make post-experience comparisons. Hence, Bonferroni post hoc test was used to compare the therapy groups with the control group.The results of Bonferroni post hoc test revealed that in the posttest and follow-up phases, there is no significant difference between the studied groups (AC-based therapy and AC-based schema therapy and the control group) in the variables of body image (P=0.98) and sexual self-esteem (P=0.85), but in the posttest and follow-up phases, a significant difference was found between the AC-based therapy group and AC-based schema therapy with the control group (P<0.05). AC-based schema therapy caused more changes in the components of body image and sexual self-esteem in dialysis women.

The results indicating the greater impact of AC-based schema therapy compared to acceptance and commitment therapy are consistent with the findings of  Aalami (2020). Paying special attention to the factors causing ineffective behaviors adopted in order to reduce the emotional pain of the schema is one of the strengths of AC-based schema therapy compared to acceptance and commitment therapy (Nikpour, 2021). Showing the difficult situation of frequent dialysis as the only factor provoking uncomfortable feelings and thoughts formed from childhood experiences causes patients to know the root of their problems instead of considering the disease as the cause of dissatisfaction with appearance and lack of self-esteem in sexual relations. As a result, it will make them more motivated and hopeful to overcome and adjust their maladaptive schemas. The other strength of AC-based schema therapy compared to acceptance and commitment therapy is that clients more easily identify their values that are beyond their maladaptive schemas, and as a result, are more motivated to follow values (McKay, 2012). Another advantage of AC-based schema therapy is dedicating some of the group therapy sessions to teach communication skills, including self-expression, overcoming feelings of anger and hatred, assertiveness and marital skills (Lev & McKay, 2017), which increases intimacy and emotional interest of women in the marital relationship. Learning these skills, in addition to providing the apportunity for experiencing more sexual pleasure and the desire to have sexual relationships, can prevent the recurrence of dialysis women’s problems, since better satisfaction of the unsatisfied basic needs make people able to prevent the activation of maladaptive schemas.