The Effects of Group Schema Therapy on Early Maladaptive Schemes and Psychological Adjustment in Females with Substance Abuse

Substance abuse and dependence are recurrent and chronic conditions that affect all aspects of an individual’s life. Research indicated that the substance dependence process is influenced by patients' beliefs and attitudes. Individuals who become dependent on substances are also affected by other disorders. One of the numerous factors influencing substance abuse etiology is the psychological adjustment. Adaptability is defined as the ability to mix, adapt, compromise, cooperate, and come to terms with oneself, the environment, and others. An acceptable treatment for various psychological disorders is schema therapy. Schema therapy identifies active substance dependence as a primary disorder. The present study aimed to determine the effects of group schema therapy on early maladaptive schemas and psychological adjustment in women with substance abuse.

This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study included all women with substance dependence, referring to substance dependence treatment centers in Rasht City, Iran, in November and December 2018. Based on the effect size of 0.25, alpha: 0.05, and power: 0.80, the minimum required sample size was 15 subjects per group (N=30). Initially, the city of Rasht was divided into 5 regions of north, south, east, west, and center. Next, 2 substance dependence treatment centers were randomly considered in each area. Then, all substance–dependent women referring to those centers (10 centers) were selected according to the inclusion and exclusion criteria of the study. Among the eligible volunteers who obtained one standard deviation more in the initial maladaptive schemas and one standard deviation less than the average in psychological adjustment, 30 individuals were randomly assigned to the experimental and control groups. The inclusion criteria of the study included female gender, literacy, no serious mental and behavioral illnesses other than substance dependence, and obtaining a more significant score on the Young Schema Questionnaire–Short Form (YSQ; Young et al., 2003) and the Bell Adjustment Inventory (BAI; Bell, 1961). The exclusion criteria of the study were absence from ≥2 intervention sessions and providing incomplete questionnaires. In the pretest and posttest stages, the YSQ and the BAI were administered in the research groups. Schema–Based cognitive therapy was performed in eight 90–minute weekly sessions for two months based on Derry’s training package (1996). The collected data were analyzed using univariate Analysis of Covariance (ANCOVA) in SPSS. The significance level of the tests was considered 0.05.

The present research findings suggested that the mean post–test scores of early maladaptive schemas and psychological adjustment (after controlling the pretest scores) were significant in the study groups. In other words, schema–based cognition therapy could effectively reduce early maladaptive schemas (p<0.001) as well as psychological maladjustment (p<0.001) in the study subjects.

The current study data revealed that schema therapy reduces early maladaptive schemas and psychological maladjustment in substance–dependent women; thus, it can be used to improve the problems of this population.