The Effects of Reality Therapy on Quality of Life and Anxiety in Recovering Substance-Dependents Using Methadone

Substance Use Disorders (SUDs) is among the biopsychosocial problems, i.e., currently recognized as a global concern. Substance dependence is, indeed, among the numerous adverse consequences of substance use, i.e., prevailing globally with astonishing statistics in the last decade. In turn, substance abuse is a non–adaptive pattern of drug use that leads to recurrent problems and adverse effects. A factor that leads to substance abuse is the sedation and reduction of anxiety and depression caused by the drugs. Accordingly, individuals start using these drugs to cope with such unpleasant mental states, leading to SUDs over time. The research data on the effects of Methadone Maintenance Therapy (MMT) on the mental health of individuals with SUDs are contradictory; thus, further investigations seem necessary. Some research revealed that compared to the general population, individuals under MMT present a high level of mental health problems and experienced mood and emotional disorders, such as depression and anxiety.The present study aimed to investigate the effects of Reality Therapy (RT) on the Quality of Life (QoL) and anxiety in patients under MMT.

 This was a quasi–experimental study with pretest–posttest–follow–up and a control group design. The statistical population of this study included all individuals with SUDs referring to the State Welfare–related medical centers in Ahvaz City, Iran, in 2020. Accordingly, one center was purposively selected; 40 individuals were randomly selected and grouped into two experimental and control groups (n=20/group). The inclusion criteria included male individuals aged 20–50 years who had not participated in other psychological treatment and had no obvious biopsychologicale illnesses. The exclusion criteria excluded individuals who fail to cooperate in any of the research stages or failed to attend the training sessions. The WHO Quality of Life (WHOQOL) scale and Four Systems Anxiety Questionnaire (FSAQ) were used to collect the required data. The experimental group received twelve 95–minute RT sessions; however, the controls continued pharmacotherapy without psychological interventions according to the center's routine schedule. The obatiend data were analyzed using Analysis of Covariance (ANCOVA) in SPSS.

The mean (SD) age of the subjects was 28.64(2.84) and 29.12(4.64) years in the experimental and control groups, respectively. The mean (SD) of the subjects' scores indicated a decrease in anxiety and an increase in QoL at the posttest. Before performing the ANCOVA, its hypotheses were tested. The results of Multivariate Analysis of Covariance (MANCOVA) in at least one of the scales of QoL and anxiety indicated that RT significantly affected the experimental group (p</em><0.001). The Eta coefficient was measured to be 0.88. The one–way ANCOVA data on the mean posttest scores of anxiety and QoL revealed that the difference in the posttest after removing the effect of pretest between the experimental and control groups was significant (p</em>≤0.001).

This study indicated that RT was influential on the QoL and anxiety among recovering individuals under MMT; thus, RT can be used in SUDs treatment centers. All ethical considerations, including receiving written informed consent from the participant before starting the research; the voluntary participation of individuals in each stage of the study; scheduling training sessions with the full cooperation of individuals, and keeping information related to subjects confidential, were observed.</div>