The Effectiveness of Schema Therapy on Self-Concept and Social Health among People Living with HIV (PLWH)

 Acquired Immune Deficiency Syndrome (AIDs) is one of the life-threatening diseases around the world. Today, different human societies are struggling with this disease. In addition to physiological effects, HIV disease can have devastating psychological and social effects. A positive HIV in person brings shock, crisis, stress and anxiety to the infected person and his family. These psychological consequences have a profound effect on the progression of the disease and adherence to treatment. Like many other chronic medical conditions, HIV can have psychosocial consequences in addition to physical consequences, including depression, anxiety, stress, low self-esteem, low life expectancy, poor problem solving, feeling lonely and stigma. Anger, emotional imbalance, poor self-concept and suicidal ideations are expected psychological consequences associated with AIDs, which usually result in. The worsening of physical symptoms, functional impairment, decreased treatment compliance, decreased social health and decreased quality of life in patients. The present study examined the effect of schema therapy on self-concept and social health among people living with HIV (PLWH) in order to promote mental health.

 The research was a quasi-experimental study with a pretest-posttest design and a control group. The statistical population were all PLWH who were referred to the voluntary counselling and testing (VCT) centre of Imam Khomeini Hospital in 2019-2020. 30 PLWH  were selected by convenience sampling and randomly divided into two experimental and control groups (n=15). Both groups were matched in terms of gender, level of education, marital status, age and history of substance abuse. The experimental group received group schema therapy training in ten sessions of 120 minutes (two sessions per week) with the Yang schema therapy model. The control group did not receive any intervention. Rogers self-concept and Keyes's social health questionnaires were used before and after the training. The Rogers self-concept questionnaire is provided in two forms, A and B. Each form contains 25 bipolar traits (positive and negative); which form A measures a person's attitude towards the authentic self, and Form B measures the ideal self. The other questionnaire is the social health questionnaire which has five sub-scales, including social adaptation, social participation, social cohesion, social prosperity and social acceptance. The obtained data were analyzed using Analysis of Covariance with α=0.05.

 The results showed a significant difference between the experimental and control groups in terms of self-concept and social health. There was a significant difference in self-concept between the two groups (p<0.001). Significant differences in all subscales of social health, including social adaptation, social cohesion, social prosperity, social acceptance (p<0.001) and social participation (p=0.018), were also observed.

 Based on the results, the implementation of schema therapy among PLWH brings the authentic self of PLWH closer to their ideal self, and as a result, it leads to a positive self-concept; Schema therapy also decreases isolation and makes more communication through membership in social groups and improving interpersonal relationships as a basis for healthy social interactions which ultimately leads to increased social health. Therefore, training in schema therapy techniques for PLWH can be a practical step in improving self-concept and social health.