Evaluation and Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Schema Therapy in Improving Self-Compassion in Men and Women with Type 2 Diabetes

Document Type : Original Article

Authors

1 PhD Student in Health Psychology, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran

2 Assistant Professor, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran

Abstract

Aim: The present study aimed to determine the effectiveness of cognitive-behavioral therapy in comparison with schema therapy in improving self-compassion in men and women with Type 2 diabetes. Methods: The present study had a quasi-experimental method with a pretest-posttest design and a control group and a follow-up stage. The statistical population consisted of men and women with type 2 diabetes who visited the Kish Island Diabetes Association from April to September 2020. After the screening, 45 individuals were selected by the purposive method and were randomly included in three groups, namely cognitive-behavioral therapy (n=15), schema therapy (n=15), and control group (n=15) after matching. Neff's self-compassion scale (2003) was the research tool. In the study, the cognitive-behavioral therapy group was treated by the Leahy treatment package (2004), and the schema therapy group by the treatment package of Yang et al. (2006) in eight 90-minute sessions. Data were analyzed using repeated-measures analysis of variance. Results: The research results indicated that the cognitive-behavioral therapy and schema therapy groups were effective in improving self-compassion (F=10.70, P=0.018) in men and women with type 2 diabetes. The findings also indicated that cognitive-behavioral therapy and schema therapy groups were effective in improving self-compassion (F=4.54, P=0.018), self-judgment (F=6.25, P=0.005), and projective identification (F=3.45, P=0.043), and the effect was also stable at the follow-up stage. The results of the post hoc test also indicated that there was no difference between scores of cognitive-behavioral and schema therapy groups in self-compassion and self-compassion, self-judgment, and projective identification (p>0.05). Conclusion: According to the results, self-compassion was created based on the individuals' self-beliefs and thoughts; hence, both treatments had the same effect since cognitive-behavioral therapies and schema therapy modified the individuals' beliefs and opinions in this field.

Keywords


رستمی، مهدی.، عبدی، منصور.، حیدری، حسن. (1393). رابطه انواع بدرفتاری با شفقت خود و سلامت روانی در افراد متأهل. فصلنامه علمی پژوهشی اصول بهداشت روانی، 16(1): 61-74
مؤمنی. فرشته.، شهیدی. شهریار.، موتابی، فرشته.، و حیدری. محمود (1392). ویژگی‌های روان‌سنجی نسخه فارسی مقیاس خود شفقت ورزی. روانشناسی معاصر، 8(2): 27-40.
References
Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T., Butcher, M. K., Condon, J. E.,... Francis, T. (2018). 2017 National standards for diabetes self-management education and support. The Diabetes Educator, 44(1), 35-50.
Fassbinder, E., & Arntz, A. (2021). Schema therapy.
Friis, A. M., Consedine, N. S., & Johnson, M. H. (2015). Does kindness matter? Diabetes, depression, and self-compassion: a selective review and research agenda. Diabetes Spectrum, 28(4), 252-257.
Ghorbani, N., Watson, P. J., Zhuo, C., & Norballa , F. (2012). Self-Compassion in Iranian Muslims: Relationships with Integrative Self-Knowledge, Mental Health, and Religious Orientation. International Journal for the Psychology of Religion, 22, 2.
Hoffart, A., Øktedalen, T., & Langkaas, T. F. (2015). Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: a study of within-person processes. Frontiers in psychology, 6(1273). doi:10.3389/fpsyg.2015.01273
Hupfeld, J., & Ruffieux, N. (2011). Validierung einer deutschen version der Self-Compassion Scale (SCS-D). Zeitschrift für klinische Psychologie und Psychotherapie.
Laidlaw, K. (2021). Cognitive behavioral therapy with older people: American Psychological Association.
Leahy, R. L. (2004). Cognitive-behavioral therapy.
Leahy, R. L. (2018). Emotional schema therapy: Distinctive features: Routledge.
Melyani, M., Allahyari, A. A., Falah, P. A., Ashtiani, A. F., & Tavoli, A. (2015). Mindfulness based cognitive therapy versus cognitive behavioral therapy in cognitive reactivity and self-compassion in females with recurrent depression with residual symptoms. Journal of Psychology, 18(4), 393-407.
Mirdrikvand, F., Sepahvandi, M. A., Khodarahimi, S., Gholamrezaei, S., Rahimian Bougar, M., & Shafikhani, P. (2019). Early Maladjustment Schemas in Individuals with and without Type 2 Diabetes Mellitus. Journal of Mind and Medical Sciences, 6(1), 150-156.
MOMENI, F., SHAHIDI, S., MOOTABI, F., & HEYDARI, M. (2014). Psychometric properties of a Farsi version of the Self-Compassion Scale (SCS).
Morrison, A. E., Zaccardi, F., Chatterjee, S., Brady, E., Doherty, Y., Robertson, N.,... Khunti, K. (2019). Self-compassion, metabolic control and health status in individuals with type 2 diabetes: A UK observational study. Experimental and Clinical Endocrinology & Diabetes.
Nanayakkara, N., Curtis, A. J., Heritier, S., Gadowski, A. M., Pavkov, M. E., Kenealy, T.,... Wong, J. (2021). Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses. Diabetologia, 64(2), 275-287.
Raftar Aliabadi, M. R., & Shareh, H. (2021). Mindfulness-based schema therapy and forgiveness therapy among women affected by infidelity: A randomized clinical trial. Psychotherapy Research, 1-13.
Rahelić, D. (2016). Of IDF diabetes atlas-call for immediate action.
Sarı, S., & Gençöz, F. (2019). Women's experiences of group intervention with schema therapy techniques: A qualitative process analysis. Counselling and Psychotherapy Research, 19(3), 301-310.
Seligman, H. K., Smith, M., Rosenmoss, S., Marshall, M. B., & Waxman, E. (2018). Comprehensive diabetes self-management support from food banks: a randomized controlled trial. American journal of public health, 108(9), 1227-1234.
Seyed Nour, S., & Homaei, R. (2019). Effectiveness of Group Cognitive-Behavioral Therapy on the Self-Care Behaviors, Psychological Wellbeing, and Hope of Patients with Type II Diabetes. Journal of Clinical Nursing and Midwifery, 8(1), 265-275.
Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of diabetes & Metabolic disorders, 12(1), 1-5.
Taylor, C. D., & Arntz, A. (2016). Schema therapy. n K. S. Dobson & D. J. A. Dozois (Eds.), Handbook of cognitive-behavioral therapies (pp. 249–270). The Guilford Press.
Thimm, J. C. (2017). Relationships between early maladaptive schemas, mindfulness, self-compassion, and psychological distress. International journal of psychology and psychological therapy, 17(1), 3-17.
Tsujimoto, T., Sugiyama, T., Shapiro, M. F., Noda, M., & Kajio, H. (2017). Risk of cardiovascular events in patients with diabetes mellitus on β-blockers. Hypertension, 70(1), 103-110.
Twig, G., Zucker, I., Afek, A., Cukierman-Yaffe, T., Bendor, C. D., Derazne, E.,... Tzur, D. (2020). Adolescent obesity and early-onset type 2 diabetes. Diabetes care, 43(7), 1487-1495.
Videler, A. C., van Royen, R. J., Legra, M. J., & Ouwens, M. A. (2020). Positive schemas in schema therapy with older adults: clinical implications and research suggestions. Behavioural and cognitive psychotherapy, 48(4), 481-491.
Wadsworth, L. P., Forgeard, M., Hsu, K. J., Kertz, S., Treadway, M., & Björgvinsson, T. (2018). Examining the role of repetitive negative thinking in relations between positive and negative aspects of self-compassion and symptom improvement during intensive treatment. Cognitive Therapy and Research, 42(3), 236-249.
Welschen, L. M., van Oppen, P., Bot, S. D., Kostense, P. J., Dekker, J. M., & Nijpels, G. (2013). Effects of a cognitive behavioural treatment in patients with type 2 diabetes when added to managed care; a randomised controlled trial. Journal of behavioral medicine, 36(6), 556-566.
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2006). Schema therapy: A practitioner's guide.