Background & Objectives: People with disabilities feel different emotions due to their special circumstances, which significantly impact the quality of work and their daily activities throughout life. These emotions can cause people with disabilities to adapt and their presence in the social environment to diminish. In psychology, emotions have a very sensitive and fundamental place, because their relationships to needs and motivations are significant and can be the root of many mental or emotional disorders. Emotional schema therapy argues that individuals have implicit theories about emotion and emotion regulation. Dialectical behavior therapy is another treatment that is considered in emotion regulation today. This treatment aims to achieve behavioral stability and emotional processing. Because of insufficient and necessary research in a society with disabilities and the importance and necessity of paying attention to this vulnerable group, this study aimed to compare the effectiveness of dialectical behavior therapy and emotional schema therapy on emotional regulation in physically disabled people.
Methods: The method of the present study was a quasi–experimental design with pretest–posttest and three–month follow–up with a control group. The statistical population was all 20 to 50 years old physically disabled people covered by Mashhad Welfare Organization, Mashhad City, Iran, in 2019. Forty–five subjects with inclusion and exclusion criteria were included in the study by a convenience sampling method. With personal consent, they were randomly divided into two experimental groups (dialectical behavior therapy and emotional schema therapy) and one control group (15 in each group). The inclusion criteria in the study were as follows: having only physical or mobility disabilities based on the diagnosis of the Welfare Medical Commission, participation of both sexes (male and female), having an age range between 20 and 50 years, holding a minimum diploma degree, not receiving concomitant therapies with research, having enough motivation and interest in treatment. The exclusion criteria included having major psychiatric disorders such as personality disorders, undergraduate education, severe medical and physical disorders, acute psychosocial problems, severe family and occupational problems affecting the treatment process; being abscent two sessions or more from intervention or concurrent participation in other psychotherapies. The study data were collected via the Emotional Cognitive Regulation Questionnaire (Garnefski & Kraaij, 2001) in the pretest and posttest phase for subjects in all three groups. For the experimental groups, dialectical behavioral therapy was performed in eleven 60–minute sessions based on the McKay et al. (2007) treatment protocol, and the emotional schema therapy based on Leahy treatment protocol (2015) was performed in eleven 60–minute sessions. No intervention was provided for the control group. Descriptive statistics indicators (mean and standard deviation) and inferential statistics (repeated measures analysis of variance and Bonferroni post hoc test) were used to analyze the data in SPSS software version 25. The significance level was considered 0.05 or less.
Results: The results showed that the effect of time and the interaction of time and group on the mean scores of the emotion regulation variable (adapted strategies and non–adapted strategies) were significant (p<0.001). The effect of the group on the mean scores of emotion regulation variables, including adapted strategies (p<0.001) and non–adapted strategies (p=0.043) was significant. Also, the mean scores of adaptive strategies of emotion regulation in the dialectical behavior therapy group were significantly lower than the emotional schema therapy group (p<0.001). The mean scores of adaptive strategies of emotion regulation in the emotional schem therapy group were significantly higher than the control group (p<0.001). The mean scores of non–adapted emotion regulation strategies in the emotional schema therapy group were significantly lower than the control group (p=0.039). Also, in the experimental groups, there was a significant difference in the mean scores of emotion regulation (adapted strategies and non–adapted strategies) in the pretest and posttest stages (p<0.001) and pretest and follow–up (p<0.001).
Conclusion: Based on the findings, the effectiveness of emotion therapy schema on adapted emotion regulation strategies is greater than dialectical behavior therapy. Therefore, therapists can use the schema of emotional therapy as one of the new models of cognitive–behavioral therapy to improve emotion regulation in people with physical and motor disabilities.