Comparing the Effectiveness of Cognitive Behavioral Therapy and Schema Therapy on Self-Coherence in Adolescents with High-Risk Behaviors
Keywords:
Cognitive Behavioral Therapy, Schema Therapy, Self-Coherence, Adolescents, High-Risk BehaviorsAbstract
The present study aimed to compare the effectiveness of cognitive behavioral therapy and schema therapy on self-coherence in adolescents with high-risk behaviors. This applied study employed a quasi-experimental design with a pretest–posttest format, including a control group and a follow-up phase. The statistical population consisted of adolescents with high-risk behaviors referred to counseling centers of the Department of Education in Karaj in 2025. A total of 45 participants were selected through purposive sampling based on inclusion criteria and were randomly assigned, after matching demographic characteristics, into two experimental groups and one control group (15 participants in each group). One experimental group received cognitive behavioral therapy and the other received schema therapy across eight structured sessions, while the control group remained on a waiting list. Data were collected using the Integrative Self-Knowledge Questionnaire at three time points: pretest, posttest, and two-month follow-up. Data analysis was conducted using SPSS-27 through descriptive statistics, multivariate analysis of variance, repeated measures analysis of variance, and Bonferroni post hoc tests after verifying statistical assumptions. The results indicated that the main effect of group on self-coherence was not statistically significant (p = 0.440), whereas the main effect of time (p < 0.001) and the interaction effect of time and group (p < 0.001) were statistically significant. Bonferroni post hoc comparisons revealed that both cognitive behavioral therapy and schema therapy groups showed significantly higher self-coherence scores compared to the control group at posttest (p < 0.05), while no significant difference was found between the two experimental groups (p > 0.05). Pairwise comparisons across time demonstrated significant improvements from pretest to posttest and from pretest to follow-up in both intervention groups (p < 0.05), with no significant differences between posttest and follow-up, indicating stability of treatment effects. Both cognitive behavioral therapy and schema therapy were effective in enhancing self-coherence among adolescents with high-risk behaviors, and their effects were maintained over time, although no significant superiority of one approach over the other was observed.
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1. Joharifard M, Zahracar K, Farokhi Na, Mardani rad M. The causal model of tendency to high-risk behaviors in adolescents based on metacognitive beliefs and identity styles with role mediating of negative repetitive thoughts and resilience. Counseling Culture and Psycotherapy. 2021;12(47):161-94. doi: 10.22054/qccpc.2021.57166.2589.
2. Sefidrood M, Hobbi MB. The Role of Attachment Styles and Cognitive Emotion Regulation in Predicting the Tendency to High-Risk Behaviors in Adolescents. International Journal of Applied Behavioral Sciences. 2023;10(1):1-8. doi: 10.22037/ijabs.v9i4.34259.
3. Mohammadi Hosseini Asl F, Saken Azari R, Abdoltajedini P, Aghdasi AN. The Role of Attachment Styles, Cognitive Emotion Regulation and Subjective Vitality in Predicting High-Risk Behaviors of Female Adolescents. Quarterly Journal of Child Mental Health. 2022;9(3):121-35. doi: 10.52547/jcmh.9.3.11.
4. Yousefi A. Investigating the Role of Family Cohesion, Social Self-Efficacy and Adjustment in Predicting High-Risk Behaviors in Adolescents in Kamiyaran City. Journal of Emergency Health Care. 2025;14(1):3.
5. Angus LE. Narrative Processes and Self-Coherence in Trauma Recovery. Psychotherapy Research. 2021;31(2):189-203.
6. Moghadamnia MM, Soleimani Farsani BH. Relationship between Marital Commitment and Marital Satisfaction with Self-Conscious Emotions and Self-Coherence married female. Psychology of Woman Journal. 2023;4(1):52-61. doi: 10.61838/kman.pwj.4.1.6.
7. Mansoori B, Hosseini Far J. The effectiveness of spiritual intelligence training on social adjustment, alexithymia, and self-coherence in divorced students. School and Educational Psychology. 2020;9(3):234-58.
8. Mosaei R, Abolmaali Alhosseini K, Bagheri F. The effectiveness of growth-oriented training for adults aged 35 to 45 in promoting self-coherence and lifelong learning. Applied Family Therapy Journal (AFTJ). 2023;4(5):192-205. doi: 10.61838/kman.aftj.4.5.11.
9. Mayer J, Smith R, Johnson K. Impact of cognitive behavioral therapy on cognitive distortions in individuals with high-risk behaviors. Journal of Behavior Therapy. 2023;45(3):312-27.
10. Pourroosta A, Hamid N, Bashlideh K, Hashemi SI. Comparison of the Effectiveness of Positive Psychology-Based Therapy and Cognitive-Behavioral Therapy on Internet Addiction and High-Risk Behaviors of Students. New Psychological Research. 2024;19(73):22-34.
11. Moshkabadi EG, Heydari S, Fakhri M. Comparison of the Effectiveness of Cognitive Behavioral Training and Acceptance and Commitment Training on High-Risk Behaviors in Self-Injurious Adolescents. Jayps. 2024;5(5):126-35. doi: 10.61838/kman.jayps.5.5.15.
12. Sabet AH, Nejad SN, Khalatbari J. Comparison of the Effect of Schema Therapy and Cognitive Group Therapy on Depression in Women Engaging in High-Risk Sexual Behaviors Who Were Referred to Hamadan Health Center. Avicenna Journal of Neuro Psych Physiology. 2016;3(1). doi: 10.17795/ajnpp-39755.
13. Mirzaalian Dastjerdi F. Predicting high-risk behaviors based on childhood maltreatment with the mediation of early maladaptive schemas in high school students. Journal of a New Approach to Children's Education. 2022;4(3):76-83.
14. Reyhani S, Ahovan M. The effectiveness of emotional schema therapy on regulating emotions and reducing high-risk behaviors in female adolescents. Journal of Research in Behavioural Sciences. 2024;22(1):137-49. doi: 10.29252/rbs.22.1.137.
15. Khajevand S, Bahrainian A, Nasri M, Shahabizadeh F. Investigating the effectiveness of metacognitive interpersonal therapy on the cognitive regulation of emotion and emotional inhibition in adolescents with high-risk behaviors. Journal of Cognitive Psychology. 2023;11(4):91-105.
16. Sharei A, Kasaeei Esfahani A, Salmani A. The Effect of Mindfulness Therapy on Emotion Regulation, Cognitive Self-Awareness, and Tendency to High-Risk Behaviors in Orphaned and Poorly Monitored Adolescents: A Quasi-Experimental Study. Journal of Rafsanjan University of Medical Sciences. 2025;23(9):812-27. doi: 10.61186/jrums.23.9.812.
17. Esmaeili Pour M, Yousefi Z, Farhadi H. Development of a life hope package based on acceptance and commitment therapy specifically for adolescents exhibiting high-risk behaviors. Quarterly Journal of Experimental and Cognitive Psychology. 2025:1-16.
18. Baramake Z, Fadavi MS, Yousefi Z. Development of a Successful Intelligence Training Package Aimed at Reducing High-Risk Behaviors Especially for Teenagers. Journal of Psychological Dynamics in Mood Disorders (PDMD). 2024;2(4):101-14. doi: 10.22034/pdmd.2024.444922.1054.
19. Zarea S, Ahi Q, Vaziri SAH, Shahabizadeh F. Sexual Schemas and High-Risk Sexual Behaviors in Female Students the Mediating Role of Cognitive Emotion Regulation. International Archives of Health Sciences. 2020;7(4):203-9. doi: 10.4103/iahs.iahs_84_20.
20. Yuan T, Zhang X, Chen X. Machine learning based enterprise financial audit framework and high-risk identification. arXiv. 2025.
21. Vega-Martínez MDC, López-Martínez C, Del-Pino-Casado R. Sense of coherence and self-care in people with diabetes: systematic review. MedRxiv. 2025. doi: 10.1101/2025.01.16.25320434.
22. Samsami M, Mohammadkhani S, editors. Cognitive emotion regulation strategies in students with high-risk behaviors: The mediating role of metacognitive beliefs. 9th International Conference on Knowledge and Technology of Educational Sciences, Social Studies and Psychology of Iran; 2022; Tehran.
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Copyright (c) 2026 Fahimeh Ghafari Moghadam (Author); Fateme Dehghani-Arani; Elham Zarghami (Author)
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