New Approaches in Educational Management and Health Sciences

New Approaches in Educational Management and Health Sciences

Comparative Effectiveness of Emotional Schema Therapy and Cognitive Behavioral Therapy on Mental Health in Students

Document Type : Original Article

Authors
Fahime Al-Sadat Sahebi
Hossein Mahdian
Mehdi Ghasemi Motlagh
Department of Psychology, Boj.C., Islamic Azad University, Bojnord, Iran.
10.22034/edus.2026.597935.1140
Abstract
Introduction and Objective: Mental health plays an important role in emotional adjustment, academic performance, and social relationships among students during adolescence. Therefore, the use of effective psychological interventions to promote mental health in this population is of particular importance. Accordingly, the present study was conducted to compare the effectiveness of Emotional Schema Therapy (EST) and Cognitive Behavioral Therapy (CBT) on mental health among female junior high school students.
Methods: This quasi-experimental study employed a pretest–posttest design with a control group and follow-up assessment. The statistical population consisted of all female junior high school students in Behshahr County who were enrolled during the 2023–2024 academic year. According to official records, 2,320 students were enrolled at this educational level. The study sample consisted of 45 students, including 15 participants in Experimental Group 1, 15 in Experimental Group 2, and 15 in the control group. The Children's Symptom Inventory-4 (CSI-4), designed for children and adolescents aged 6–14 years, was used to assess mental health. Emotional Schema Therapy was delivered in 10 sessions based on the protocol developed by Ezzatpour et al. (2018), while Cognitive Behavioral Therapy was administered based on the protocol developed by Kharazi, Danesh, and Heydarzadegan (2018). The research findings were analyzed using mixed-design analysis of variance and the Bonferroni post hoc test.
Results: The results showed that both Emotional Schema Therapy and Cognitive Behavioral Therapy had significant effects on mental health. In addition, significant differences were observed in mental health scores across the three assessment stages (pretest, posttest, and follow-up), regardless of group. A comparison of the two therapeutic approaches indicated that Emotional Schema Therapy was more effective than Cognitive Behavioral Therapy in improving mental health.
Conclusion: Overall, these findings highlight the importance of selecting an appropriate therapeutic approach based on the type of psychological problem and individual needs, as each approach may yield better outcomes in specific contexts.
Keywords
Emotional Schema Therapy
Cognitive-Behavioral Therapy
Mental Health
Female Students
First-Stage Secondary School

Ethics Approval ID:IR.IAU.SARI.REC.1401.178

1.             Thomas SP. Global Boiling: Implications for Mental Health. Issues Ment Health Nurs. 2023;44(9):797-798. doi: 10.1080/01612840.2023.2244338
2.             Tomisato S, Yada Y, Wasano K. Relationship between social anxiety and coping profile in adults who stutter. J Commun Disord. 2022;95:106167. doi:  10.1016/j.jcomdis.2021.106167
3.             Toti L, Manzia TM, Sensi B, Blasi F, Baiocchi L, Lenci I, Angelico R, Tisone G. Towards tolerance in liver transplantation. Best Pract Res Clin Gastroenterol. 2021;54-55:101770. doi: 10.1016/j.bpg.2021.101770
4.             Trenoska Basile V, Newton-John T, Wootton BM. Remote cognitive-behavioral therapy for generalized anxiety disorder: A preliminary meta-analysis. J Clin Psychol. 2022;78(12):2381-2395. doi: 10.1002/jclp.23360
5.             Tripathi S, Guleria I. Biomarkers in Fetomaternal Tolerance. Clin Lab Med. 2019;39(1):145-156. doi: 10.1016/j.cll.2018.11.002
6.             Tyc O, Shi Y, Fan YC, Trebicka J, Xiang X. Editorial: Acute-on-chronic liver failure: systemic inflammation and immunosuppression. Front Immunol. 2023;14:1260749. doi: 10.3389/fimmu.2023.1260749
7.             Uğurpala C, Tükel R, Ziylan EÇ, Ertekin E, Berberoğlu E. Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder. J Nerv Ment Dis. 2023;211(11):828-834. doi: 10.1097/NMD.0000000000001696
8.             Ünal D, Çelebi F. Is There a Difference in Parental Attitudes and Attachment for ADHD-Social Phobia Comorbidity? Turk Psikiyatri Derg. 2023;34(1):24-30. doi: 10.5080/u26580
9.             Uysal M, Gurel Ficicioglu IE, Mutlu M, Mutluer T. Schema Therapy for Children and Adolescents: A Systematic Review of Individual, Group, and Parent-Based Interventions. Clin Child Fam Psychol Rev. 2026. doi: 10.1007/s10567-026-00568-4
10. Vader JM, Givertz MM, Starling RC, McNulty SE, Anstrom KJ, Desvigne-Nickens P, et al; LIFE Investigators. Tolerability of Sacubitril/Valsartan in Patients With Advanced Heart Failure: Analysis of the LIFE Trial Run-In. JACC Heart Fail. 2022;10(7):449-456. doi: 10.1016/j.jchf.2022.04.013
11.          Wu W, Huang L, Yang F. Social anxiety and problematic social media use: A systematic review and meta-analysis. Addict Behav. 2024;153:107995. doi: 10.1016/j.addbeh.2024.107995
12.          Velikova T, Krastev B, Lozenov S, Gencheva R, Peshevska-Sekulovska M, Nikolaev G, Peruhova M. Antibiotic-Related Changes in Microbiome: The Hidden Villain behind Colorectal Carcinoma Immunotherapy Failure. Int J Mol Sci. 2021;22(4):1754. doi: 10.3390/ijms22041754
13.          Videler AC, van Royen RJJ, Legra MJH, Ouwens MA. Positive schemas in schema therapy with older adults: clinical implications and research suggestions. Behav Cogn Psychother. 2020;48(4):481-491. doi: 10.1017/S1352465820000077
14.          Vincent N, Dirkse D, Giannouli E, McQuarrie A. Transdiagnostic cognitive behavioral therapy for nightmares and parasomnias. J Clin Sleep Med. 2023;19(3):499-509. doi: 10.5664/jcsm.10374
15.          Vuijk R, Deen M, Geurts HM, Arntz A. Schema therapy for personality disorders in autistic adults: Results of a multiple case series study. Clin Psychol Psychother. 2023;30(2):458-472. doi: 10.1002/cpp.2817.
16.          Walder N, Berger T, Hürzeler D, McDougal E, Edbrook-Childs J, Schmidt SJ. Prevention and treatment of social anxiety disorder in adolescents: mixed method randomised controlled trial of the guided online intervention SOPHIE. Sci Rep. 2025;15(1):25141. doi: 10.1038/s41598-025-10193-w
17.          Walenda A, Bogusz K, Kopera M, Jakubczyk A, Wojnar M, Kucharska K. Emotion regulation in binge eating disorder. Psychiatr Pol. 2021;55(6):1433-1448. English, Polish. doi: 10.12740/PP/OnlineFirst/122212.
18.          Walker L, Cross M, Barnett T. Mapping the interprofessional education landscape for students on rural clinical placements: an integrative literature review. Rural Remote Health. 2018;18(2):4336. doi: 10.22605/RRH4336.
19.          Watson T, Tindall R, Patrick A, Moylan S. Mental health triage tools: A narrative review. Int J Ment Health Nurs. 2023;32(2):352-364. doi: 10.1111/inm.13073.
20.          Wibbelink CJM, Arntz A, Grasman RPPP, Sinnaeve R, Boog M, Bremer OMC, et al. Towards optimal treatment selection for borderline personality disorder patients (BOOTS): a study protocol for a multicenter randomized clinical trial comparing schema therapy and dialectical behavior therapy. BMC Psychiatry. 2022;22(1):89. doi: 10.1186/s12888-021-03670-9.
New Approaches in Educational Management and Health Sciences
Volume 3, Issue 2
July 2026
Summer 2026
Pages 133-147

  • Receive Date 21 April 2026
  • Revise Date 16 July 2026
  • Accept Date 16 August 2026