Effectiveness of Schema Therapy on Cognitive-Emotional Regulation, Distress Tolerance and Quality of Life in Women as Heads of Households

Document Type : Original Article

Authors

1 Professor, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

2 Ph.D. Candidate in Counseling, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

3 Department of Psychology, Stockton University, Galloway, New Jersey, USA.

Abstract

Objective: The present study was conducted with the aim of investigating the effectiveness of schema therapy on cognitive-emotional regulation, distress tolerance, and quality of life in women as heads of households.
Methods:  The present study employed a quasi-experimental design with pre-test-post-test and a control group. The sample consisted of 30 women as heads of households with adolescent children in Ardabil city, selected through convenience sampling and randomly assigned to experimental (n=15) and control (n=15) groups. The experimental group received eight 90-minute sessions of schema therapy (Young et al., 2003), while the control group received no intervention. Data were collected using the Cognitive Emotion Regulation Questionnaire (CERQ-18), the Distress Tolerance Scale (DTS), and Quality of Life Questionnaire (SF-36). Multivariate analysis of covariance (MANCOVA) was used for data analysis.
Results: The results of the analysis of covariance showed that schema therapy significantly improved cognitive-emotional regulation, distress tolerance, and quality of life in women as heads of households (p < .001). Effect sizes were strong for adaptive strategies (η² = .76), maladaptive strategies (η² = .77), distress tolerance (η² = .71), and quality of life (η² = .81).
Conclusion: Schema therapy, by modifying maladaptive schemas and improving emotion regulation, increases distress tolerance and quality of life in women as heads of households. This brief and efficient method, if widely implemented in counseling and support centers, leads to positive individual and intergenerational outcomes.

Keywords

References

Azizi, A. R. (2010). Reliability and validity of the persian version of distress tolerance scale. Iran J Psychiatry, 5(4), 154–158. https://pubmed.ncbi.nlm.nih.gov/22952509/ 
Ballabrera, Q., Gómez-Romero, M. J., Chamarro, A., & Limonero, J. T. (2024). The relationship between suicidal behavior and perceived stress: the role of cognitive emotional regulation and problematic alcohol use in Spanish adolescents. Journal of health psychology, 29(9), 950–962. Doi:10.30476/whb.2024.103315.1300
Choheili, H., Marashian, F. S., Safarzadeh, S., & Asgari, P. (2026). The effect of schema therapy and mindfulness-based cognitive therapy on coping strategies in individuals with stimulant substance use disorder. Journal of Substance Use, 1–9. Doi:10.1080/14659891.2026.2627203
Choobforoushzadeh, A., Ahmadi Ardakani, Z., & Attarianpour Esfahani, H. (2025). The Effectiveness of Positive Parenting Programs on Parenting Stress and Parenting Self-Efficacy of Women as Heads of Households. Journal of Family Relations Studies, 5(4), 11–18. Doi:10.22098/jfrs.2024.14387.1171
Del-Valle, M. V., Zamora, E. V., Urquijo, S., Vernucci, S., Andrés, M. L., & Canet-Juric, L. (2024). Empirical evidence of the role of executive functions in tolerance of emotional distress. Journal of Cognitive Psychology, 36(8), 916–926. Doi:10.1080/20445911.2024.2408770
Dharani, M. K., & Balamurugan, J. (2024). The psychosocial impact on single mothers' well-being - A literature review. J Educ Health Promot, 13, 148. Doi:10.4103/jehp.jehp_1045_23
Ekaputri, R. A., Sukiyono, K., Yefriza, Y., Febriani, R. E., & Nopiah, R. (2025). Gendered Dimensions of Poverty in Indonesia: A Study of Financial Inclusion and the Influence of Female-Headed Households. Economies, 13(8), 240. Doi:10.30476/whb.2024.103315.1300
Farokhtaj, M., Marashi, S. A., & Hashemi, S. E. (2025). Comparing the Effectiveness of Positive-Oriented Psychotherapy with Schema Therapy on the Quality of Life and Irrational Beliefs. Journal of Psychological Studies, 20(4), 121–136. Doi:10.22051/psy.2025.48184.3013 
Fereydooni, F., & Sheykhan, R. (2024). The Effectiveness of Schema Therapy on Depression, Self-Esteem, and Distress Tolerance in Fatherless Depressed Adolescents. Journal of Adolescent and Youth Psychological Studies, 5, 87–96. Doi:10.61838/kman.jayps.5.8.10
Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual differences, 30(8), 1311–1327. Doi:10.1016/S0191-8869(00)00113-6
Hassas, O., Mashhadi, A., Shamloo, Z. S., & Bordbar, M. R. F. (2024). Emotional Schema Therapy for Bipolar Disorder: Improving Emotional Schemas, Quality of Life, Cognitive Emotion Regulation, and Symptom Management. International Journal of Cognitive Therapy, 17(3), 347–368. Doi:10.1007/s41811-023-00196-8
Heriani, A., Afdal, A., & Hariko, R. (2024). Challenges Faced by Career Women in Balancing Work and Home Responsibilities: a Systematic Literature Review. Jurnal Kepemimpinan dan Pengurusan Sekolah, 9, 339–347. Doi:10.34125/jkps.v9i3.565
Jackson, A. P., Brooks-Gunn, J., Huang, C. C., & Glassman, M. (2000). Single mothers in low-wage jobs: financial strain, parenting, and preschoolers' outcomes. Child Dev, 71(5), 1409–1423. Doi:10.1111/1467-8624.00236
Jafari goloche, A., Yosefi, E., & Khajepoor, L. (2024). Comparing the Effectiveness of Cognitive-Behavioral Therapy and Emotional Schema Therapy on Difficulties in Emotion Regulation and Positive and Negative Affect in Students with Anxiety Disorders [Original]. Iranian Evolutionary Educational Psychology Journal, 6(3), 121–140. Doi:10.22059/japr.2024.375061.644904
Karakolias, S., & Iliopoulou, A. (2025). Health-Related Quality of Life and Psychological Burden Among and Beyond Children and Adolescents With Type 1 Diabetes: A Family Perspective. Cureus, 17(4), e81744. Doi:10.7759/cureus.81744
Ladwig, S., Volz, M., Haupt, J., Pedersen, A., & Werheid, K. (2025). Disentangling the relationships of health-related quality of life, depressive symptoms, disability and social support after stroke: A network analysis. Journal of Affective Disorders Reports, 19, 100855. Doi:10.1016/j.jadr.2024.100855
Lass, A. N. S., Veilleux, J. C., DeShong, H. L., & Winer, E. S. (2023). What is distress tolerance? Presenting a need for conceptual clarification based on qualitative findings. Journal of Contextual Behavioral Science, 29, 23–32. Doi:10.1016/j.jcbs.2023.05.003
Li, T., Zhou, D., Zhang, W., & Ju, C. (2026). The Relationship Between Mindfulness and Test Anxiety Among High School Students: The Chain Mediating Role of Emotion Regulation and Psychological Resilience. Psychology in the Schools, 63(1), 53–63. Doi:10.1002/pits.70074
Liu, X., Zhang, X., Wang, D., Zhou, J., & Li, Y. (2025). Investigation of the quality of life and influencing factors among perimenopausal women. Arch Gynecol Obstet, 312(4), 1253–1265. Doi:10.30476/whb.2025.105249.1333
Lopez, M. M., Naragon-Gainey, K., & Conway, C. C. (2025). Defining distress tolerance in a structural model of Big Five personality domains. J Pers, 93(3), 567–580. Doi:10.1111/jopy.12952
Mansourzadeh, A., Shaygannejad, V., Mirmosayyeb, O., Afshari-Safavi, A., & Gay, M.-C. (2023). Effectiveness of Schema Therapy on Anxiety, Depression, Fatigue, Quality of Life, and Sleep in Patients with Multiple Sclerosis: A Randomized Controlled Trial. Middle East Journal of Rehabilitation and Health Studies, 11. Doi:10.5812/mejrh-132571
McGonigal, L. E., & Herres, J. (2025). Distress tolerance mediates the association between parental responses to distress during childhood and distress during college. Journal of Affective Disorders, 388, 119540. Doi:10.1016/j.jad.2025.119540
Milam, A. L., & Judah, M. R. (2023). The association of emotion regulation with distress tolerance depends on a neural correlate of cognitive control. Biol Psychol, 180, 108571. Doi:10.1016/j.biopsycho.2023.108571
Montazeri, A., Goshtasebi, A., Vahdaninia, M., & Gandek, B. (2005). The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Quality of life research, 14, 875–882. Doi:10.22059/jcsr.2025.404866.1024
Moradpour, A., & Bavi, S. (2025). The Effectiveness of Emotional Schema Therapy on Academic Self-efficacy, Test Anxiety, Distress Tolerance, and Academic Resilience in Students with Test Anxiety. Educational Research in Medical Sciences, 14. Doi:10.5812/ermsj-160978
Noroozi Homayoon, M., Akhavi Samarein, Z., Sadeghi, M., Hatami Nejad, M., & Jafari Moradlo, M. (2025). Comparing the Efficacy of Emotion-Focused Therapy and Transcranial Direct Current Stimulation On Impulsivity, Emotion Regulation, And Suicidal Ideation In Young People With Borderline Personality Disorder. Journal of Research in Psychopathology, 6(1), 33–42. Doi:10.22098/jrp.2024.14488.1221
Noroozi Homayoon, M., Ghohari, F., & Sadri Damirchi, E. (2025). Developing a Self-harm Model Based on Cognitive Emotion Regulation and Childhood Trauma With the Mediating Role of Insecure Attachment Styles in Students of Ardabil City, Iran: A Descriptive Study [Original Research Article]. Practice in Clinical Psychology, 13(3), 239–252. Doi:10.32598/jpcp.13.3.1049.1
Ren, H., Yang, T., Mei, S., Zhu, Z., Shi, J., Tong, L., Yang, J., & Sun, Y. (2025). Dyadic effects of illness perception and maladaptive cognitive-emotional regulation strategies on the fear of cancer recurrence in breast cancer patients and spouses: an actor-partner interdependence mediation model. BMC Psychiatry, 25(1), 41. Doi:10.30495/jpmm.2024.32628.3877
Rostami, M., Abolghasemi, A., & Narimani, M. (2016). The effectiveness of quality of life therapy on quality of life in maladjustment couples. Pajouhan Scientific Journal, 15(1), 19–27. Doi:10.22126/jap.2025.11026.1801
Sadri Damirchi, E., Moradi, Z., & Noroozi Homayoon, M. (2024). Investigating the effectiveness of based-on-mentality schema therapy on feelings of loneliness, depression and self-concept of unmarried girls over 40 years old in Khorram Abad city. Preventive Counseling, 5(4), 39–57. Doi:10.22098/jpc.2024.15112.1236
Sadri Damirchi, E., Noroozi Homayoon, M., Gohari, F., & Rashidi, M. (2025). Comparison of the Effectiveness of Emotion-Focused Therapy and Psychodrama on Cognitive Emotion Regulation, Rumination, and Cognitive Flexibility in Athlete Students with Social Anxiety Disorder. Sport Psychology Studies, 14(54), 154–178. Doi:10.22089/spsyj.2025.18326.2596
Simons, J., & Gaher, R. (2005). The Distress Tolerance Scale: Development and Validation of a Self-Report Measure. Motivation and Emotion, 29, 83–102. Doi:10.22070/cpap.2025.19843.1637  
Skaramagkas, V., Kyprakis, I., Karanasiou, G. S., Fotiadis, D. I., & Tsiknakis, M. (2025). A Review on Deep Learning for Quality of Life Assessment Through the Use of Wearable Data. IEEE Open J Eng Med Biol, 6, 261–268. Doi:10.1109/ojemb.2025.3526457
Sobhani, Z., Hosseini, S. V., Honarparvaran, N., Khazraei, H., Amini, M., & Hedayati, A. (2023). The effectiveness of an online video-based group schema therapy in improvement of the cognitive emotion regulation strategies in women who have undergone bariatric surgery. BMC Surgery, 23(1), 98. Doi:10.1186/s12893-023-02010-w
Talayry, A., & bavi, s. (2023). Comparison of the effectiveness of mindfulness-based stress reduction therapy and emotional schema therapy on perceived stress and distress tolerance of women undergoing drug treatment with psoriasis in Ahvaz city [Applicable]. Journal of Nursing Education, 11(5), 40–52. Doi:10.22034/ijpn.11.5.40
Tracy, M., Penney, E., & Norton, A. R. (2025). Group schema therapy for personality disorders: Systematic review, research agenda and treatment implications. Psychother Res, 35(6), 884–903. Doi:10.1080/10503307.2024.2361451
Trias-Prats, R., & Esteve, A. (2025). Rising Female-Headed Households: Shifts in Living Arrangements or Heightened Gender Symmetry? Population and Development Review, 51(2), 889–917. Doi:10.22098/j9032.2025.14563.1016
Turkzadeh, M. H., Azadi, S., Ranjbar Barkadehi, F., Khosravi, M., & Nokhbezare, F. (2025). Effectiveness of Spirituality-based Schema Therapy on Worry, Quality of Life, and Mental Well-being of Women with Generalized Anxiety Disorder. Razavi Journal of Medicine, 13(1), 100–114. Doi:10.30483/rijm.2025.254540.1338
Van Vreeswijk, M. F., & Zedlitz, A. M. E. E. (2025). The Foundation of Training, Supervision, and Personal Development in (Group) Schema Therapy. In W. Wen Li, G. M. Griffith, S. Shapiro, & Z. Zhu (Eds.), The Palgrave Handbook of Third-Wave Psychotherapies (pp. 579–610). Springer Nature Switzerland. Doi:10.1007/978-3-032-00353-9_24
Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care, 30(6), 473–483. Doi:10.22126/jap.2025.11478.1821
Yıldız, E., & Büyükfırat, E. (2025). Psychological Flexibility in Individuals With Substance Use Disorder: The Mediating Effect of Distress Tolerance and Stress. J Psychiatr Ment Health Nurs, 32(3), 610–622. Doi:10.22054/jpe.2024.76827.2634
Yılmaz, Y., & Bahadır, E. (2026). Cognitive disengagement syndrome and attention deficit hyperactivity disorder: An examination of relationships with alexithymia and emotion regulation difficulties. Applied Neuropsychology: Adult, 33(2), 523–529. Doi:10.1080/23279095.2024.2385444
Ying, L., & Yang, Q. (2025). The impact of combat sports on undergraduate students’ subjective well-being: chain mediation effects of emotional intelligence and self-esteem [Original Research]. Frontiers in Psychology, Volume 16 - 2025. Doi:10.3389/fpsyg.2025.1659084
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2006). Schema therapy: A practitioner's guide. guilford press.
Zaorska, J., Rydzewska, M., Kopera, M., Wiśniewski, P., Trucco, E. M., Kobyliński, P., & Jakubczyk, A. (2023). Distress tolerance and emotional regulation in individuals with alcohol use disorder. Front Psychiatry, 14, 1175664. Doi:10.3389/fpsyt.2023.1175664
Journal of Family Relations Studies
Volume 6, Issue 3 - Serial Number 22
September 2026
Pages 37-46

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History

  • Receive Date: 18 May 2026
  • Revise Date: 03 June 2026
  • Accept Date: 29 June 2026

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