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Comparison of the Effectiveness of Paradox Therapy and Metacognitive Therapy on Psychological Helplessness and Emotion Regulation in Patients with Multiple Sclerosis
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Zahra Bahadori   , Saied Malihi alzackerini * , Sheida Sodagar , Mojtaba Ansari Shahidi , Alireza Shokrgozar |
| Health and Clinical Psychology Department, Karaj Branch, Islamic Azad University, Karaj, Iran. , saied.malihi@kiau.ac.ir |
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Abstract: (33 Views) |
Introduction: Multiple sclerosis is a chronic neurological disease that, in addition to physical complications, is associated with increased psychological helplessness and difficulties in emotion regulation. These psychological challenges can undermine patients’ psychological adjustment and reduce their quality of life. Therefore, identifying and comparing effective psychotherapeutic interventions to alleviate these outcomes is of particular importance.
Methods: This study employed a quasi-experimental design with pretest, posttest, and three-month follow-up, including a control group. The statistical population consisted of all patients with multiple sclerosis who referred to the outpatient clinic of Naft Hospital in Tehran between December 2024 and March 2025. A total of 45 patients were selected using purposive sampling and randomly assigned to two experimental groups (paradox therapy and metacognitive therapy) and one control group. Research instruments included the Psychological Helplessness Questionnaire (Quinless & Nelson, 1988) and the Emotion Regulation Questionnaire (Gross & John, 2003). Paradoxical therapy (PTC) based on the Basharat protocol (2017) in 7 sessions of 60 minutes and Metacognitive Therapy for Depression (D-MCT) (Malihi al-Zakerini, 2024) were implemented in 8 sessions of 60 minutes. Data were analyzed using repeated measures analysis of variance (ANOVA) in SPSS-24 software.
Findings: The findings indicated that paradox therapy had a significant effect on reducing psychological helplessness in patients with multiple sclerosis (p < 0.01), with a significantly greater reduction observed compared to the metacognitive therapy group. In contrast, metacognitive therapy led to a significant improvement in emotion regulation, with significantly higher increases in emotion regulation scores compared to the paradox therapy group (p < 0.01).
Conclusion: Based on the findings, paradox therapy appears to be more effective in reducing psychological helplessness, whereas metacognitive therapy is more effective in improving emotion regulation in patients with multiple sclerosis. Accordingly, selecting and applying these interventions in line with patients’ psychological needs may play an important role in enhancing their mental health.
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| Keywords: Paradox Therapy, Metacognitive Therapy, Psychological Helplessness, Emotion Regulation, Multiple Sclerosi |
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Full-Text [PDF 325 kb]
(29 Downloads)
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Type of Study: Psychiatric and Mental Health Nursing |
Subject:
behavioral sciences
Received: 2026/02/17 | Accepted: 2026/04/7 | Published: 2026/03/30
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