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Comparison of the Effectiveness of Metacognitive Therapy and Emotion-Focused Therapy on Psychological Distress in Patients with Diabetes
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Negar Sadegh Esfahani   , Saied Malihialzackerini * , Mojtaba Ansari Shahidi , Sheida Sodagar , Alireza Shokrgozar |
| Department of Health and Clinical Psychology, Ka.C., Islamic Azad University, Karaj, Iran & - , saied.malihi@Kiau.ac.ir |
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Abstract: (19 Views) |
Introduction: Diabetes is one of the most prevalent chronic metabolic diseases and is associated not only with physical complications but also with a wide range of psychological problems. Psychological factors play a critical role in disease management and metabolic control among patients with diabetes. Therefore, the application of effective psychological interventions may contribute significantly to improving both mental health and physical outcomes in this population. The present study aimed to compare the effectiveness of Metacognitive Therapy and Emotion-Focused Therapy on psychological distress in patients with diabetes.
Methods: This study employed a quasi-experimental design with a pretest–posttest and three-month follow-up, including a control group. The study population consisted of patients with diabetes attending specialized diabetes clinics and healthcare centers in 2025 (1404 SH). Forty-five participants were selected using purposive sampling and randomly assigned to two experimental groups (Metacognitive Therapy and Emotion-Focused Therapy) and one control group. Data were collected using the Depression, Anxiety, and Stress Scale (DASS-21) developed by Lovibond and Lovibond (1995). The Metacognitive Therapy intervention was delivered according to the depression treatment protocol developed by Malihi Alzakarini (2024) in eight 60-minute sessions, while the Emotion-Focused Therapy intervention followed the protocol of Greenberg and Geller (2012) in eight 90-minute sessions. Data were analyzed using repeated-measures analysis of variance in SPSS version 24.
Results: The findings indicated that both Metacognitive Therapy and Emotion-Focused Therapy significantly reduced psychological distress compared with the control group (p < .05). Pairwise comparisons further revealed that Metacognitive Therapy was significantly more effective than Emotion-Focused Therapy in reducing stress and depression (p < .05). However, no significant difference was found between the two interventions in reducing anxiety (p > .05).
Conclusion: The findings suggest that both therapeutic approaches are effective in reducing psychological distress among patients with diabetes. However, Metacognitive Therapy demonstrated greater effectiveness than Emotion-Focused Therapy in alleviating psychological distress, particularly symptoms of depression and stress. Therefore, incorporating Metacognitive Therapy alongside routine medical care may represent an effective strategy for enhancing the psychological well-being of patients with diabetes.
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| Keywords: Metacognitive Therapy, Emotion-Focused Therapy, Psychological Distress, Diabetes |
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Type of Study: Psychiatric and Mental Health Nursing |
Subject:
behavioral sciences
Received: 2026/07/29 | Accepted: 2026/08/17 | Published: 2026/08/1
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