The Effectiveness of Existential Group Therapy on Anxiety and Depression in Female High School Students
DOI:
https://doi.org/10.63053/ijhes.203Keywords:
anxiety, depression, existential therapy, studentsAbstract
Background: Anxiety and depression are among the most common mental disorders that can significantly impact individuals' cognition, behavior, and emotions. The present study aimed to investigate the effectiveness of existential group therapy on anxiety and depression levels in female high school students.
Methods: This study employed a quasi-experimental pre-test-post-test design with a control group and a two-month follow-up. The statistical population comprised all 420 female secondary school students in District 15 of Tehran during the 2023-2024 academic year. Based on the Krejcie and Morgan table, 200 students were selected through convenience sampling for initial screening. After administering Beck Anxiety and Beck Depression questionnaires, 96 students scored above the cut-off points. From these, 30 students were randomly selected and assigned to experimental (n=15) and control (n=15) groups. The experimental group received 9 sessions (90 minutes each) of existential therapy based on Prochaska and Norcross's protocol (2010). Data were analyzed using repeated measures ANOVA.
Results: The findings demonstrated that existential group therapy significantly reduced anxiety (F=54.739, P<0.01, η²=0.662) and depression (F=16.102, P<0.01, η²=0.365) in female high school students. The effects were maintained during the two-month follow-up period.
Conclusion: Existential group therapy appears to be an effective intervention for reducing anxiety and depression in female adolescents. By addressing core existential concerns such as meaning, freedom, responsibility, and mortality, this therapeutic approach helps students develop greater self-awareness and more adaptive coping strategies.
References
1. Balogh L, Tanaka M, Török N, Vécsei L, Taguchi S. Crosstalk between existential phenomenological psychotherapy and neurological sciences in mood and anxiety disorders. Biomedicines. 2021;9(4):340.
2. Peeters N, van Passel B, Krans J. The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: A systematic review and research agenda. British Journal of Clinical Psychology. 2022;61(3):579-795.
3. Martins Esteves I, Silva Coelho M, Neves H, Pestana-Santos M, Santos MR. Effectiveness of family-centred educational interventions in the anxiety, pain and behaviours of children/adolescents and their parents' anxiety in the perioperative period: A systematic review and meta-analysis. Journal of Perioperative Nursing. 2022;35(1):1.
4. Akyunus M, Gültekin BF. Representations of the early maladaptive schemas on the interpersonal circumplex. International Journal of Cognitive Therapy. 2023;1-18.
5. Shahson N, Abdollahi D. Examining defense mechanisms in depressed individuals. National Conference on Modern Achievements in Education, Psychology, Law, and Cultural-Social Studies. Khoy, Iran: Islamic Azad University; 2018.
6. Islami N, Jafartabatabaei TS. Systematic review of existential psychotherapy effects on depression, anxiety, and anger variables. Third National Conference on Psychology, Education, and Lifestyle. Qazvin, Iran; 2019.
7. Jafari S, Jahanfar H, Kordani S, Elahgholizadeh Qezel Qayeh A, Abbasiannejad H. Effectiveness of existential psychotherapy on suicidal ideation in major depressive disorder: A single-case study. First National Conference on Psychotherapy in Iran. Ardabil, Iran; 2021.
8. Bhargava A, Tan X. A longitudinal analysis of internal migration, divorce and well-being in China. Journal of Biosocial Science. 2018;50(5):706-27.
9. Saffari M, Zomorodi S, Banesi P. Effectiveness of schema therapy on psychological capital of housewives in Mashhad. Seventh National Conference on Studies and New Research in Education, Psychology, and Counseling. Tehran, Iran; 2020.
10. Emam MM, Abdelrasheed NSG, Omara E. Negative cognition, emotional and behavioural difficulties, negative life events and depressive symptoms among adolescents in Oman. Current Psychology. 2019;1-10.
11. Morris L, Stander J, Ebrahim W, Eksteen S, Meaden OA, Ras A, et al. Effect of exercise versus cognitive behavioural therapy or no intervention on anxiety, depression, fitness and quality of life in adults with previous methamphetamine dependency: A systematic review. Addiction Science & Clinical Practice. 2018;13(1):4.
12. Berghuis KJ, Pössel P, Pittard CM. Perceived discrimination and depressive symptoms: Is the cognitive triad a moderator or mediator? Child & Youth Care Forum. 2019;1-14.
13. Parizan N, Banesi P. Effectiveness of schema therapy education on depression and anxiety in discharged COVID-19 patients from treatment centers. New Approach in Educational Sciences. 2022;4(3):6-14.
14. Diamond SA. Existential therapy and Jungian analysis: Toward an existential depth psychology. Journal of Humanistic Psychology. 2021;61(5):665-720.
15. Yalom ID. Existential psychotherapy. New York: Basic Books; 1980.
16. Hwang B, Ju HJ, Jang SH, Lee U, Shin SM. The development and effectiveness of motivational interviewing-existential psychotherapy program for Korean college students with depression. Journal of College Student Psychotherapy. 2023;1-21.
17. Stålsett G, Gude T, Rønnestad MH, Monsen JT. Existential dynamic therapy ("VITA") for treatment-resistant depression with Cluster C disorder: Matched comparison to treatment as usual. Psychotherapy Research. 2012;22(5):579-95.
18. Tarsha AA. The role of existential therapy in the prevention of social media-driven anxiety. Existential Analysis. 2016;27(2):382-98.
19. Sherry DL, Sherry SB, Hewitt PL, Mushquash A, Flett GL. The existential model of perfectionism and depressive symptoms: Tests of incremental validity, gender differences, and moderated mediation. Personality and Individual Differences. 2015;76:104-11.
20. Ghafourian Norouzi P, Ghanbari Hashemabadi BA, Hassanabadi H. Comparison of effectiveness of group therapy with existential and spiritual approaches on trust, self-esteem, and anxiety in divorced women. Counseling Research. 2013;12(47):82-99.
21. Shirali S, Dasht Bozorgi Z. Effect of existential group therapy on distress tolerance, existential anxiety, meta-worry, and health anxiety in elderly women with cardiovascular diseases. Journal of Cardiovascular Nursing. 2018;7(4):24-33.
22. Asadi L, Sirfi MR, Ahadi M. Effectiveness of existential therapy on health anxiety, loneliness, and death anxiety in the elderly. Medical Journal of Mashhad. 2023;5:43-65.
23. Guthrie C. How I learned to stop worrying and love the environmental apocalypse: An existential approach to accepting anxiety. 2023.
24. Chavatel W. Revelatory anxiety and dissociative disorders: An existential-humanistic approach. Journal of Humanistic Psychology. 2022;00221678221138385.
25. Beck AT, Epstein N, Brown G, Steer R. Beck anxiety inventory. Journal of Consulting and Clinical Psychology. 1993.
26. Kaviani H, Mousavi AS. Psychometric properties of Beck Anxiety Inventory in different age and sex groups of Iranian population. Tehran University Medical Journal. 2008;66(2):136-40.
27. Beck AT, Steer RA, Brown GK. Beck depression inventory-II (BDI-II). San Antonio: Psychological Corporation; 1996.
28. Rahimi C. Application of Beck Depression Inventory-II in Iranian students. Clinical Psychology and Personality. 2014;12(1):173-88.
29. Prochaska JO, Norcross JC. Systems of psychotherapy: A transtheoretical analysis. 7th ed. Belmont, CA: Brooks/Cole; 2010.
30. Diamond SA. Existential therapy and Jungian analysis: Toward an existential depth psychology. Journal of Humanistic Psychology. 2021;61(5):665-720.
31. Yalom ID, Leszcz M. The theory and practice of group psychotherapy. 5th ed. New York: Basic Books; 2005.
32. MacDonald P, Higgins C. Group therapy for anxiety disorders: A review. Journal of Anxiety Disorders. 2019;65:101-12.
33. Sadri Damirchi E, Ramezani S. Effectiveness of existential therapy on loneliness and death anxiety in the elderly. Aging Psychology. 2016;2(1):1-12.
34. Pashib M, Yazdanfar A. Effectiveness of existential therapy on reducing anxiety in veteran and martyr students. National Conference on Women's Role and Position in Jihadist Management. Torbat-e-Heydarieh, Iran; 2014.
35. Moghaddasi R, Manshaei G. Comparison of effectiveness of existential group therapy and art therapy on reducing ontological anxiety. Clinical Psychology and Counseling Research. 2015;5(2):122-35.
36. Farhangi Z, Aghaei M, Tayebi A. Effectiveness of existential therapy on postpartum depression symptoms in women. National Conference on New Research in Management, Economics, and Humanities. Kazerun, Iran; 2017.
37. Kamali Z. Effectiveness of schema-focused cognitive-behavioral group therapy on improving depression, anxiety, and childhood maladaptive schemas in abused women. Journal of Applied Research in Counseling. 2022;5(3):19-35.
38. Rudaki S. Determining the effectiveness of existential group therapy on depression in cancer patients. Second National Conference on Lifestyle and Stable Family. Tehran, Iran; 2021.
39. Rosli MR, Rafae NM, Alim AAA. The effectiveness of existential therapy to reduce the level of depression among residents in moral rehabilitation schools. Journal Contemporary of Islamic Counselling Perspective. 2022;1(1).
40. Yılmaz O, Mırçık AB, Kunduz M, Çombaş M, Öztürk A, Deveci E, et al. Effects of cognitive behavioral therapy, existential psychotherapy and supportive counselling on facial emotion recognition among patients with mild or moderate depression. Psychiatry Investigation. 2019;16(7):491.
41. Taghipour B, Barzegaran R. Effectiveness of existential therapy on depressive symptoms in women with major depressive disorder. Second National Conference on Psychopathology. Ardabil, Iran; 2021.
42. Renner F, Arntz A, Peeters FP, Lobbestael J, Huibers MJ. Schema therapy for chronic depression: Results of a multiple single case series. Journal of Behavior Therapy and Experimental Psychiatry. 2016;51:66-73.
43. Rek K, Kappelmann N, Zimmermann J, Rein M, Egli S, Kopf-Beck J. Evaluating the role of maladaptive personality traits in schema therapy and cognitive behavioural therapy for depression. Psychological Medicine. 2022;1-10.
44. Islami N, Jafartabatabaei TS. Systematic review of existential psychotherapy effects on depression, anxiety, and anger variables. Third National Conference on Psychology, Education, and Lifestyle. Qazvin, Iran; 2019.
45. Straarup NS, Renneberg HB, Farrell J, Younan R. Group schema therapy for patients with severe anxiety disorders. Journal of Clinical Psychology. 2022;78(8):1590-600.
46. Penney ES, Norton AR. A novel application of the schema therapy mode model for social anxiety disorder: A naturalistic case study. Clinical Case Studies. 2022;21(1):34-74.
47. Kopf-Beck J, Zimmermann P, Egli S, Rein M, Kappelmann N, Fietz J, et al. Schema therapy versus cognitive behavioral therapy versus individual supportive therapy for depression in an inpatient and day clinic setting: Study protocol of the OPTIMA-RCT. BMC Psychiatry. 2020;20(1):1-19.
48. Ranjbari T, Karimi J, Mohammadi A, Norouzi MR. Evaluation of triple vulnerability model in predicting emotional disorders. Iranian Journal of Psychiatry and Clinical Psychology. 2017;23(4):408-23.
49. Rahbari Ghazani N, Babapour J. The role of brain-behavioral systems and positive and negative strategies of cognitive emotion regulation in predicting depressive symptoms in patients with major depressive disorder. Razi Journal of Medical Sciences. 2018;25(10):61-70.
50. Qasemi F, Movahedi Y. Effectiveness of schema therapy on rumination, cognitive fusion, cognitive avoidance, and neurocognitive processing in divorce-seeking couples. Nursing Rehabilitation Research Journal. 2022;9(1):64-74.
51. Ghadampour E, Hosseini Ramghani NS, Moradi S. Effectiveness of emotional schema therapy on cognitive avoidance strategies in students with clinical symptoms of social anxiety. Ninth International Conference on Psychology and Social Sciences. Tehran, Iran; 2017.
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