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IRCT20250521065821N1 IRCT 2025-07-29 Islamic Azad University The effect of cognitive behavioral therapy on anger control, distress tolerance, and negative automatic thoughts in single-parent women with symptoms of social anxiety The effectiveness of cognitive behavioral therapy on anger control, distress tolerance, and negative automatic thoughts in widowed women with symptoms of social anxiety 2025-08-16 anticipated 30 Complete https://irct.ir/trial/85140 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Education/Guidance, Randomization description: The selection will be done through a simple randomization method. According to this method, the names of each selected member will be written on paper as research samples, placed in a box for drawing, and then the pieces of paper will be drawn one by one. The first 15 individuals (1 to 15) will be part of the experimental group, and the next 15 individuals (16 to 30) whose names are drawn from the box will be members of the control group. N/A Not applicable.. Intervention 1: Intervention group: 1. First Session:The first session included psychoeducation, which consisted of:a) Teaching the basics of cognitive-behavioral therapy (CBT) and presenting the rationale for treatment.b) Educating about the fundamental principles of symptoms related to social anxiety disorder (SAD), introducing and discussing the cognitive-behavioral model of SAD.c) Encouraging patient engagement in therapy sessions and completing between-session assignments.d) Homework: Reviewing the cognitive-behavioral model worksheet for SAD. 2. Second Session:a) Reviewing the treatment model.b) Educating the patient about anxiety and the role of avoidance in maintaining social anxiety.c) Raising awareness about the importance of exposure and the nature of exposure situations.d) Creating a fear and avoidance hierarchy.e) Homework: Daily recording of anxiety-provoking social situations. 3. Third Session:a) Introducing the patient to negative automatic thoughts and maladaptive beliefs.b) Teaching the patient skills to identify and categorize negative automatic thoughts and challenge them.c) Homework: Completing the automatic thought challenging worksheet. 4-5. Fourth and Fifth Sessions:a) Developing a fear and avoidance hierarchy.b) Introducing the patient to the video feedback technique.c) Conducting video feedback exposure in the session: (The patient is asked to speak in front of a video camera about what they have learned in previous therapy sessions. The recorded video is then played back for the patient and those present during the exposure).d) Homework: (The patient is asked to stand in front of a mirror daily for a few minutes and talk about a topic or describe their own characteristics). 6-7. Sixth and Seventh Sessions:a) Preparing the patient for exposure in natural settings outside therapy sessions.b) Designing appropriate exposure situations for the patient based on the fear and avoidance hierarchy.c) Conducting exposure outside the therapy session.d) Providing feedback to the patient after exposure.e) Homework: The patient is asked to design and carry out several exposure situations and assess their anxiety levels before and after exposure. 8-9. Eighth and Ninth Sessions:a) Teaching assertiveness skills to the patient.b) Introducing the patient to assertiveness techniques and their different forms.c) Homework: The patient is asked to identify situations requiring assertiveness that they previously avoided and apply this skill. 10-11. Tenth and Eleventh Sessions:a) Relapse prevention.b) Identifying maintaining factors to prevent relapse in daily life.c) Preparing the patient to cope with temporary anxiety recurrence.d) Reviewing all therapy sessions, summarizing the patient's progress, and providing feedback. 12. Twelfth Session:Administering post-test questionnaires and thanking the participants. Intervention 2: Control group: They receive no training. Yes - There is a plan to make this available What will be shared: Only part of the data, such as information related to the primary outcome or similar, can be shared. When: Access period begins 6 months after publication of results. To whom: The data will only be accessible to researchers affiliated with academic or scientific institutions. Conditions: Any type of analysis is permitted on the delivered data. Where to obtain: Via email: nargesyousefi0203@gmail.com How to obtain: The data will be sent after emailing narges yousefi Sheikh Robat and receiving approval from the research team members Comments:
public Narges Yousefi Sheikh Robat
No. 60, 3rd Street, Phase 3, Koroush District
Ahvaz Iran (Islamic Republic of) ۶۱۶۴۸۷۸۷۸۴ 009832242836 nargesyousefi0203@gmail.com Islamic Azad University scientific Iran Davodi
South Kargar Boulevard؛ Farhang Shahr District؛ Golestan Highway
Ahvaz Iran (Islamic Republic of) 6134937333 +98 61 3334 8421 info@iauahvaz.ac.ir Islamic Azad University Iran (Islamic Republic of) Non-attendance in educational classes concurrent with the training sessions of this study Informed consent of the participant to participate in the research Obtaining a low score on the anger control and distress tolerance questionnaire based on the questionnaire's cutoff score. Obtaining a high score on the negative automatic thoughts questionnaire according to the questionnaire's cutoff score. Absence of any specific physical or psychological illness affecting the treatment process. no limit no limit Both Absence in more than 2 intervention sessions. Concurrent use of psychiatric medications with this treatment. Not participating in other psychological interventions. Developing a pervasive disorder. Behavior N/A Intervention group: 1. First Session:The first session included psychoeducation, which consisted of:a) Teaching the basics of cognitive-behavioral therapy (CBT) and presenting the rationale for treatment.b) Educating about the fundamental principles of symptoms related to social anxiety disorder (SAD), introducing and discussing the cognitive-behavioral model of SAD.c) Encouraging patient engagement in therapy sessions and completing between-session assignments.d) Homework: Reviewing the cognitive-behavioral model worksheet for SAD. 2. Second Session:a) Reviewing the treatment model.b) Educating the patient about anxiety and the role of avoidance in maintaining social anxiety.c) Raising awareness about the importance of exposure and the nature of exposure situations.d) Creating a fear and avoidance hierarchy.e) Homework: Daily recording of anxiety-provoking social situations. 3. Third Session:a) Introducing the patient to negative automatic thoughts and maladaptive beliefs.b) Teaching the patient skills to identify and categorize negative automatic thoughts and challenge them.c) Homework: Completing the automatic thought challenging worksheet. 4-5. Fourth and Fifth Sessions:a) Developing a fear and avoidance hierarchy.b) Introducing the patient to the video feedback technique.c) Conducting video feedback exposure in the session: (The patient is asked to speak in front of a video camera about what they have learned in previous therapy sessions. The recorded video is then played back for the patient and those present during the exposure).d) Homework: (The patient is asked to stand in front of a mirror daily for a few minutes and talk about a topic or describe their own characteristics). 6-7. Sixth and Seventh Sessions:a) Preparing the patient for exposure in natural settings outside therapy sessions.b) Designing appropriate exposure situations for the patient based on the fear and avoidance hierarchy.c) Conducting exposure outside the therapy session.d) Providing feedback to the patient after exposure.e) Homework: The patient is asked to design and carry out several exposure situations and assess their anxiety levels before and after exposure. 8-9. Eighth and Ninth Sessions:a) Teaching assertiveness skills to the patient.b) Introducing the patient to assertiveness techniques and their different forms.c) Homework: The patient is asked to identify situations requiring assertiveness that they previously avoided and apply this skill. 10-11. Tenth and Eleventh Sessions:a) Relapse prevention.b) Identifying maintaining factors to prevent relapse in daily life.c) Preparing the patient to cope with temporary anxiety recurrence.d) Reviewing all therapy sessions, summarizing the patient's progress, and providing feedback. 12. Twelfth Session:Administering post-test questionnaires and thanking the participants. Control group: They receive no training. Anger control. Timepoint: Measurements will be conducted at pre-test, post-test, and three-month follow-up after the post-test. Method of measurement: Spielberger Anger Questionnaire. Distress tolerance. Timepoint: Measurements will be conducted at pre-test, post-test, and three-month follow-up after the post-test. Method of measurement: Simmons and Gahr Distress Tolerance Questionnaire. Negative self-talk. Timepoint: Measurements will be conducted at pre-test, post-test, and three-month follow-up after the post-test. Method of measurement: Automatic Negative Thoughts Questionnaire (ATQ). Social anxiety. Timepoint: Measurements will be conducted at pre-test, post-test, and three-month follow-up after the post-test. Method of measurement: Social Anxiety Questionnaire. Islamic Azad University Approved 2024-11-11 The Ethics Committee in Research of Islamic Azad University - Ahvaz Branch South Kargar Boulevard؛ Farhang Shahr؛ Golestan Highway Ahvaz Khouzestan Iran (Islamic Republic of)