Sport Psychology Studies

Sport Psychology Studies

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

Document Type : Original research

Authors
1 Professor, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
2 Ph.D. Student in Counseling, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
3 M.َA in Rehabilitation Counseling, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
4 Master Student in School Counseling, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
Abstract
The present study aimed to compare the effectiveness of Emotion-Focused Therapy (EFT) and psychodrama on cognitive emotion regulation, rumination, and cognitive flexibility in athlete students with social anxiety disorder. Methodologically, the study was quasi-experimental with a pre-test–post-test control group design. The statistical population consisted of all male high school students in Baneh County during the 2024–2025 academic year who were actively participating in sports and diagnosed with social anxiety disorder. A purposive sample of 45 students was selected and randomly assigned to three groups of 15 (EFT, psychodrama, and control). The diagnosis of social anxiety disorder was made based on a structured clinical interview in accordance with DSM-5 and the Social Anxiety Questionnaire. The instruments used to assess the dependent variables included the Cognitive Emotion Regulation Questionnaire (CERQ), the Ruminative Responses Scale (RRS), and the Cognitive Flexibility Scale (CFS). Interventions were conducted in ten weekly group sessions. Data were analyzed using multivariate analysis of covariance (MANCOVA). The findings revealed that both therapeutic approaches significantly improved cognitive emotion regulation and cognitive flexibility and reduced rumination compared to the control group (p < 0.05). Moreover, Emotion-Focused Therapy was found to be more effective than psychodrama in enhancing cognitive-emotional variables. Based on these results, both interventions—particularly Emotion-Focused Therapy—can be utilized in psychological interventions for athlete students with social anxiety.
Keywords
Subjects

1.       Ahmadi, E., Rostami, H., & Javani, Z. (2024). The effectiveness of mindfulness on rumination and cognitive regulation of emotion in students with depressive symptoms. Medical Journal of Tabriz University of Medical Sciences, 46(1), 87-96. https://B2n.ir/hw7247
2.       Almeida, B., Silva, S., & Cunha, C. (2025). Emotion‐Focused Therapy for Resolving Emotional Injuries in Older Adults: A Hermeneutic Single‐Case Efficacy Design Study. Counselling and Psychotherapy Research, 25(2), e70014. https://doi.org/10.1002/capr.70014
3.       Bagherian, M., Azadi, M., & Abdullahpour, M. A. (2025). Comparison of the Effectiveness of Individual and Group Psychodrama on Life Satisfaction, Self-Compassion, and Positive Emotions in Depressed Patients. International Journal of Education and Cognitive Sciences, 6(1), 118-127.
4.       Bardak, F., Kızılpınar, S. Ç., & Aydemir, M. Ç. (2024). Investigation of rumination and cognitive flexibility levels in patients with depression. Journal of Cukurova anesthesia and surgical sciences, 7(1), 1-7. https://doi.org/10.36516/jocass.1372677
5.       Çataldaş, S. K., Atkan, F., & Eminoğlu, A. (2024). The effect of psychodrama-based intervention on therapeutic communication skills and cognitive flexibility among nursing students: A 12-month follow-up study. Nurse Education in Practice, 80, 104118. https://doi.org/10.1016/j.nepr.2024.104118
6.       Dehghan, N., Sharifi, T., & Ahmadi, R. (2024). Comparative Analysis of the Effectiveness of Mindfulness-Based Stress Reduction and Emotion-Focused Therapy on Cognitive Flexibility in Cardiovascular Patients. https://www.sid.ir/paper/1155212/en
7.       Edgar, E. V., Richards, A., Castagna, P. J., Bloch, M. H., & Crowley, M. J. (2024). Post-event rumination and social anxiety: a systematic review and meta-analysis. Journal of psychiatric research, 173, 87-97. https://doi.org/10.1016/j.jpsychires.2024.03.013
8.       Farhadi, F. (2024). The Effectiveness of Emotion-Focused Therapy on Rumination and Alexithymia in People with Emotional Failure. Journal of Psychology New Ideas, 19(23), 1-15. http://jnip.ir/article-1-1138-en.html
9.       Hatami Nejad, M., Sadeghi, M., Sadri Damirchi, E., & Noroozi Homayoon, M. (2025). Examining the influence of alexithymia, gender, and age on drug use among iranian students: the mediating role of emotion regulation difficulties. Scientific Reports15(1), 3650. https://doi.org/10.1038/s41598-025-87394-w
10.    Hatami Nejad, M., Sadri Damirchi, E., Akhavi Samarein, Z., Jafari Moradlo, M., & Noroozi Homayoon, M. (2024). Comparing the effectiveness of narrative therapy and emotion focused therapy on primary maladaptive schemas, impulsivity and depression in students with suicidal thoughts. Journal of Psychological Studies20(3), 7-23. https://doi.org/10.22051/psy.2024.47061.2955
11.    Hayatipoor, S., Bavi, S., Khalafi, A., Dasht Bozorgi, Z., & Gatezadeh, A. (2024). Effects of stress management training on cognitive avoidance and emotion regulation strategies in Female students with social anxiety disorder: A mindfulness and emotional schema therapy approach. International Journal of School Health, 11(1), 40-49. https://doi.org/10.30476/intjsh.2023.100698.1357
12.    Homayoon, M. N., Samarein, Z. A., Sadeghi, M., & Hatami, M. (2024). 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. https://doi.org/10.22098/jrp.2024.14488.1221
13.    Jamshidi Bourkhani, Z., Imani, S., Jafari, A., & Ghamari, M. (2025). Effectiveness of Psychodrama Therapy on Fear of Intimacy, Rumination and Psychological Symptoms of Women Affected by Marital Infidelity. Journal of Modern Psychological Researches, 20(77), 208-223. https://doi.org/10.22034/jmpr.2024.63957.6470
14.    Kebritchi, A., Abolghasemi, S., & Shahriari Ahmadi, M. (2025). The effectiveness of emotion-focused therapy on cognitive flexibility and distress tolerance married women with social anxiety disorder. Journal of Psychological Science, 23(143), 97-113. https://doi.org/10.52547/JPS.23.143.2667 Krüger, R. T. (2024). What is Psychodrama?. In Disorder-Specific Psychodrama Therapy in Theory and Practice (pp. 1-6). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-99-7508-2_1
15.    Le, G. H., Wong, S., Au, H., Badulescu, S., Gill, H., Vasudeva, S., Teopiz, K. M., Rhee, T. G., Ho, R., Kwan, A. T. H., Mansur, R. B., Rosenblat, J. D., & McIntyre, R. S. (2025). Association between rumination, suicidal ideation and suicide attempts in persons with depressive and other mood disorders and healthy controls: A systematic review and meta-analysis. Journal of affective disorders, 368, 513–527. https://doi.org/10.1016/j.jad.2024.09.118
16.    Maya, J., Pérez-Berbel, M., Giraldo-Arroyave, L., & Hurtado, I. (2025). Psychodrama: implementation, study design and effectiveness: a systematic review. BMC Complementary Medicine and Therapies, 25, 232.
17.    Mikaeili, N., Narimani, M., & Marhamati, F. (2024). The Mediating Role of Cognitive Emotion Regulation in the Relationship between Experiential Avoidance and Social Anxiety Symptoms in College Students: A Descriptive Study. Journal of Rafsanjan University of Medical Sciences, 22(10), 1037-1052. http://dx.doi.org/10.61186/jrums.22.10.1037
18.    Musslick, S., & Bizyaeva, A. (2024). Examining cognitive flexibility and stability through the lens of dynamical systems. Current Opinion in Behavioral Sciences, 57, 101375. https://doi.org/10.1016/j.cobeha.2024.101375
19.    Nakhostin-Khayyat, M., Borjali, M., Zeinali, M., Fardi, D., & Montazeri, A. (2024). The relationship between self-regulation, cognitive flexibility, and resilience among students: a structural equation modeling. BMC psychology, 12(1), 337. https://doi.org/10.1186/s40359-024-01843-1
20.    Noroozi Homayoon, M., Gohari, 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. Practice in Clinical Psychology, 13(3), 0-0. http://dx.doi.org/10.32598/jpcp.13.3.1049.1
21.    Noroozi Homayoon, M., Nasiri, A., Sadri Damirchi, E., & Narimani, M. (2025). The Comparison of the Effectiveness of Emotional Cognitive Regulation Training and Transcranial Direct Current Stimulation on Resilience, Cognitive Flexibility, and Rumination in Older Women with Major Depressive Disorder. Aging Psychology11(1), 42-21.  https://doi.org/10.22126/jap.2025.11478.1821
22.    Noroozi Homayoon, M., Hatami Nejad, M., & Sadri Damichi, E. (2024). The effectiveness of psychodrama group therapy and cognitive behavioral play therapy on executive functions (working memory, response inhibition, cognitive flexibility and emotional self regulation) in male students with social anxiety disorder. Neuropsychology, 9(35), 1-17. https://doi.org/10.30473/clpsy.2024.68482.1710
23.    Nugent, C. D., & Foster, C. (2025). After the Psychodrama: The Importance & Process of Integration. Journal of Psychodrama, Sociometry, and Group Psychotherapy71(1), 1-13.
24.    Örnek, B. Y., & Şimşek, B. K. (2023). The effects of group psychodrama on the ruminative thinking style, dysfunctional attitudes, anxiety and depressive symptoms: a quasi-experimental study. Archives of Psychiatry and Psychotherapy, 3, 84-93. https://doi.org/10.12740/APP/166563
25.    Özdal, M. A. (2024). The Reflection of Rumination in Art Education on General Student Motivation. The Journal of Limitless Education and Research, 9(2), 170-218. https://doi.org/10.29250/sead.1431500
26.    Pourabdol,S. , Roshan,R. , Yaghubi,H. And Gholami Fesharaki,M. (2020). The Relationship between Intensity of Anger and its Expression in Competitive Athletes: The Mediating Role of Psychological Inflexibility. Sport Psychology Studies, 9(32), 97-116. Doi: 10.22089/spsyj.2020.8422.1915
27.    Rafiepoor, A., Darvish, G., Parivar, M., Rostami, H., & Nikoozadeh, E. K. (2025). The Effectiveness of Emotion-Focused Therapy on Self-Conscious Affect, Illness Perception, and Mental Rumination in Breast Cancer Patients. International Journal of Body, Mind & Culture (2345-5802), 12(1). https://doi.org/10.61838/ijbmc.v12i1.731
28.    Rajaei, M., Nasri, M., & Shahabizadeh, F. (2024). The effectiveness of emotion focused therapy on cognitive fusion and emotional self-regulation of spouses of veterans. Journal of Modern Psychological Researches, 19(73), 47-56. https://doi.org/10.22034/jmpr.2023.56106.5526
29.    Rosa-Alcázar, A. I., Rosa-Alcázar, Á., Martínez-Esparza, I. C., Storch, E. A., & Olivares-Olivares, P. J. (2021). Response inhibition, cognitive flexibility and working memory in obsessive-compulsive disorder, generalized anxiety disorder and social anxiety disorder. International Journal of Environmental Research and Public Health, 18(7), 3642. https://doi.org/10.3390/ijerph18073642
30.    Rowa, K., & Antony, M. M. (2025). Social anxiety disorder (Vol. 12). Hogrefe Publishing.‏ https://B2n.ir/hw7247
31.    Sadri Damirchi, E., Noroozi Homayoon, M., & Hatami Nejad, M. (2025). Developing a Model of Social Anxiety in Students Based on Insecure Attachment Styles and Fear of Failure with the Mediating Role of Rumination: A Descriptive Study. Journal of Rafsanjan University of Medical Sciences24(5), 438-451.  http://dx.doi.org/10.61882/jrums.24.5.438
32.    Soysal, F. S. Ö. (2023). The effects of psychodrama on emotion regulation skills in emerging adults. Current Psychology, 42(6), 4469-4482. https://doi.org/10.1007/s12144-021-01800-w
33.    Stiegler, J. R., Schanche, E., Danielsen, Y. S., & Hjeltnes, A. (2024). Growth in challenging situations: A qualitative investigation of therapists’ experience of delivering emotion-focused therapy. Psychotherapy Research, 1-13. https://doi.org/10.1080/10503307.2024.2432680
34.    Zhang, H., Zhu, X., Zhang, H., Xie, X., Wei, E., & Huang, W. (2025). The relationship between childhood trauma and social anxiety in college students: the mediating role of evaluation fear. BMC psychiatry, 25(1), 280. https://doi.org/10.1186/s12888-025-06668-9
35.    Zhao, D., & Zhang, J. (2024). The effects of working memory training on attention deficit, adaptive and non-adaptive cognitive emotion regulation of Chinese children with Attention Deficit/Hyperactivity Disorder (ADHD). BMC psychology, 12(1), 59. https://doi.org/10.1186/s40359-024-01539-6
Volume 14, Issue 54
Autumn 2025
Pages 154-178

  • Receive Date 04 August 2025
  • Revise Date 14 September 2025
  • Accept Date 17 September 2025