دانشگاه رازی روان‌شناسی پیری 2423-7647 12 2 2026 06 26 The Effectiveness of Compassion-Focused Therapy on Ego Strength and Metacognitive Beliefs in Depressed Older Adults اثربخشی درمان مبتنی بر شفقت بر توانمندی من و باورهای فراشناختی سالمندان افسرده 253 235 4192 10.22126/jap.2026.13507.1902 FA زهرا شادکام گروه روانشناسی، واحد دزفول، دانشگاه آزاد اسلامی، دزفول، ایران 0009-0008-1712-9659 همایون هارون رشیدی گروه روانشناسی، واحد دزفول، دانشگاه آزاد اسلامی، دزفول، ایران 0000-0002-7912-3382 سعید مشتاقی گروه روانشناسی، واحد دزفول، دانشگاه آزاد اسلامی، دزفول، ایران 0000-0002-7953-3314 Journal Article 2026 01 07 Background: Older adulthood is a sensitive period of life in which examining different dimensions of mental health is of particular importance. Ego strength and metacognitive beliefs are among the factors that may substantially influence the mental health of older adults. Therefore, the present study aimed to investigate the effectiveness of Compassion-Focused Therapy (CFT) in improving ego strength and metacognitive beliefs among depressed older adults in Ahvaz, Iran. Methods: This study employed a quasi-experimental pretest–posttest design with a control group. The study population consisted of older adults residing in Ahvaz during the first half of the Iranian calendar year 2025. The sample included 30 depressed older adults aged 65–75 years who were selected through purposive sampling based on the study inclusion criteria and then randomly assigned to the experimental and control groups. The instruments used in this study were the Metacognitions Questionnaire developed by Wells and Cartwright-Hatton and the Psychosocial Inventory of Ego Strengths developed by Markstrom and colleagues. The experimental group received Gilbert’s CFT in eight weekly 90-minute sessions. Data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS version 22. Results: After controlling for pretest scores, the results showed statistically significant differences between the experimental and control groups at posttest in both ego strength and metacognitive beliefs (p<.001). Conclusion: The findings indicate that CFT can improve ego strength and metacognitive beliefs among depressed older adults. These findings may open new avenues for clinical interventions and suggest that CFT can be used as an effective intervention to improve ego strength and metacognitive beliefs in this population. EXTENDED ABSTRACT Introduction Aging is a natural process, a global phenomenon, and one of the stages of human growth and development. According to United Nations estimates, the global population of older adults is projected to rise from 350 million in 1975 to 1.1 billion by 2025. Given this increasing demographic trend, providing an appropriate context for the mental and psychological well-being of older adults is of paramount importance. Among the variables that assist older individuals in coping with and managing unpleasant life experiences are ego strength and metacognitive beliefs. In recent years, various therapeutic approaches have been employed to support older adults; however, Compassion-Focused Therapy (CFT) has garnered considerable attention. Given the high prevalence of depression and the challenges associated with aging, the need for research in this area is clearly evident. Since the existing literature has rarely addressed the effectiveness of CFT on ego strength and metacognitive beliefs among depressed older adults, and considering the paucity of studies conducted in Iran regarding the efficacy of diverse therapeutic modalities in improving psychological components in this population, the present study was undertaken to determine the effectiveness of CFT on metacognitive beliefs and ego strength in older adults. Method This was an applied, quasi-experimental study using a pretest–posttest control group design. The statistical population comprised all depressed older adults aged 65 to 75 years in the city of Ahvaz during the first half of the Iranian calendar year 1404 (2025). From this population, 30 depressed older adults who met the inclusion criteria were selected through purposive sampling and were randomly assigned to the experimental and control groups in equal proportions. Inclusion criteria consisted of obtaining a score above the mean on the depression and metacognitive beliefs scales and a score below the mean on the ego strength scale, being over 65 years of age, being diagnosed with depression, and having at least a high school diploma. Exclusion criteria included concurrent participation in other therapeutic interventions and the presence of acute cognitive disorders. Data collection instruments included the Zung Self-Rating Depression Scale (1971), the Ego strength Scale (Markstrom et al., 1977), and the Metacognitions Questionnaire (Wells & Cartwright-Hatton, 2004). The therapeutic content was adapted from Gilbert's CFT protocol (2009) and was delivered by a psychotherapist to the experimental group over eight 90‑minute sessions, one session per week. Each session included an introduction to the objectives and topics of that session, group discussion, and in‑session exercises. The content of the sessions is presented separately in Table 1. Data were analyzed using univariate analysis of covariance (ANCOVA) with SPSS statistical software (version 23). Results In accordance with the research design, univariate analysis of covariance (ANCOVA) was employed to analyze the primary results. Initially, Levene's test for homogeneity of variances was used to examine the equality of variances between the two groups in the posttest phase. The Levene's test statistics for ego strength and metacognitive beliefs were not statistically significant, thus confirming the homogeneity of variances assumption. Furthermore, the crucial assumption of homogeneity of regression slopes was tested by examining the interaction effect of the independent variable and the pretest of each dependent variable on its posttest, with results indicating that the F‑values were non‑significant at the 0.05 level for both ego strength and metacognitive beliefs. Additionally, the Shapiro–Wilk test was used to assess the normality of the distribution of the dependent variables. According to the results, the distributions were normal, as the Shapiro–Wilk test results were not statistically significant at the 0.05 level. Since the assumptions for ANCOVA were met, univariate analysis of covariance was performed to evaluate the effectiveness of CFT on total scores of ego strength and metacognitive beliefs. The results indicated a statistically significant difference between the experimental and control groups in terms of ego strength and metacognitive beliefs. In other words, CFT, as reflected in the mean scores of the experimental group compared to those of the control group, led to a significant improvement in both ego strength and metacognitive beliefs among the participants in the experimental group. Conclusion In interpreting these findings, it can be stated that in CFT, individuals learn not to avoid or suppress their painful emotions; consequently, they are first able to recognize their own experiences and then cultivate compassion toward them. CFT appears to enhance one's ability to manage choices and facilitates positive appraisals of cognitive strategies, control over challenges and adverse internal experiences, and reduction of motivational and emotional distress. Moreover, it seems to increase individuals' willingness and engagement in selecting positive behaviors. Furthermore, self‑compassion training, through the modification of the individual's cognitive system and the alteration of irrational and maladaptive beliefs that underlie emotional reactions, endeavours to diminish undesirable behaviours and replace them with more adaptive ones, ultimately leading to improvements in metacognitive beliefs and ego strength among depressed older adults. Among the limitations of this study were the use of purposive sampling and the inability to control for variables such as economic status, occupation, and stressors. Accordingly, it is recommended that future studies employ random sampling methods and control for intervening variables. Given the findings discussed, it is suggested that the infrastructure and context for implementing such therapeutic interventions for older adults be facilitated. Additionally, to ensure the sustainability of the training effects, measures should be considered to encourage continued practice of the learned exercises beyond the posttest phase. Ethical Consideration Ethical Code This article is derived from the master's thesis of the first author in Personality Psychology at Islamic Azad University, Dezful Branch. Funding This study received no external funding. Authors’ Contributions Z.Sh.: Conceptualization, methodology, software, validation, formal analyses, data curation, visualisation. 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Journal of Consultation and Liaison Psychiatry, 12(6), 371-379. https://doi.org/10.1016/s0033-3182(71)71479-0 زمینه: سالمندی دوره حساسی است که بررسی ابعاد مختلف سلامت ‌روان در آن‌ اهمیت زیادی پیدا می‌کند. توانمندی من و باورهای فراشناختی از عواملی است که می‌تواند تأثیر بسزایی بر سلامت‌روان سالمندان داشته باشد. بنابراین این مطالعه با هدف اثربخشی درمان مبتنی بر شفقت بر توانمندی من و باورهای فراشناختی سالمندان افسرده شهر اهواز انجام شد. روش: روش پژوهش نیمه‌آزمایشی با طرح پیش‌آزمون پس‌آزمون با گروه گواه بود. جامعه آماری پژوهش تمامی سالمندان شهر اهواز در نیمۀ اول سال 1404 بودند. حجم نمونه پژوهش شامل 30 نفر سالمند افسرده (65 تا 75 ساله) بود که با روش نمونه‌گیری هدفمند و بر اساس معیارهای ورود به مطالعه انتخاب و به‌طور تصادفی در دو گروه آزمایش و گواه گمارش شدند. مقیاس‎های مورد استفاده در این پژوهش شامل مقیاس باورهای فراشناختی ولز و کارترایت- هاتن و مقیاس توانمندی مارک استروم و همکاران بود. گروه آزمایش درمان مبتنی بر شفقت گیلبرت را در هشت جلسه 90 دقیقه‌ای هفتگی دریافت نمودند. داده‌ها با تحلیل کوواریانس تک‌متغیره، با استفاده از نرم‌افزارSPSS نسخه 22 مورد تجزیه و تحلیل قرار گرفتند یافته‌ها: نتایج نشان داد که با کنترل اثر پیش‌آزمون در مرحله پس‌آزمون بین دو گروه گواه و آزمایش در متغیرهای توانمندی من و باورهای فراشناختی تفاوت معناداری وجود دارد. بحث و نتیجه‌گیری: بر اساس یافته‌های این مطالعه، درمان مبتنی بر شفقت سبب بهبود توانمندی من و باورهای فراشناختی سالمندان می‌شود و نمایانگر افق‌های تازه‌ای در مداخلات بالینی است و می‌توان از آن به‌عنوان یک روش مداخله‌ای مؤثر در بهبود توانمندی من و باورهای فراشناختی سالمندان افسرده استفاده کرد.

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