Comparison of the Effectiveness of Intensive Short-Term Dynamic Psychotherapy and Schema Therapy on Intolerance of Uncertainty and Cognitive Flexibility in Patients with Generalized Anxiety Disorder

Abstract

The objective of this study was to compare the effectiveness of Intensive Short-Term Dynamic Psychotherapy and Schema Therapy on intolerance of uncertainty and cognitive flexibility in patients with Generalized Anxiety Disorder. This research employed a quasi-experimental design using pretest–posttest with a control group and a three-month follow-up. The statistical population consisted of women aged 20–45 diagnosed with Generalized Anxiety Disorder who attended counseling centers in Tehran between June 2024 and October 2024. A total of 45 participants were selected through purposive sampling and assigned to three groups of 15 (ISTDP, Schema Therapy, and control). Data were collected using the Intolerance of Uncertainty Questionnaire (Freeston et al., 1994) and the Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010). Data analysis was performed through repeated-measures analysis and Bonferroni post-hoc tests. Inferential results indicated that Intensive Short-Term Dynamic Psychotherapy significantly reduced intolerance of uncertainty more than Schema Therapy (p < .01). ISTDP also demonstrated significantly greater improvement in cognitive flexibility compared to Schema Therapy (p < .05). While both intervention groups showed improvement from pretest to follow-up, the control group exhibited no meaningful changes across stages. The findings suggest that Intensive Short-Term Dynamic Psychotherapy is a more effective intervention than Schema Therapy for enhancing cognitive flexibility and reducing intolerance of uncertainty among patients with Generalized Anxiety Disorder, highlighting its value for therapeutic planning.