Comparison of the Effectiveness of Classical Cognitive-Behavioral Group Therapy and Cognitive-Behavioral Psychodrama on Negative Emotions in Patients with Gastroesophageal Reflux Disease

Abstract

This study aimed to compare the effectiveness of classical CBT and cognitive-behavioral psychodrama in reducing negative emotions among patients with GERD. This quasi-experimental pretest–posttest study with a control group was conducted on 45 patients with chronic GERD recruited from gastroenterology clinics in Kerman in 2024 using purposive sampling and randomly assigned to classical CBT, psychodrama CBT, or control group; data were collected using GSAS and DASS-21 and analyzed by multivariate analysis of covariance in SPSS-26. MANCOVA demonstrated a significant overall intervention effect on negative emotions (Wilks’ Lambda=0.224, F=13.72, p<0.001, η²=0.527); both interventions significantly reduced depression (F=21.00, p<0.001, η²=0.519), anxiety (F=13.39, p<0.001, η²=0.407), and stress (F=13.11, p<0.001, η²=0.402) compared with the control group; Bonferroni tests indicated that classical CBT produced greater reductions in depression and anxiety, while both treatments were similarly effective in stress reduction. Both therapeutic approaches significantly improved emotional outcomes in GERD patients, with classical CBT demonstrating superior effects on depression and anxiety.