LAPORAN PRAKTIKUM REVIEW CINEMA EDUCATION

KEPERAWATAN KELUARGA

Oleh

Kelompok 5

KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI

PROGRAM STUDI SARJANA KEPERAWATAN

FAKULTAS KEPERAWATAN

UNIVERSITAS JEMBER

2018
 KEPERAWATAN KELUARGA

Disusun untuk memenuhi tugas Mata Kuliah Keperawatan Keluarga dengan Dosen Pengampu
Ns. Tantut Susanto, M. Kep, Sp. Kep. Kom, Ph.D.

Oleh

Eka Edyawati 162310101059

Restu Retno S. 162310101073

Riska Dwi Wahyuni 162310101075

Agustin Dwi p. 162310101081

Renata Oktavian Haris 162310101084

Imroatul Khoiriyah 162310101100

KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI

PROGRAM STUDI SARJANA KEPERAWATAN

FAKULTAS KEPERAWATAN

UNIVERSITAS JEMBER
2018
A. Kehadiran Keluarga

1. Gambaran Singkat Tentang Film Tentang Film (Anggota Film Dan

Deskripsikan Khusus Anggota Keluarga Yang Akan Menjadi Pasien)
Suami : Sam Daniels (mantan suami)
Istri : Robby Keough (mantan istri)
Dokter :
a. Casey
b. Julio Ruiz
c. Mascelli
d. Henry Seward
e. Benjamin Iwabi
f. Raswani
Bregader Jendral : Morgan Freeman
Film Outbreak ini menceritakan sepasang suami istri yang sudah bercerai
Colonel Sam Daniels dan Robby Keough. Colonel Sam sebenarnya masih
menyangi Robby dan tidak ingin berpisah. Mereka bekerja sebagai dokter ahli
dalam menangani kasus, meliha cara penularan dan mengatasi penyebaran virus.
Suatu hari terdapat virus yang mematikan Colonel Sam beserta timnya dan Robby
menangani kasus tersebut, kasus ini bercerita tentang virus dari hewan, yaitu
monyet. Virus tersebut sangat berbahaya bagi kelangsungan hidup manusia. Virus
ini secara tidak sengaja tersebar melalui monyet yang berasal dari afrika setelah
berhasil diselendupkan ke Amerika. Awal mula penyebaran virus tersebut, ketika
monyet berinteraksi langsung dengan pemuda laki-laki yang bernama Jimbo dan
ia hendak menjual monyet tersebut di toko hewan. Akan tetapi Rudi pemilik
hewan tersebut menolak membelinya karena harga monyet yang mahal dan
monyet tersebut belum jinak. Sehingga Jimbo memutuskan untuk melepas monyet
tersebut di sebuah hutan dekat dengan pemukiman dan ia kembali ke pulang ke
rumahnya. Pada saat itu Jimbo sudah terinfeksi tersebut karena berkontak dengan
liur monyet tersebut begitu pula pemilik toko hewan ia sempat dicakar. Monyet
ini ternyata mengidap virus demam yang sangat mematikan dan dapat membunuh
orang yang terkontaminasi hanya dalam beberapa jam saja. Dengan gejala awal
 flu, tubuh lemas, dan demam yang berkepanjangan. Virus yang berasal dari afrika
ini begitu tak terkendali, dalam sekejap saja seisi kota sudah tercemar virus
tersebut dan warga diseluruh penjuru kota mulai panic. Pasukan militer mulai
dikerahkan untuk mengatasi kepanikan warga. Semua dokter hebat dikumpullkan
termasuk Sam dan Robby, ia dikumpulkan untuk meyelamatkan warga dan
mencari cara agar virus ini tidak menyebar lebih luas

2. Gambaran Ecomap Keluarga

USAMRIID
SAM ROBBY

SALT

CASSEY

RS

MILITER

* KETERANGAN

A. : Hubungan kuat
B. : Hubungan normal

C. : Pria ,pasien yang teridentifikasi

D. : Wanita , pasien yang teridentifikasi

E. : Cerai

3. Analisis Ecomap Secara Spesifik Terkait Hubungan Keluarga Dan

Lingkungan Sekitar
Sam dan Robby disini sempat menikah akan tetapi ia bercerai. Mereka
tidak memiliki anak. Sam dan Robby bekerja sebagai tenaga kesehatan, ketika
Robby terkena penularan wabah dari seekor monyet ia mendapat dukungan penuh
dari suami dan tenaga kesehatan lainnya di rumah sakit. Hubungan Sam dengan
petugas kesehatan sangat kuat, begitu juga hubungan Sam dengan militer yang
sangat kuat juga dengan teman-temannya untuk kesembuhan Sam dan Robby.
Selain itu petugas kesehatan tentara (USAMRIID) juga memberikan pertolongan
dan tanggap serta memotivasi Sam dalam menangani permasalahan virus tersebut.
B. PENILAIAN KELUARGA DAN PRIORITAS KEBUTUHAN

1. KONDISI FISIK DAN PSIKOSOSIAL

1. Tipe Keluarga
Keluarga dalam film ini termasuk dalam tipe keluarga Nuclear Family karena terdapat
istri dan suami. Suasana dalam keluarga tersebut awalnya tidak terlalu harmonis
semenjak Tn. Sam bercerai dengan istrinya yang bernama Ny.Boby, akan tetapi setelah
Ny.Boby terjangkit virus Hanta Tn.Sam sangat peduli dan memperjuangkan agar mantan
istrinya tersebut tetaphidup dengan mencari antivirus untuk menyembuhkan virus yang
sedang melanda warga California.
2. Latar Belakang Kebudayaan
 Dalam film disebutkan bahwa keluarga ini tinggal di California dan Keluarga dalam
kekehidupan sehari-hari menggunakan bahasa Inggris dalam berkomunikasi. Agama
yang dianut oleh keluarga Tn.Sam adalah agama Kristen.
3. Status Kelas Sosial
a. Status social ekonomi keluarga
Berdasarkan keadaan ekonomi Tn.Sam termasuk pada keluarga dengan tingkat
ekonomi menengah keatas, hal ini terbukiti dari pekerjaan Tn. Sam sebagai
Kolonel (Tentara) . Kebutuhan kelurga Tn. Sam juga selalu terpenuhi dan tidak
penah kekurangan.
b. Aktivitas rekreasi keluarga
Tn. Sam tidak pernah sempat untuk berekreasi dengan keluarganya dikarenakan
kesibukan dengan pekerjaanya yang membuatnya tidak pernah ada waktu.
4. Mobilitas Kelas Sosial
Dalam film tersebut dijelaskan bahwa Tn. Sam berpergian ke mana-mana menggunakan
mobil, contohnya ktika pergi ke rumah istrinya yaitu Ny. Boby menggunakan mobil.
5. Tahap Perkembangan dan Riwayat Keluarga
a. Tahap perkembangan keluarga saat ini
i. Tahap perkembangan keluarga Tn. Sam saat ini termasuk dalam tahap
perkembangan keluarga dengan “Newly Established Couple (no
children)”. Keadaan mantan istri Tn. Sam saat ini mengalami infeksi virus
yang di tularkan oleh monyet yang memberikan dampak yang besar bagi
Tn. Sam dan ingin menyelamatkan nyawa mantan istrinya tersebut.
b. Riwayat keluarga inti
i. Dalam film dijelaskan bahwa Tn. Sam menikah dengan Ny.Boby, akan
tetapi Tn. Sam dan Ny. Boby telah bercerai.
c. Riwayat keluarga sebelumya
Didalam film tidak diceritakan mengenai Tn. Sam yang ingin menyelamatnya nyawa
mantan istrinya dan menyelamatnya warga yang sudah terjangkit virus Hanta tersebut,
akan tetapi banyak yang menghalangi niat baik yang akan dilakukan oleh Tn.Sam.
6. Data Lingkungan
a. Karakteristik Rumah
 Tn. Sam dalam film tersebut memiliki tempat tinggal, pertama ketika menikah sebelum
dia bercerai dengan istrinya ia menepati rumah dengan lingkungan kompleks perumahan
dengan desain bergaya Amerika, berdinding batu bata kayu yang di cat dengan warna
terang ataupun putih, memiliki jendela di rumahnya, dan penggunaan perabotan rumah
yang simple.
b. Karakteristik lingkungan sekitar dan komunitas yang lebih besar
Pada film ini tidak menampilkan keadaan lingkungan sekitar dari keluarga Tn.Sam.
Lingkungan tempat tinggal yang ditempati Tn. Sam saat ini berada di suatu laboratorium
yang meneliti tentang virus yang disebarkan oleh monyet.
c. Amati suplai air minum dan sanitasi
kebutuhan suplai air minum di rumah sakit tidak dimunculkan dalam film dan untuk
sanitasi di rumah sakit tersebut sudah baik.
d. Keadaan umum kebersihan dan sanitasi rumah
rumah sakit yang ada di film tersebut terlihat bersih serta peralatannya terlihat rapi dan di
dalam terdapat banyak ruangan untuk penelitian.
e. mobilitas geografis
Tn. Sam tinggal di kota California bersama dengan Istinya, kemudian Tn. Sam dan istri
bekerja sebagi ilmuan dalam film sering berada di rumah sakit untuk melakukan
penelitian. Tn. Sam sering menggunakan mobilnya dan helicopter untuk kegiatan bekerja
dan beraktivitas.

2. PENILAIAN KELUARGA DAN PRIORITAS

1. Kondisi Fisik dan Psikososial Klien

a. Kondisi fisik
Kondisi fisik Tn.Sam sangat baik akan tetapi mantan istri Tn. Sam terjangkit oleh virus
mematikan yang disebarkan oleh monyet.
b. Psikososial
Tn. Sam, ia merupakan seorang Kolonel yang memiliki sifat yang sangat tegas dan suka
dalam pengambilan suatu keputusan yang sangat beresiko bagi dirinya.
2. Faktor Lingkungan dan Sosiokultural: Nilai, Keyakinan, Spiritual
 Keluarga Tn. Sam memiliki keyakinan agama yang sama yaitu agama Kristen, namun dalam
film tidak dijelaskan bagaimana aktivitas keagamaanya. Kondisi sosiokultural sikap Tn. Sam
sangat tegas dan suka mengambil keputusan yang sangat beresiko.

3. Status Gizi dan Obat-Obatan

a. Status gizi: dalam film dijelaskan bahwa Tn. Sam jarang makan karena sibuk
dengan pekerjaannya untuk sebuah penelitian suatu virus.
b. Obat-obatan: pada film tersebut tidak dijelaskan masalah obat-obatan hanya saja
menjelaskan tentang serum antivirus untuk menyelamatkan nyawa orang-orang
yang sudah terjankit oleh virus Hanta.

4. Penggunaan Sumber Perawatan Kesehatan atau Pengobatan

Fasilitas pelayanan kesehatan sudah memadai seperti adanya rumah sakit di daerah tersebut. Dan
penangannya cukup baik seperti dijelaskan pada film saat warga terkena virus mematikan akan
segera di tanganni.

5. Diagnosa Medis

Virus Ebola, Motaba

6. Bagaimana Kondisi Klien Mempengaruhi dan Keluarga

Saat Tn. Sam mengetahui bahwa mantan istrinya yaitu Ny. Boby terjangkit suatu virus, Tn. Sam
gelisah, panik , dan tidak percaya akan hal itu. Namun Tn. Sam selalu mendukung istrinya
bahwa dia pasti bisa sembuh dan selamat akan virus yang mematikan tersebut, dapat dilihat saat
Tn.Sam berada di dekat mantan istrinya dan membuka helm yang melindunginya dari virus agar
Ny. Boby bisa menyentuh kedua pipi Tn. Sam.

7. Persepsi Keluarga Tentang Kesehatan

Tn. Sam sebagai mantan suami dari Ny. Boby menganggap bahwa kesehatan itu sangat penting
dengan di tunjukan saat Ny. Boby positif terjangkit Virus dengan sigapnya Tn. Sam langsung
mencari obat antivirus yang dapat menyembuhkan mantan istrinya.

8. Kekuatan Keluarga
Keluarga Tn. Sam memiliki ikatan keluarga yang kuat karena mereka saling mendukung dan
tetap mendampingi Ny. Boby dalam proses penyembuhan. Dukungan, kasih sayang, cinta dan
simpati terlihat dalam diri Tn. Sam yang dapat menerima Ny. Boby dalam kondisi apapun.
Meskipun ada adegan Ny. Boby sempat menyerah terhadap kondisi penyakitnya.

Fungsi keluarga

1. Fungsi afektif
Tn. Sam sangat peduli dengan keadaannya Istrinya ketika sakit
terlihat dari Tn. Sam yang ikut merawat dan memberikan obat untuk
mengobati penyekit akibat seranagn virus. Keakraban antar keluarga
masih terjalin harmonis.
2. Fungsi Sosialisasi

Tn. Sam dan istri banyak melaukan sosialisasi dengan bayak orang
dibuktikan dalam film saat mereka bertemu banyak orang untuk
mengobati penyakit yang melanda kota California yang terserang virus
mematikan.

3. Fungsi perawatan kesehatan

Dalam melakukan perawatan kesehatan Tn. Sam dan istri
melakuakan dengan baik.
4. Stres, koping, dan adaptasi keluarga

Stressor yang dihadapi oleh Tn. Sam yaitu karena seluruh warga kota
dan Istri terserang penyakit yang mematikan yang berasar dari monyet,
tetapi utuk adaptasi koping Tn. Sam sangat Baik dibuktikan saat Tn. Sam
berusaha mencari obat penawar dari virus tersebut dan selalu setia
merawat istri.
C. IDENTIFIKASI PERMASALAHAN KELUARGA
DATA DIAGNOSA RENCANA TINDAKAN JURNAL
MALAD KEPERAWATAN KEPERAWATAN KEPERAWA RUJUKA
APTIF TAN / N
TERAPI
KELUARGA
1. Saat Ansietas b.d (5820)- (5820)-
Ny. perubahan besar Pengurangan Pengurangan
Robby pada status Kecemasan Kecemasan
terkena kesehatan 1. Bantu klien 1. Membantu
jarum mengidentifikasi klien
suntik situasi yang mengidentif
2. Tn. mampu memicu ikasi situasi
Sam kecemasan yang
kesulitan 2. Gunakan mampu
dalam pendekatan yang memicu
mencari tenang dan kecemasan
inang atau menyakinkan 2. Menggunak
sumber 3. Dukung dalam an
pembawa penggunaan pendekatan
virus mekanisme yang tenang
3.Khawati koping yang dan
r dan sesuai menyakink
waspada 4. Instruksikan klien an
saat Tn. untuk 3. Mendukung
Casey menggunakan dalam
menunjuk teknik relaksasi penggunaan
kan gejala 5. Kaji terkait tanda mekanisme
virus verbal dan koping
 nonverbal yang sesuai
kecemasan 4. Menginstru
ksikan klien
(5230)- untuk
Peningkatan menggunak
Koping an teknik
1. Bangun relaksasi
hubungan 5. Mengkaji
terapeutik untuk terkait
saling percaya tanda
2. Bantu klien untuk verbal dan
menyelesaikan nonverbal
masalah dengan kecemasan
cara yang
konstruktif (5230)-
Berikan penilaian Peningkatan
dan diskusikan Koping
respon alternative 1. Membangu
terhadap situasi n hubungan
terapeutik
untuk
saling
percaya
2. Membantu
klien untuk
menyelesai
kan
masalah
dengan cara
yang
konstruktif
 Memberikan
penilaian dan
diskusikan
respon
alternative
terhadap
situasi

1. Tn Sam Diskontinuitas (7130)- (7130)-

dan Ny. proses keluarga bd Pemeliharaan Pemeliharaan
Robby pergeseran peran proses keluarga proses
sudah keluarga keluarga
bercerai
1. Identifikasi efek 1. Mengidenti
2. Tn Sam
perubahan peran fikasi efek
dan Ny.
terhadap proses perubahan
Robby
keluarga peran
tidak
2. Bantu anggota terhadap
tingga
keluarga untuk proses
serumah
menerapkan keluarga
strategi
normalisasi 2. Membantu
terhadap situasi anggota
mereka keluarga
3. Diskusikan untuk
strategi untuk menerapka
menormalkan n strategi
kehidupan normalisasi
keluarga dengan terhadap
seluruh anggota situasi
keluarga mereka
 Mendiskusikan
strategi untuk
menormalkan
kehidupan
keluarga
dengan seluruh
anggota
keluarga

D. TERAPI
Judul film : Outbreak
Masalah keluarga : Sam dan Robby adalah mantan suami istri yang sebenarnya saling
mencintai namun karena mereka terlalu sibuk dengan pekerjaanya
akhirnya menyebabkan keduanya kurang saling mengerti satu sama lain
dan itulah yang menyebabkan mereka bercerai

TERAPI SPIRITUAL EMOTIONAL FREEDOM TECHNIQUE

(SEFT)
PSIK
UNIVERSITAS
JEMBER
1. PENGERTIAN Spiritual emotional freedom technique (SEFT) adalah
metode sederhana yang menekankan fokus pada masalah
dalam diri individu disertai dengan menekan secara lembut
padatitik akupuntur (tapping) di wajah, tubuh bagian atas
dan tangan.
2. TUJUAN 1. Menurunkan skala nyeri
2. Mengurangi kecemasan
3. Menghilangkan fobia dan kecanduan
4. Menurunkan tekanan darah
3. INDIKASI fobia, gangguan fisik dan seksual, stress dan kecemasan,
trauma, alergi, sakit kepala, migrain, kecanduan,
kepercayaan diri, dan insomnia.
4. KONTRAINDIKASI -
5. PERSIAPAN KLIEN 1. Pastikan klien siap untuk dilakukan SEFT
2. Jauhkan benda toxin (jam, sabuk, handphone, laptop,
cincin, pakaian yang wangi atau benda yang berada di
tubuh kita atau didepan kita dijauhkan)
3. Anjurkan untuk meminum air putih terlebih dahulu
(untuk mencegah energi yang keluar saat tapping)
4. Posisi SEFTer dengan pasien tidak boleh berhadapan
karena adanya hantaran energi yang keluar dari tubuh,
dianjurkan untuk posisi menyamping antara SEFTer
dengan pasien
5. Tentukan masalah yang akan diterapi. Masalah ini harus
jelas dan spesifik, bisa dibayangkan atau rasakan
langsung
6. PERSIAPAN ALAT 1. Pakaian yang nyaman dan longgar

7. CARA BEKERJA :
1. Estimate Severity
a. Ukur skala awal dari masalah dengan kisaran angka 0 sampai 10
b. Identifikasi rasa sakitnya, bukan nama sakitnya. Contoh: (sakit kepala bagian
samping, nyeri pundak atas kanan, dan lain-lain).
Angka 0 berarti tidak ada gangguan (tidak terasa sakit sama sekali)
Angka 10 berarti gangguan sangat kuat atau masalahnya sangat berat.
2. Melakukan Set Up
 Ucapkan kalimat set up sesuai dengan masalah yang sedang anda hadapi dengan
penuh perasaan sebanyak 3 kali, sambil menekan dada di bagian sore spot, yaitu di
daerah sekitar dada atas yang jika ditekan terasa agak sakit.
Contoh:Ya Allah, meskipun saya menderita nyeri perut yang sangat hebat dan
sering beser, saya ikhlas, saya pasrah padaMu sepenuhnya. (Bila anda beragama
lain, anda bisa mengganti Ya Allah dengan Ya Tuhan)
3. Lakukan Tune In
a. Pikirkan dan bayangkan peristiwa spesifik yang membangkitkan emosi negatif
yang ingin dihilangkan sambil mengulangi kata pengingat yang mewakili emosi
negatif yang kita rasakan. Kata pengingat terbaik, biasanya diambil dari kalimat
yang kita pilih dalam set up, misalnya: rasa nyeri.
b. Cara lain melakukan tune in ialah sambil membayangkan peristiwanya atau
merasakan sakitnya, lalu kita mengganti kata pengingatnya dengan doa
khusyuk: Saya ikhlas, saya pasrah padaMu Ya Allah.
4. Lakukan Tapping
Tapping adalah mengetuk ringan dengan dua ujung jari pada titik-titik tertentu di
tubuh kita sebanyak kurang lebih 5-7 kali ketukan, sambil terus melakukan tune in
(mengucapkan permasalahn yang sedang dialami klien). Adapun titik-titik tersebut
adalah:
a. top of head (bagian atas kepala)
b. end of eyebrow (titik permulaan alis mata)
c. side of eye (titik permulaan alis mata)
d. under eye (2 cm di bawah mata)
e. under nose (di bawah hidung)
f. chin (antara dagu dan bagian bawah bibir)
g. collarbone (pada ujung tempat bertemu tulang dada dan tulang rusuk pertama)
h. under arm (untuk laki-laki terletak di bawah ketiak sejajar dengan putting susu
dan wanita terletak di perbatasan antara tulang dada dan bagian bawah
payudara)
i. gamut (di bagian antara perpanjangan tulang jari manis dan tulang jari
kelingking)
 j. karate point (di samping telapak tangan)
5. Di titik terakhir (Gamut Spot), lakukan 9 Gamut procedure sambil menekan pada
titik gamut dan tuning adalah sebagai berikut:
a. Menutup mata
b. Membuka mata
c. Menggerakkan mata dengan keras ke kanan bawah
d. Menggerakkan mata dengan keras ke kanan bawah
e. Memutar bola mata searah jarum jam
f. Memutar bola mata berlawanan arah jarum jam
g. Bergumam dengan berirama selama 2 detik
h. Menghitung dari 1 sampai 5
i. Bergumam dan bersenandung lagi selama 2 detik
6. The Tapping Again
langkah terakhir adalah mengulang lagi the tapping dan diakhiri dengan tarik
nafas panjang, hembuskan dan ucapkan rasa syukur (sesuai agama masing-
masing).
8. Hasil :
Pasien memiliki perasaan lega dengan beban yang dirasakan selama ini, missal
kecemasan, rasa takut, stress, kecewa, nyeri
9. Hal-hal yang perlu diperhatikan :
Pastikan lingkungan nyaman dan tenang

Indikasi terapi keluarga : Terapi Keterampilan sosial dilakukan pada klien dan keluarga klien
dengan penderita penyakit s fobia, gangguan fisik dan seksual, stress dan kecemasan, trauma,
alergi, sakit kepala, migrain, kecanduan, kepercayaan diri, dan insomnia.

Kontraindikasi terapi keluarga : Tidak ada kontraindikasi

Persiapan terapi keluarga :

Prosedur terapi keluarga :

 1. Pra interaksi 

 Persiapan perawat

a. Lakukan pengkajian data : baca catatan keperawatan dan medis

b. Rumuskan diagnosa terkait

c. Buat rencana tindakan

d. Cuci tangan dan siapkan alat

 Persiapan pasien

a. Pastikan identitas pasien

b. Kaji kondisi pasien

c. Jaga privacy pasien

d. Tempatkan di posisi nyaman

2. Orientasi

a. Berikan salam, perkenalan nama

b. Menanyakan nama panggilan kesukaan klien

c. Jelaskan prosedur, tujuam dan lamanya tindakan

d. Melakukan validasi (kognitif, afektif, psikomotor)

e. Kontrak waktu, tempat, dan kesediaan klien menerima tindakan

3.Kerja

a. Mengumpulkan setiap anggota

b. Memulai tindakan dengan cara baik untuk menciptakan rasa percaya dan nyaman

c. Mempertahankan kontak mata selama tindakan

d. Terapi dilakukan selama 15 menit

 e. Mengajukan pertanyaan kepada klien ataupun anggota keluarga klien yang bertujuan
untuk menggali informasi lebih dalam masalah klien

f. Memahami komunikasi nonverbal dari klien dan anggota keluarga klien

g. Menyesuaikan dan menyederhanakan pesan dengan kemampuan lawan bicara

h. Menanggapi konflik, menghindari konflik dan memberikan respon dengan jujur

i. Mendiskusikan jalan keluar konflik dengan klien dan anggota keluarga klien dengan
terapi komunikasi yang efektif

4. Terminasi

fase ini merupakan fase terakhir, pada fase ini perawat melakukan pengevaluasian terhadap
terapi yang telah diberikan apakah berhasil atau tidak dengan cara penilaian secara subyektif
dan obyektif . Selain itu pada fase ini ada RTL (Rencana tindak lanjut) dan penyampaian
kontrak selanjutnya.

5.Evaluasi terapi keluarga :

1. Keadaan fisik

2. Sikap/psikologis

3. Pengetahuan atau kelakuan belajar

4. Perilaku kesehatan

5. Evaluasi Subjektif: Tanyakan bagaimana perasaan klien dan setiap angggota keluarga
setelah kita memberikan terapi komunikasi efektif.

6. Evaluasi Objektif: Evaluasi dan minta klien juga setiap anggota keluarga untuk
mempraktekkan dan mencontohkan Keterampilan sosial; bermain peran yang dapat
dilakukan untuk menyeleaikan masalah.

E. CRITICAL APPRAISAL
1. Penulis Artikel Arefeh Erfan
 Ahmad Ali Noorbala

Abolfazl

Peyman Adibi

2. Judul Artikel The Effectiveness of Emotional Schema Therapy on

Psychological Symtomps of Patients with Irritable
Bowel Syndrome

3. Nama Jurnal , Edisi dan Tahun International : Journal of Education & Psychological
Researches, 2018

4. Tujuan Penelitian Tujuan penelitian ini untuk menyelidiki efektivitas

terapi skema emosional pada pengurangan gejala
psikologis pasien dengan irritable bowel syndrome
(IBS).

5. Metode Penelitian Penelitian ini diimplementasikan dalam kerangka

desain eksperimen subjek tunggal yang menggunakan
rencana multiple-baselines stepwise. Lima pasien
dengan IBS dipilih sebagai sampling kenyamanan
atas dasar keinginan partisipasi individu untuk
penelitian kemudian menerima terapi skema
emosional (EST). Alat penelitian termasuk skala
ROMA III, wawancara semi-terstruktur untuk
membuat wawancara DSM-IV, dan kuesioner depresi,
kecemasan, dan skala stres (DASS-21). Analisis data
dilakukan menggunakan grafik analisis visual,
persentase pemulihan, dan indeks perubahan yang
dapat diandalkan.

6. Analisis Hasil Hasil penelitian menunjukkan bahwa pasien

pertama, kedua, dan keempat mengalami perubahan
 atau penurunan bermakna dalam gejala depresi dari
intervensi follow-up 3 bulan yang disebabkan oleh
EST. Karena skor depresi pasien ketiga juga menurun,
dapat dikatakan EST mempengaruhi pengurangan
gejala depresi pasien ketiga. Persentase pemulihan
total dari variabel depresi adalah −24,34 dalam
posttest, dan jumlah RCI berarti dalam posttest dan
follow up pasien pertama dan keempat (P ≤ 0,05).
Namun, itu tidak bermakna pada pasien kedua dan
ketiga (P> 0,05).

7. Kesimpulan Dalam penelitian ini secara singkatnya, hasil

menunjukkan EST menurunkan gejala psikologis
pasien dengan IBS. Ini dapat digunakan sebagai
pendekatan terapeutik independen atau dengan terapi
lain yang tersedia untuk mengurangi gejala psikologis
pasien dengan IBS.
[Downloaded free from http://www.ijeprjournal.org on Saturday, October 27, 2018, IP: 114.125.126.0]

Original Article

Access this article online

Quick Response Code:
Website:
www.ijeprjournal.org
DOI:
10.4103/jepr.jepr_46_16
The effectiveness of emotional
schema therapy on psychological
symptoms of patients with irritable
Bowel syndrome
Arefeh Erfan, Ahmad Ali Noorbala1, Abolfazl Mohammadi, Peyman Adibi2
Abstract:
AIM: positive and negative emotional states are the most important factors in the process of treatment
and prevention of psychosomatic diseases. This research aimed to investigate the effectiveness
of emotional schemas therapy on the reduction of psychological symptoms of patients with irritable
bowel syndrome (IBS).
METHODS: This research was implemented in the framework of single‑ subject experimental design
using of stepwise multiple‑baselines plan. Five patients with IBS were selected as convenience
sampling on the base of the participation willingness of individuals to the research then received
emotional schema therapy (EST). Research tools included ROME III scale, semi‑structured interview
for making DSM‑IV interview, and depression, anxiety, and stress scale (DASS‑21) questionnaire.
The analysis of data was done using visual analysis charts, recovery percentage, and reliable
change index.
RESULTS: The results showed patients that received EST detected decrease of the scores in
DASS‑ 21 rate than baseline (P ≤ 0.05).
CONCLUSIONS: EST decreases psychological symptoms of patients with IBS. Therefore, it can be
proposed as an alternative therapy or together with other therapies for these patients.
Keywords:
Emotional schemas therapy, irritable bowel syndrome, psychological symptoms

Introduction such as intestinal permeability, visceral

hypersensitivity, food intolerance, brain‑gut
rritable bowel syndrome (IBS) is axis dysregulation, and psychological
Department of Psychiatry,
I one of the most common functional
gastrointestinal disorders throughout the
stress help pathogenesis of IBS.[1] Chronic
symptoms of IBS have a negative impact on
Tehran University
of Medical Science, world. The prevalence of the disease in patients’ activity level and cause increase
1
Psychosomatic Medicine the general population has been reported of cost of patient, family, and health‑care
Research Center, between 1.1% and 29.2%.[1] Rate infection system. [5] IBS is a large challenge for
Imam Khomeini Hospital,
Tehran University of of women to IBS is more than men. [2] general hygiene. [6] IBS is heterogeneous
Medical Sciences, Tehran, Abdominal pain, bloat, and some of bowel disorder due to numerous genetic,
2
Integrative Functional dysfunction are symptoms of IBS. Patients hormone, infectious, immunological, and
Gastroenterology with IBS often complain of nonbowel psychological factors.[7] Many studies have
Research Center, Isfahan
University of Medical symptoms such as constant lethargy, low investigated psychological symptoms of
Sciences, Isfahan, Iran backache, nausea, irritable bladder, and the disease. The results of studies indicate
chest pain.[3] The threshold of pain is low that IBS accompany by psychological
Address for in patients with IBS. [4] Several factors symptoms of depression,[2,8‑10] anxiety,[2,7‑11]
correspondence:
Arefeh Erfan, This is an open access article distributed under the terms of the
Department of Psychiatry, Creative Commons Attribution-NonCommercial-ShareAlike 3.0 How to cite this article: Erfan A, Noorbala AA,
Tehran University of License, which allows others to remix, tweak, and build upon Mohammadi A, Adibi P. The effectiveness of emotional
Medical Science, the work non-commercially, as long as the author is credited schema therapy on psychological symptoms of
Tehran, Iran. and the new creations are licensed under the identical terms. patients with irritable Bowel syndrome. Int J Educ
E-mail: aerfan3024@ Psychol Res 2018;4:26-32.
yahoo.com For reprints contact: reprints@medknow.com

26 © 2018 International Journal of Educational and Psychological Researches | Published by Wolters Kluwer - Medknow
[Downloaded free from http://www.ijeprjournal.org on Saturday, October 27, 2018, IP: 114.125.126.0]
Erfan, et al.: The effectiveness of emotional schema therapy on the psychological symptoms
and stress.[10,12] The research show stress exacerbates
symptoms of patients with IBS and influences bowel
movements and visceral hypersensitivity. Visceral
hypersensitivity is strong predictive of severity of
gastrointestinal‑specific anxiety. [13] Patients with IBS
have negative schemas about self and others. Schemas
generate a systematic error in thought that plays an
important role in the development and systematic
error of stress and depression. Irrational beliefs are
a prevalent vulnerability factor for the generation of
IBS. Patients with IBS distort the sense of daily events
and negatively interpret themselves experiences due
to irrational beliefs.[14] Research shows that negative
beliefs and catastrophizing about abdominal pain are
intermediate of the relationship between severity of
abdominal pain and depression of patients with IBS.[15]
Recommended therapies for IBS are dietary,
pharmacological, and psychological interventions.
Some patients with low symptoms respond to
instruction, dietary, and change of lifestyle while
patients with moderate or severe symptoms are treated
by pharmacological and psychological interventions. [16]
Findings of a meta‑analysis (41 trials) for evaluation
of immediate, short‑term, and long‑term effectiveness
of psychological treatment on decrease of severity
of gastrointestinal symptoms of patients with IBS
suggested that their immediate effect after treatment
is moderate and remains moderate during short‑term
follow‑up periods (1–6 months after treatment) and
long‑term follow‑up periods (6–12 months after
treatment).[17] For patients with IBS, it is recommended
psychological therapies such as cognitive behavioral
therapy (CBT) or hypnotherapy that symptoms
are resistant to treatment. [16] Among psychological
therapies, CBT is one of the scant valid therapies for
IBS.[18] However, studies show the effectiveness of CBT
on IBS decrease when depression and anxiety level are
higher than baseline.[16] Therefore, it is required new
therapies for decrease of psychological symptoms of
patients with IBS.
Emotional schema therapy (EST) is a form of CBT
treatment [19] that Leahy codifies it derived from
some aspects of traditional cognitive therapy and
metacognitive and acceptance‑based models. The
treatment is focused on the content of thoughts
about emotions and resulted inefficient oppositional
approaches. [20] EST helps patient identify troubling
beliefs and strategies that are used for interpretation,
judgement, control, and action for emotion.[19] It seems
that EST is an appropriate therapeutic option to decrease
psychological symptoms of patients with IBS. Because
research indicates that beginning of IBS symptoms
and its accompanying emotional disorders are due to
inappropriate cognitive interpretations.[21]
International Journal of Educational and Psychological Researches - Volume 4, Issue 1, January-March 2018
According to the conducted studies by researchers, it
was not observed any research about the effectiveness of
EST on decrease of psychological symptoms of patients
with IBS. However, the findings support the effectiveness
of some EST techniques including mindfulness on the
improvement of psychological symptoms of patients
with IBS. One of the major results of mindfulness
exercise is reduction of depression, anxiety, and stress
scale (DASS‑21) and ability of regulation of negative
emotions.[22] Results of conducted research on women
with IBS showed that there is meaningful reduction in
scores average of psychological symptoms of patients
after implementation of mindfulness technique. [23,24]
On the base of mentioned contents, in this research,
the effectiveness of EST on decrease of psychological
symptoms of patients with IBS was considered to
generate research knowledge through it.
Methods
The method of research is of single‑subject design type.
It was used A‑B schema with stepwise method. In
general, the first position (a) is the basic line, in second
position (b) it is performed a therapeutic intervention,
and then, dependent variable is evaluated. In the study,
independent variable is EST, and dependent variables
are therapeutic variations due use of the treatment
method on the reduction of DASS‑21. Statistical people
included all women with IBS that came to the office
of a specialist in Isfahan in summer of 2016. Five
people were selected as convenience sampling based
on the participation willingness of individuals to the
research and taking criteria for inclusion of study
(having ROME III diagnostic criteria confirmed by
digestion specialist for differentiation IBS from other
functional gastrointestinal disorders, no consumption of
psychiatry drugs during 3 months ago, no participation
in psychology interventions session during 6 months
ago, having at least high school education, dominance on
Persian language, having satisfaction for participation,
and lack of sever psychiatry diseases) and exclusion from
study (no participation in three consecutive session of
psychotherapy sessions). After the statement of consent
and endorsement of written testimonial, treatment was
begun. To control the demographic effects, subjects were
matched on the base of age, education, disease history,
lack of other physical diseases, and lack of mental
disorders through semi‑structured interview for making
DSM‑IV (SCID) screening tools. Treatment was started
with stepwise method with 1‑week interval, so that first
patient initially enters to the therapy schema. In second
treatment session of the first patient, second patient
enters to the treatment schema and in third therapy
session of first patient and sec session of second patient,
third patient and as the same way to fifth patient enter
to treatment schema. EST was implemented according
27
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Erfan, et al.: The effectiveness of emotional schema therapy on the psychological symptoms

to the Leahy therapeutic protocol through 12 sessions.
Patients performed baseline stage tests in baseline as well
as third, sixth, ninth, and twelfth sessions. In addition,
at last session, each patient was asked to refer once a
month for 3 months. In addition, to follow‑up patients’
problems, 1 month, 2 months, and 3 months follow‑up
test were done. After completion of questionnaires,
researcher investigated them whether all questions
were answered. If a questionnaire was incomplete, with
the presentation of more explanation, participations
were asked to answer reminder questions. It has been
presented a summary of the content of sessions of EST
in Table 1.
Data were collected by researchers using ROME III and
SCID diagnostic interviews and DASS‑21 questionnaire.
ROME III is about functional gastrointestinal disorders
that have been normalized by Safaee et al. (2013) in
Iran. Reliability of questionnaire by Cronbach’s alpha
was >0.7 in all principal symptoms.[25] In the research,
this tool was performed by gastrointestinal specialist to
differentiate between IBS and functional gastrointestinal
disorders. SCID interview is a semi‑structured interview
that provides diagnostics based on the DSM‑IV. The tool
has been devised by Spitzer et al. (1992) In addition, it
has been normalized by Sharifi et al. in Iran.[26] In the
current study, the interview was used for investigation
of lack of sever psychiatry diseases (inclusion criteria)
such as psychosis and chronic bipolar, etc., DASS‑21
scale is a self‑report scale that evaluates each symptoms
of DASS‑21. Subjects should reply to multiple choice
terms (never to very much) with scoring zero for never
and three for very much choice. Asgharimoghadam
et al. (2008) reported the internal consistency coefficients
of 0.93, 0.90, and 0.93 and retest coefficients of 084, 0.89,
and 0.90 for DASS‑21, respectively. In addition, retest
reliability has been reported 0.78, 0.87, and 0.80 for
DASS‑21, respectively.[27] In this research, the test was
used to investigate psychological components.
Like more single‑subject schemas, the first strategy of
obtained results analysis was visual method. In addition
to visual and chart analysis, recovery percent[28] as well
as reliable change index (RCI) that have initially been
presented by Jacobson and Truax to analyze resultant
data of single‑subject experimental schemas, were
used.[29] In the RCI formula, if variations rate or difference
between before and after treatment is >1.96, by regarding
0.5 error probability, it can be resulted that obtained
change and improvement are due to therapy intervention
and resultant change is not accident.
Results
Of five participant patients, an individual ended
treatment from third session because of his parent death.
Of four patients, three were undergraduate, and one
of them was graduate. An individual was single, and
three of them were married. Mean age of patients was
34. For investigation of research questions, results of

Table 1: A summary of content of sessions of emotional schema therapy

Sessions Content of sessions
First session Formation of therapeutic relation, planning of case formulation, presentation of treatment logic and treatment aims,
presentation of etiologic model, and treatment from EST approach
Second session Normal and problematic emotions, consideration of painful emotions of patients and normalization of them, emotion
self‑awareness, instruction and introduction of emotion, identification and labeling of emotion, differentiation between
different emotions, identification of emotion in physical and psychological state
Third session Self‑evaluation with the aim to recognize own emotion experiences, self‑evaluation with the aim to identification of the
amount of individuals emotion vulnerability, self‑evaluation with the aim to identification of the strategies for emotion
regulation, cognitive issues of emotion responses, physiologic issues of emotion responses, behavior outcomes of
emotion responses and relation among them, introduction of rage emotion, and the ways for dominance on rage
Fourth session Proceeding identified emotional schemas in patient, verbal challenges, and Socratic dialog
Fifth session Proceeding other identified emotional schemas in patient and verbal challenges and Socratic dialog, instruction of the
technique of writing of negative memorabilia with the aim to facility of emotion processing
Sixth session Prevention of social seclusion and avoidance, instruction of strategy of problem‑ solving, training of interpersonal
skills (talking, self‑expression and conflict resolution), preliminary introduction of the conception of acceptance, and
emotion validation
Seventh session Helping people for acceptance of own emotion, proceeding intervening emotional schemas in acceptance and
experience of painful emotion, presentation of detached mindfulness technique
Eighth session Introduction of kinds of negative beliefs about emotions and challenge to them, identification of false evaluation and
their effects on the emotion states
Ninth session Identification of the amount and the way of using of inhibition strategy and investigation of its emotion outcomes,
instruction of emotion expression, encounter, training of abreaction, and relaxation
Tenth session Discussion about severity of schemas before and after of confrontation, proceeding reminder avoidance of patient
Eleventh session Review of sessions and practice of learned skills
Twelfth session Work on therapy program (prevention of recurrence), schematization for support sessions, homework, commitment to
continuous usage of treatment practices
According to the observed therapeutic sessions’ content, therapist used a skill for patients and clarified it with examples of themselves. EST: Emotional schema therapy

28 International Journal of Educational and Psychological Researches - Volume 4, Issue 1, January-March 2018
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Erfan, et al.: The effectiveness of emotional schema therapy on the psychological symptoms

psychological symptoms test (depression, anxiety, and The results indicate that first, second, and fourth patient
stress) of patients during pretest, posttest, and 3 months have had meaningful change or decrease in depression
follow‑up, recovery percent, and RCI were reported symptoms of 3‑month follow‑up due EST intervention.
in [Table 2 and Figures 1‑3]. Because depression score of third patient has also
decreased, it can be said EST influences reduction of
According to the Table 2, total recovery percent of depression symptoms of third patient. All patients
depression variable is −34.33 in posttest. The amount of
RCI of the depression score is meaningful just for first
patients. However, decrease of scores of other patients is Depression
Depression
observed in Figure 1. In follow‑up test, recovery percent 35
Baseli Intervention
nterventio Follow
30
is −41.80 and RCI of first, second, and fourth patient is 25
higher than 1.96 and statistically meaningful (P ≤ 0.05). 20

It is concluded with 95% confidence that obtained change 15

10
or recovery is due to intervention effect (P ≤ 0.05). 5
0
Baselin
aselin Third
Thir Sixth
Sixt Ninth
int Twelfth
Twelft follow One follow tow followthree
Total recovery percent of depression variable is −27.65 in session
ession session
session session
session session
ession Month Month Month

posttest, and the amount of RCI of depression variable is Patient 1 Patient 2 Patient 3 Patient 4

meaningful only in first and second patient in posttest.

Figure 1: Changes in patients’ scores in depression
However, decrease of score of anxiety is observed in two
other patients, too. In follow‑up test, recovery percent
is −27.65 and RCI of all patients is >1.96 and statistically Anexity

meaningful (P ≤ 0.05). Then, with 95% confidence, it is 30

Baselin
aselin ntervention
Intervention Follow
concluded that obtained change or recovery is due to 25
20
intervention effect (P ≤ 0.05).
15
10
Total recovery percentage of depression variable 5
is −24.34 in posttest, and the amount of RCI is 0
meaningful in posttest and follow‑up of the first and ase i
Baselin Thir
Third
essio
session
Sixt
Sixth
session
session
int
Ninth
ess on
session
Twelft
Twelfthfollow One follow tow followthree
ession
session Month Month Month
fourth patient (P ≤ 0.05). However, it is not meaningful Patient 1 Patient 2 Patient 3 Patient 4
in second and third patient (P > 0.05). However, there
is decrease of score compared to baseline. Then, with Figure 2: Changes in patients’ scores in anxiety
95% confidence, it is concluded that obtained change or
recovery is due to intervention effect (P ≤ 0.05).
Stress

Discussion 40 Baselin
selin Intervention
nterventio Follow
30
20
The results of current study show high level of score of
10
psychological symptoms (DASS‑21)) of patients with 0
IBS in baseline. These results are in agreement with Baselin
seli Thir
Third Sixth sessio int
session Ninth Twelfth follow One follow tow followthree
ession
session session
ession session
ess o Month Month Month
findings of the past investigations mention that DASS‑21
atient 1
Patient atient 2
Patient atie t 3
Patien Patient 4
accompany by IBS.[6]
Figure 3: Changes in patients’ scores in stress

Table 2: Subjects’ depression, anxiety, and stress

Depression Anxiety Stress
First Second Third Fourth First Second Third Fourth First Second Third Fourth
patient patient patient patient patient patient patient patient patient patient patient patient
Before intervention 30 28 16 32 24 18 22 18 36 16 22 36
After intervention 18 20 10 22 16 14 16 13 22 14 18 26
Recovery (%) −40 −29 −38 −31 −33 −22 −27 −28 −39 −13 −18 −28
Total recovery (%) −34 −28 −24
RCI −2.24 −1.49 −1.12 −31 −2.66 −1.33 −2 −1.66 −3.56 −0.51 −1.02 −2.54
3 months follow‑ up 16 17 9 20 15 12 14 12 19 15 20 27
Recovery (%) −47 −39 −44 −38 −38 −33 −36 −33 −47 −6 −9 −25
Total recovery (%) −38 −35 −22
RCI −2.61 −2.05 −1.31 −2.24 −3 −2 −2.66 −2 −4.33 −0.25 −0.51 −2.29
−: Reduction of scores. RCI: Reliable change index

International Journal of Educational and Psychological Researches - Volume 4, Issue 1, January-March 2018 29
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Erfan, et al.: The effectiveness of emotional schema therapy on the psychological symptoms
with IBS have also had meaningful change or decrease
in anxiety symptoms of 3‑month follow‑up because of
EST intervention. In this research, the process of change
of stress symptoms in posttest and 3‑month follow‑up
is statistically meaningful for first and fourth patient.
However, it is not for second and third patient. Because
decrease of score of this component is observed than
baseline, it can be said that EST successes for reduction
of stress symptoms of patients with IBS.
In explanation of effectiveness of EST on reduction of
psychological symptoms of patients with IBS, it can be
hinted about the presence of some techniques and skills
in EST therapy protocol. The therapy helps patients in
processing of emotions through mindfulness, cognitive
reconstruction, and decrease of stress.[30] The results
of studies suggest the effectiveness of mindfulness on
reduction of psychological symptoms of DASS‑21 of
patients with IBS.[16,23,24,31,32] The results of the current
study are agreement with these findings and support
them. Catastrophizing (exaggeration in expression of
own problem) is one of thought styles of patients with
IBS, and its outcome is the experience of DASS‑21.
Mindfulness training targets infrastructure mechanisms
of IBS that is catastrophic evaluation of sensation and
emotion processing of pain by increasing of individual
nonreactive awareness about experience of emotion
and sensation[33] and it appears that it can be reduced
psychological symptoms of patients with IBS using this
method. When patient with IBS feels turmoil, it is possible
to pass a difficult time to know his emotion. At first, it is
likely to have only physical sensations such as abdominal
pain, diarrhea, irregularity, bloat, and inflation while he
reacts to sensations and what has occurred, knows that
he is experiencing sadness. The sadness amazes patient
with IBS. He does not recognize what has depressed
him. He entangles in negative evaluations of his sadness.
Then, he feels inability about sadness because he does
not find any reason for it. He is despaired and disturbed
about his sadness. It seems mindfulness training destroys
the erroneous cycle. Mindfulness training can improve
the performance of emotion processing by intensifying
direct translation of physical sense to different emotions
and without inordinate relating of these emotions with
narrative memories.[19] In addition to main feature of
mindfulness that is emotion awareness, other its features
including observation and internal attention, expression
and labeling of experience, ability to implementation
of activities with conversance and without distraction
and no reaction to internal experiences are important.[34]
Cognitive reconstruction is the other EST technique that
such as mindfulness technique decreases psychological
symptoms of patients with IBS by targeting IBS
infrastructure mechanism, that is, catastrophizing about
abdominal pain. The results of current research support the
30 International Journal of Educational and Psychological Researches - Volume 4, Issue 1, January-March 2018
researchers’ opinion that believes cognitive reconstruction
is of essential components for behavior change.
It appears that patients with IBS are not aware of their
body tension when they experience symptoms. EST
can help the patient with IBS decrease his stress using
of muscle progressive relaxation technique when
experience symptoms by generating kind of awareness
about this tension and then learning of relaxation of body
muscles approach.
In sum, the results of study indicate that it can be used
EST as independent therapeutic approach or with other
available therapies to decrease psychological symptoms
of patients with IBS. EST does not focus on the beginning
of IBS symptoms but more on wrong beliefs and schemas
that patient has for interpretation, judgement, and
control of related emotions to IBS. Patients with IBS
and even some physicians are not aware that intruder
factors such as wrong beliefs about disease can divert a
process of an integrated therapy. Therefore, the emphasis
on individual medical and the most important involved
variables of it including evaluations of sick about
disease is now one of the most important domains that
it is necessary to proceed it in sciences such as health
psychology, clinical psychology, and medic.
Regarding some limitations of case studies including
small sample and being single‑sex limit generalizability
of findings. Thus, to remove the limitations and to
confirm efficiency and capability of EST intervention for
decrease of psychological symptoms of patients with IBS,
more studies with larger sample are necessary.
The results of research show the effectiveness of
mindfulness on reduction of psychological symptoms of
depression,[23‑24] anxiety,[16,23,24,31] and stress[32] of patients
with IBS. The results of present study are agreement with
the findings. Mindfulness training targets infrastructure
mechanisms of IBS, that is, catastrophic evaluation of
sensation and emotion processing of pain by increasing
of individual nonreactive awareness about experience
of emotion and sensation. [33] Mindfulness training
can improve the performance of emotion processing
by intensifying direct translation of physical sense to
different emotions and without inordinate relating
of these emotions with narrative memories. [19] In
addition to evaluation of main feature of mindfulness
that is emotion awareness, other its features including
observation and internal attention, expression, and
labeling of experience, ability to the implementation of
activities with conversance and without distraction and
no reaction to internal experiences are important, too.[34]
Cognitive reconstruction is the other EST technique
that targets IBS infrastructure mechanism, that is,
[Downloaded free from http://www.ijeprjournal.org on Saturday, October 27, 2018, IP: 114.125.126.0]
Erfan, et al.: The effectiveness of emotional schema therapy on the psychological symptoms
catastrophizing about abdominal pain. Cognitive
reconstruction is of essential components of behavior
change. Of course, regarding some limitations of case
studies including small sample and being single‑sex
limit generalizability of findings. Thus, to remove the
limitations and to confirm efficiency and capability of
EST intervention for decrease of psychological symptoms
of patients with IBS, more studies with larger sample
are necessary.
Conclusions
In sum, the results suggest EST decreases psychological
symptoms of patients with IBS. It can be used as an
independent therapeutic approach or with other
available therapies to decrease psychological symptoms
of patients with IBS.
Acknowledgment
This article is a part of Master’s thesis approved at
Tehran University of Medical Sciences. From support
of Research Assistant of Tehran University of Medical
Sciences as well as helpful cooperation of patients and
other experts are acknowledged.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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32 International Journal of Educational and Psychological Researches - Volume 4, Issue 1, January-March 2018