Emotional schema therapy training for improving resilience and emotion regulation in hemodialysis patients: a quasi-experimental study

Hemodialysis patients often experience chronic stress, leading to psychological challenges such as difficulty in emotion regulation and reduced resilience. Emotional schema therapy may offer an effective strategy to address these issues. This study investigated the impact of an emotional schema therapy program on resilience and difficulties in emotion regulation in hemodialysis patients. This quasi-experimental, two-center study included 60 hemodialysis patients from two medical centers in Rafsanjan, southeastern Iran. Participants were selected via convenience sampling and then participants were sampled from two centers non-randomly assigned to intervention or control by lot. The intervention group participated in ten sessions of an emotional schema therapy program, each of which took 90 min during a total of five weeks, while the control group received routine care only. Both groups completed a demographic information questionnaire, the Connor-Davidson Resilience Scale, and the Difficulties in Emotion Regulation Scale (Gratz & Roemer) before and three months after the intervention. Data were analyzed using SPSS 22. Before the intervention, the two groups showed no significant differences in the total mean scores or subscale scores for difficulties in emotion regulation or resilience. However, following the intervention, the total score for difficulties in emotion regulation significantly decreased and the total resilience score increased in the intervention group compared with the control group ( P < 0.001). The findings suggest that the emotional schema therapy program may be effective in improving resilience and reducing difficulties in emotion regulation in hemodialysis patients. Future research should determine the long-term stability of these effects and compare emotional schema therapy with other psychological treatments. Trial registration : Trial registration Iranian Registry of Clinical Trial, IRCT20250507065634N10 registered on 16/11/2025 (prospectively registered).