The Effectiveness of Cognitive-Behavioral Group Therapy and Existential Group Therapy on Anxiety in ‎Addicted Patients Undergoing Methadone Maintenance Treatment


  • Saeid Alami Department of Health Psychology, Khorramshahr Persian Golf International Branch, Islamic Azad University, Khorramshahr, Iran
  • Saeid Bakhtiarpour Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
  • Parviz Asgari Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
  • Naser Seraj-Khorrami Department of Psychology, Dezful Branch, Islamic Azad University, Dezful, Iran


Background: The aim of this study was to compare the effects of cognitive-behavioral group therapy (CBGT) and existential group therapy on anxiety in addicts undergoing methadone maintenance treatment (MMT).

Methods: The present semi-experimental research was conducted with a pretest-posttest design, follow-up, and a control group. The statistical population of the study consisted of all addicted men undergoing MMT and referring to addiction treatment and harm reduction clinics in Qazvin, Iran, in 2019 (n = 1139). A total of 36 addicted patients referring to addiction treatment and harm reduction clinics were randomly assigned to 2 experimental groups (12 in each group) and 1 control group (n = 12). After random assignment, 1 experimental group participated in 10 sessions (120 minutes for each session) of existential therapy and the other experimental group participated in 10 sessions (120 minutes for each session) of CBGT. The Beck Anxiety Inventory (BAI‎) was used to collect the data. Data were analyzed using mixed analysis of variance (ANOVA).

Results: The results showed that CBT (F = 16.84, P = 0.0001) and existential group therapy (F = 4.81, P = 0.0001) decreased anxiety levels at the level of 99% confidence interval (CI). This effect remained stable until the follow-up stage. In addition, among the two methods, CBGT was more effective on anxiety than existential group therapy (P = 0.017).

Conclusion: Therapists should prioritize CBGT over other treatment modalities to reduce psychological problems such as anxiety in addicts.


Ahmadvand, A., Saie, R., Sepehrmanesh, Z., & Ghanbari, A. R. (2011). Effect of cognitive-behavioral group therapy on anxiety and depression hemodialysis patients in Kashan, Iran. Qom Univ Med Sci J, 5(1), 35-39.

Bador, K., & Kerekes, N. (2020). Evaluation of an integrated intensive cognitive behavioral therapy treatment within addiction care. J Behav Health Serv Re, 47(1), 102-112.

Bahadorzade, M., Jajarmi, M., Jalalabadi, M., & Eydi-Baygi, M. (2015). Effectiveness of cognitive-behavioral group therapy on anxiety in addicts with successful cut off. Urmia Med J, 25(11), 961-967.

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. J Consult.Clin Psychol, 56(6), 893-897. doi:10.1037//0022-006x.56.6.893 [doi]. Retrieved from PM:3204199

Breitbart, W., Rosenfeld, B., Pessin, H., Applebaum, A., Kulikowski, J., & Lichtenthal, W. G. (2015). Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. J Clin Oncol., 33(7), 749-754. doi:JCO.2014.57.2198 [pii];10.1200/JCO.2014.57.2198 [doi]. Retrieved from PM:25646186

Can, G. G., & Okanli, A. (2019). The Effects of Cognitive-Behavioral Model-Based Intervention on Depression, Anxiety, and Self-Efficacy in Alcohol Use Disorder. Clin Nurs Res, 28(1), 52-78. doi:10.1177/1054773817722688 [doi]. Retrieved from PM:28778134

Clemens Farkas, & Elisabeth Andritsch. (2018). Psychoonkologie und Existenzanalyse. Existenzanalys, 35(1), 20-26.

Crapanzano, K. A., Hammarlund, R., Ahmad, B., Hunsinger, N., & Kullar, R. (2019). The association between perceived stigma and substance use disorder treatment outcomes: A review. Subst.Abuse Rehabil., 10, 1-12. doi:10.2147/SAR.S183252 [doi];sar-10-001 [pii]. Retrieved from PM:30643480

Harris, K. R., & Norton, P. J. (2019). Transdiagnostic cognitive behavioral therapy for the treatment of emotional disorders: A preliminary open trial. J Behav Ther Exp.Psychiatry, 65, 101487. doi:S0005-7916(18)30336-7 [pii];10.1016/j.jbtep.2019.101487 [doi]. Retrieved from PM:31132511

Hemati, G., Khorasani, S., Najafi, M., Jabbari, F., & Shojaee, S. (2019). The effect of cognitive-behavioral therapy on depression, anxiety, and stress levels in iranian males with addiction. SAGE Open, 9(1), 215824401882446.

Hopkinson, M. D., Reavell, J., Lane, D. A., & Mallikarjun, P. (2019). Cognitive behavioral therapy for depression, anxiety, and stress in caregivers of dementia patients: A systematic review and meta-analysis. Gerontologist., 59(4), e343-e362. doi:4908661 [pii];10.1093/geront/gnx217 [doi]. Retrieved from PM:29529290

Kamarzarin, H., Zaree, H., & Brouki, M. (2012). The Effectiveness of cognitive behavioral therapy on increasing of self-efficacy and improving of addiction symptoms among drug dependency patients. Research on Addiction, 6(22), 75-85.

Kang, K. A., Kim, S. J., Song, M. K., & Kim, M. J. (2013). Effects of logotherapy on life respect, meaning of life, and depression of older school-age children. J Korean Acad.Nurs, 43(1), 91-101. doi:201302091 [pii];10.4040/jkan.2013.43.1.91 [doi]. Retrieved from PM:23563072

Khaledian, M., & Mohammadifar, M. A. (2016). On the Effectiveness of Group Cognitive-Behavioral Therapy and Logotherapy in Reducing Depression and Increasing Life Expectancy in Drug Addicts. Research on Addiction, 9(36), 63-80. Retrieved from

Khesht-Masjedi, M. F., Omar, Z., & Masoleh, S. M. K. (2015). Psychometrics properties of the Persian version of Beck Anxiety Inventory in North of Iranian adolescents. International Journal of Educational and Psychological Researches, 1(2), 145.

Kiamini, M., Nikbakht, M., Amirabadi, B., Ramezani, A., & Nikyar, A. (2014). Effects of cognitive behavioral therapy on psychopathological signs and high risk behaviors in prisoners. Journal of Inflammatory Diseases, 18(2), 53-58.

Kiluk, B. D., Nich, C., Babuscio, T., & Carroll, K. M. (2010). Quality versus quantity: acquisition of coping skills following computerized cognitive-behavioral therapy for substance use disorders. Addiction, 105(12), 2120-2127. doi:10.1111/j.1360-0443.2010.03076.x [doi]. Retrieved from PM:20854334

Shamsi Meymandi, M., Zia Aldini, S. H., & Sharifi Yazdi, A. R. (2008). Opinion of high school students of Kerman towards affecting factors on narcotics tendency (2005). J Qazvin Univ Med Sci, 12(3), 80-88.

Morrison, A. S., Mateen, M. A., Brozovich, F. A., Zaki, J., Goldin, P. R., Heimberg, R. G. et al. (2019). Changes in empathy mediate the effects of cognitive-behavioral group therapy but not mindfulness-based stress reduction for social anxiety disorder. Behav Ther, 50(6), 1098-1111. doi:S0005-7894(19)30051-6 [pii];10.1016/j.beth.2019.05.005 [doi]. Retrieved from PM:31735245

Murthy, P., Mahadevan, J., & Chand, P. K. (2019). Treatment of substance use disorders with co-occurring severe mental health disorders. Curr.Opin.Psychiatry, 32(4), 293-299. doi:10.1097/YCO.0000000000000510 [doi];00001504-201907000-00007 [pii]. Retrieved from PM:31157674

Peles, E., Sason, A., Malik, E., Schreiber, S., & Adelson, M. (2016). Characteristics and outcome of methadone maintenance treatment (MMT) patients with depression. 33(S1), S311-S312.

Quinn, G., & Keough, M. (2002). Experimental Design and data analysis for biologists. Cambridge, UK: Cambridge University Press.

Reavell, J., Hopkinson, M., Clarkesmith, D., & Lane, D. A. (2018). Effectiveness of cognitive behavioral therapy for depression and anxiety in patients with cardiovascular disease: A systematic review and meta-analysis. Psychosom.Med, 80(8), 742-753. doi:10.1097/PSY.0000000000000626 [doi];00006842-201810000-00008 [pii]. Retrieved from PM:30281027

Roos, C. R., Bowen, S., & Witkiewitz, K. (2017). Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention. J Consult.Clin Psychol, 85(11), 1041-1051. doi:2017-48283-002 [pii];10.1037/ccp0000249 [doi]. Retrieved from PM:29083220

Thir, M., & Batthyany, A. (2016). The State of Empirical Research on Logotherapy and Existential Analysis. In A. Batthyany (Ed.). Logotherapy and Existential Analysis (pp. 53-74) Cham, Switzerland: Springer International Publishing.

van Emmerik-van, O. K., Vedel, E., Kramer, F. J., Blankers, M., Dekker, J. J. M., van den Brink, W. et al. (2019). Integrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: Results of a randomized clinical trial. Drug Alcohol.Depend., 197, 28-36. doi:S0376-8716(19)30038-9 [pii];10.1016/j.drugalcdep.2018.12.023 [doi]. Retrieved from PM:30769263

Williams, M. T., Domanico, J., Marques, L., Leblanc, N. J., & Turkheimer, E. (2012). Barriers to treatment among African Americans with obsessive-compulsive disorder. J Anxiety Disord., 26(4), 555-563. doi:S0887-6185(12)00032-1 [pii];10.1016/j.janxdis.2012.02.009 [doi]. Retrieved from PM:22410094




How to Cite

Alami, S., Bakhtiarpour, S. ., Asgari, P., & Seraj-Khorrami, N. (2020). The Effectiveness of Cognitive-Behavioral Group Therapy and Existential Group Therapy on Anxiety in ‎Addicted Patients Undergoing Methadone Maintenance Treatment. International Journal of Body, Mind and Culture, 7(4), 248-255. Retrieved from



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