A Comparison of the Effectiveness of Emotion-Focused Therapy and Metacognitive Therapy on Cognitive-Emotional Constructs (Thought-Action Fusion and Intolerance of Uncertainty) in Female Students with Obsessive–Compulsive Disorder

Authors
hava Mahmoudzadeh Kenari
afsaneh Khajevand Khoshli
javanshir asadi
Abstract
Obsessive–compulsive disorder (OCD) in adolescents is associated with maladaptive cognitive–emotional patterns, including thought–action fusion and intolerance of uncertainty, which can impair academic performance and interpersonal relationships. This study aimed to compare the effectiveness of emotion-focused therapy and metacognitive therapy on these constructs in adolescent girls with OCD. The quasi-experimental study employed a pretest–posttest design with a control group and included 45 high school girls in Babolsar, selected through purposive sampling and randomly assigned to three groups of 15 participants each. Interventions consisted of eight weekly 90-minute group sessions. Data were collected using the Thought–Action Fusion Scale and the Intolerance of Uncertainty Questionnaire and analyzed using multivariate analysis of covariance (MANCOVA). Results indicated that both interventions significantly reduced thought–action fusion and intolerance of uncertainty compared to the control group, and pairwise comparisons showed that metacognitive therapy was more effective in reducing thought–action fusion, whereas emotion-focused therapy was relatively more effective in reducing outcomes related to intolerance of uncertainty. These findings suggest that targeted psychotherapeutic interventions can improve maladaptive cognitive–emotional patterns associated with OCD in adolescents and reduce anxiety and compulsive behaviors. The results provide guidance for selecting tailored treatments based on individual clinical needs and for designing school- and clinic-based intervention programs.
Keywords
Emotion-focused therapy
Metacognitive therapy
Thought–Action Fusion
intolerance of uncertainty
Obsessive–Compulsive Disorder
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