The Effectiveness of Dialectical Behavior Therapy on Rumination and Cognitive Avoidance in Teachers

NCT07650617 | Completed

• 1 other identifier: I/05/117
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial evaluated the effectiveness of Dialectical Behavior Therapy (DBT) skills training in reducing rumination and cognitive avoidance among middle-school teachers in Isfahan, Iran. Teachers often experience occupational stress that may contribute to maladaptive cognitive and emotional responses. DBT is a skills-based psychological intervention that aims to improve emotional regulation, mindfulness, distress tolerance, and interpersonal effectiveness. Thirty-four eligible teachers were randomly assigned to either a DBT intervention group or a control group. Participants in the intervention group attended ten group sessions, while the control group received no intervention during the study period. Levels of rumination and cognitive avoidance were assessed at baseline, post-intervention, and two-month follow-up using standardized questionnaires. The study aimed to determine whether DBT skills training could reduce maladaptive cognitive processes and promote psychological well-being among teachers.

Conditions

Rumination; Cognitive Avoidance

Keywords

Dialectical Behavior Therapy; Teachers; Rumination; Cognitive Avoidance; Emotion Regulation; Mindfulness; Psychological Resilience; Psychoeducational Intervention; Group Skills Training; Occupational Stress; Middle-School Teachers; Randomized Controlled Trial

Outcome Measures

Primary Outcomes (2)

• Cognitive Avoidance

  Change in cognitive avoidance scores measured using the Cognitive Avoidance Questionnaire. Total scores range from 25 to 125, with higher scores indicating greater cognitive avoidance and worse outcomes.

  Baseline, post-intervention (5 weeks), and 2-month follow-up.

• Rumination

  Change in rumination scores measured using the Ruminative Response Scale. Total scores range from 22 to 88, with higher scores indicating greater rumination and worse outcomes.

  Baseline, post-intervention (5 weeks), and 2-month follow-up.

Study Arms (2)

Dialectical Behavior Therapy Skills Training

EXPERIMENTAL

Participants received ten face-to-face group sessions of Dialectical Behavior Therapy (DBT) skills training. The intervention included mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills. Assessments were conducted at baseline, post-intervention, and two-month follow-up.

Behavioral: Dialectical Behavior Therapy Skills Training

No-Intervention Control

NO INTERVENTION

Participants assigned to the control group received no intervention during the study period and completed assessments at baseline, post-intervention, and two-month follow-up.

Interventions

Dialectical Behavior Therapy Skills Training BEHAVIORAL

Participants assigned to the experimental group received a manualized Dialectical Behavior Therapy (DBT) skills training program delivered in a face-to-face group format. The intervention consisted of ten sessions conducted over a five-week period. The program was based on Linehan's DBT model and included training in mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills. Sessions involved psychoeducation, group discussion, and practical exercises designed to improve cognitive and emotional self-regulation. Participants in the control group received no intervention during the study period.

Dialectical Behavior Therapy Skills Training

Eligibility Criteria

• Age: 35 Years - 52 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Female middle-school teachers from districts 4 and 5 of Isfahan, Iran.
• Age between 35 and 52 years.
• Willingness to participate and provide written informed consent.
• Ability to attend the intervention sessions and complete study assessments.

You may not qualify if:

• Absence from more than two intervention sessions.
• Withdrawal of consent at any stage of the study.
• Failure to complete post-intervention or follow-up assessments.

Sponsors & Collaborators

• Islamic Azad University, Sanandaj: lead

Study Sites (1)

Department of Psychology, Islamic Azad University, Mobarakeh Branch

Isfahan, Isfahan, 8481914411, Iran

Location

MeSH Terms

Conditions

Rumination Syndrome; Emotional Regulation; Occupational Stress

Condition Hierarchy (Ancestors)

Gastrointestinal Diseases; Digestive System Diseases; Feeding and Eating Disorders; Mental Disorders; Self-Control; Social Behavior; Behavior; Occupational Diseases; Stress, Psychological; Behavioral Symptoms

Study Officials

• Maryam Kadkhodaee, PhD of Psychology

  Assistant Professor of Psychology, Department of Psychology, Mo. C., Islamic Azad University, Isfahan, Iran.

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Due to the nature of the behavioral intervention, neither participants nor investigators were blinded to group assignment. Outcome measures were self-administered questionnaires completed by participants.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Participants were randomly assigned in a 1:1 ratio to one of two parallel groups. The intervention group received ten sessions of group-based Dialectical Behavior Therapy (DBT) skills training, whereas the control group received no intervention during the study period. Outcomes were assessed at baseline, post-intervention, and two-month follow-up.

Study Record Dates

• First Submitted: June 9, 2026
• First Posted: June 16, 2026
• Study Start: September 15, 2024
• Primary Completion: September 15, 2024
• Study Completion: December 18, 2024
• Last Updated: June 16, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, ANALYTIC CODE
• Time Frame: De-identified individual participant data and supporting documents will be available beginning 6 months after publication and ending 5 years after publication.
• Access Criteria: Qualified researchers with a methodologically sound proposal will be able to access de-identified individual participant data, the study protocol, informed consent form, and analytic code. Requests should be directed to the corresponding author. Data access will be granted following review of the proposed use and execution of an appropriate data access agreement.

Locations

IR (1)