The Effectiveness of Compassion-Based Therapy and Emotion-Focused Therapy on Self-Control and Distress Tolerance in Women with Substance Use Disorder

Background: Substance use disorder (SUD), particularly opioid dependence, poses significant challenges for women and is frequently associated with impaired self-control and reduced distress tolerance—two key factors strongly linked to relapse risk. The present study aimed to investigate the effectiveness of compassion-based therapy (CBT) and emotion-focused therapy (EFT) in improving self-control and distress tolerance among women with SUD.Methods: This quasi-experimental study employed a pre-test, post-test, and three-month follow-up design with a waitlist control group. The study participants were women receiving treatment for SUD in Ahvaz, Iran, in 2023. Forty-five eligible women were recruited through convenience sampling technique and randomly assigned to three equal groups of compassion-based therapy, emotion-focused therapy, and waitlist control group (n=15 each). The intervention groups received eight weekly 90-minute sessions, while the control group continued with routine care only. Outcomes were assessed using the Brief Self-Control Scale (BSCS) and the Distress Tolerance Scale (DTS). Data were analyzed using repeated-measures analysis of variance (ANOVA) in SPSS version 27.Results: Both intervention groups showed statistically significant improvements in self-control and distress tolerance compared with the control group (P<0.001). In the compassion-based therapy group, self-control scores increased from a pre-test mean value of 32.13±4.27 to 39.26±5.22 at post-test (P<0.001). In the EFT group, scores increased from 33.13±3.58 to 42.13±4.24 (P<0.001). The control group showed only a negligible change (33.13±4.30 to 33.73±3.56; P=0.593). Similarly, distress tolerance scores improved significantly in the compassion-based therapy group (from 34.06±4.71 to 41.38±4.40; P<0.001) and the EFT group (from 33.60±4.68 to 41.26±4.77; P<0.001), while remaining essentially were unchanged in the control group (33.00±4.17 to 33.26±4.36; P=0.799).Conclusions: Our findings indicated that both compassion-based therapy and emotion-focused therapy are effective interventions for enhancing self-control and distress tolerance in women with substance use disorder. These approaches offer promising options for improving recovery outcomes and reducing relapse risk in this vulnerable population.