The Effectiveness of Schema Therapy on Rejection Sensitivity and Distress Tolerance in Older Adults

Abstract

Introduction and Aim: Older adults often experience psychological challenges associated with aging, including heightened rejection sensitivity and reduced distress tolerance, which may adversely affect their mental health and interpersonal functioning. The present study aimed to investigate the effectiveness of schema therapy on rejection sensitivity and distress tolerance among older adults.

Methodology: This study employed a quasi-experimental pretest–posttest design with a control group. The statistical population consisted of older adults residing in nursing homes in Rasht, Iran, in 2025. Thirty eligible participants were selected through purposive sampling and randomly assigned to an experimental group (n = 15) and a control group (n = 15). The experimental group received ten 90-minute sessions of schema therapy, while the control group received no psychological intervention. Data were collected using the Boyce and Parker Interpersonal Sensitivity Questionnaire and the Simons and Gaher Distress Tolerance Scale. Multivariate and univariate analyses of covariance (MANCOVA and ANCOVA) were used for data analysis.

Findings: Multivariate covariance analysis revealed a significant difference between the experimental and control groups in the combined dependent variables after controlling for pretest scores (Wilks’ Lambda = 0.293, F = 30.14, p < 0.001, η² = 0.707). Univariate ANCOVA results further indicated that schema therapy significantly reduced rejection sensitivity (F = 34.86, p < 0.001, η² = 0.573) and significantly increased distress tolerance (F = 31.15, p < 0.001, η² = 0.550) among older adults.

Conclusion: The findings suggest that schema therapy is an effective intervention for improving psychological functioning in older adults. By modifying maladaptive schemas, restructuring dysfunctional interpersonal beliefs, and strengthening adaptive emotional coping strategies, schema therapy can reduce rejection sensitivity and enhance distress tolerance. Therefore, its application in counseling centers, nursing homes, and geriatric mental health services is recommended.