International Archives of Health Sciences

: 2018  |  Volume : 5  |  Issue : 4  |  Page : 131--134

The effectiveness of the integrated group therapy on increasing the prisoners' self-esteem

Zahra Keshtkar1, Mahsa Nabavi2, Mustafa Bolghan-Abadi3,  
1 Department of Psychology, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
2 Department of Psychology and Counseling, Faculty of Sciences, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran
3 Department of Counseling, Young Researcher and Elite Club, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran

Correspondence Address:
Dr. Mustafa Bolghan-Abadi
Department of Counseling, Young Researcher and Elite Club, Neyshabur Branch, Islamic Azad University, Neyshabur


Context: The previous studies have shown the commitment of most crimes and offensive behaviors are the root of psychological disorders. Aims: The purpose of this study is to investigate the effectiveness integrated group therapy in increasing the male prisoners' self-esteem of central prison of Mashhad. Settings and Design: Statistical population included all the male prisoners of the central prison of Mashhad who were addicted to drugs. A sample from these prisoners was selected randomly and was assigned in experimental and control groups (12 participants in each group). Subjects and Methods: The research method of this study was semi-experimental with pretest/posttest/follow-up and control group design. Weekly group sessions were holding which last for 2 h during 1½ months. For gathering the data demographic and Coopersmith's self-esteem questionnaire were used. Statistical Analysis Used: For analyzing the data, ANCOVA test was used. Results: Findings show that those who had received the intervention expressed high level of self-esteem to those who had not received it (control group participants). Conclusions: It could be concluded that the group therapy by the integrated approach has effective influence on increasing the male prisoner's self-esteem of central prison of Mashhad.

How to cite this article:
Keshtkar Z, Nabavi M, Bolghan-Abadi M. The effectiveness of the integrated group therapy on increasing the prisoners' self-esteem.Int Arch Health Sci 2018;5:131-134

How to cite this URL:
Keshtkar Z, Nabavi M, Bolghan-Abadi M. The effectiveness of the integrated group therapy on increasing the prisoners' self-esteem. Int Arch Health Sci [serial online] 2018 [cited 2019 Jan 18 ];5:131-134
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Mental disturbance and disorder are one of the problems and issues attached to the life of these days in the world. Approximately all over the world, many people in different ways suffer from it, and to cope with it need specific psychological services. There is no doubt that the modern human being deals with training and education issues, child rearing, crimes, and offenses, diseases, and social and psychological harms in various ways.[1] Depression is one of the mental disturbances and disorders. Depressive disorders are one of the main kinds of temperamental disorders.[2] Prison and prisoners are the bitter truth of each society. Punishing people in the way of confining out of the sight of society and forgetting them is not a good solution and does not bring safety. Because just by confining the person, a process will be formed in which all social, economic, domestic, political, and judicial arenas of a government will be involved in a serious problem.[3] Beck[4] states that more negative emotional reactions are caused by lack of self-esteem.

Kelley et al.[5] found that there is a positive relationship between committing crime and low self-esteem. They noticed that there a relationship between high self-esteem and the decrease of criminal behavior, that is to say, as much as the self-esteem increases, the criminal behaviors decrease. Some of mental health specialists in America by investigating 541 adolescent criminals (13–18 year-old), reach to this point that the mount of internalizing problems (including depression, obsession, somatic complaints, and schizoid) and externalizing problems (such as hyperactivity, aggression, and offensiveness) in these adolescents is as twice as the other adolescents.[6] The feeling of being worthy has an effect on all aspects of their life and also on the way how they view their abilities.[7] Studies have shown that there is a relationship between high self-esteem and positive personal traits. Individuals with high self-esteem have characteristics like psychological maturity, steadiness, realism, calmness, and great ability in bearing disappointment and failure, while those who possess low self-esteem don't have such traits. High level of self-esteem has relationship with appropriate psychological traits as perceptional accuracy, proper adjustment with agedness, less harmony with surrounding, and sexual role flexibility.[8]

Hermann and Betz[9] in a study that they did on students of Ohio University found that individuals with low self-esteem get depressed more easily. And also, they suggested that the low self-esteem merely may lead to depression. Deb and Bhattacharjee[10] also in a study that had done on 118 depressed patients, they concluded that the self-esteem of depressed patients significantly is lower than ordinary individuals. In this research, depressed females had lower self-esteem than depressed males. Silverstone cited by Hall and Tarrier[11] noted that in different studies the low self-esteem significantly is correlated with pathological symptoms and has relationship with health issues and problems, and usually leads to mental traumas.

Most of studies done in the field of self-esteem are descriptive and less interventional researches have been conducted in this field. As an example, McManus et al.[12] in their study that was done by conducting the cognitive-behavioral intervention on a case with low self-esteem reach to this result that changing and individual thoughts and beliefs could cause increasing the amount of self-esteem and decreasing the amount of depression and anxiety. Since the self-esteem is important and plays a vital role in mental health and the amount of conducted intervention are limited in this field, it is necessary to apply an effective and appropriate intervention for raising the amount of self-esteem.

Integrated group therapy is an economical method for understanding human interactions as they happen in social networks. Integrated group therapy approach incorporates different effective psychotherapy approaches. This model reconstructs psychotherapy principles and paves the way for understanding human experience as a social-interactional process in which each person makes his concepts and structures as they relate to others.[13]

The aim of present study is to investigate the effectiveness of integrated group therapy on male prisoners' self-esteem of central prison of Mashhad.

 Subjects and Methods

The present research method is a semi-experimental with pretest/posttest/follow-up research and control group design. The research population was all the male addicted prisoners of central prison of Mashhad, who were sentence to 3 years' imprisonment. The inclusion criteria were include: (1) addiction, (2) age range from 20 to 50-year-old, and (3) having 3 years conviction at least. The exclusion criteria were include (1) lack of cooperation. From this population, 24 participants were chosen randomly and also randomly assigned to interventional and control groups (12 participants in each group).


The age range of participants was 25–45 (mean = 36.27, standard deviation [SD] = 4.21). The status of their educational level was six participants were illiterate (25%), 10 participants had middle school grade (41.67%), the other 6 participants had diploma (25%), and finally, two participants had academic education (8.33%). From these 24 participants, 18 participants were married (75%), three participants were single (12.5%), and the other three participants got divorced. They were healthy physically and had no special problems. All the prisoners were addicted and under methadone therapy. The rate of convictions was from 3 years to life imprisonment. All the participants had illegal experiences. Three criminals had committed murder (12.5%), ten criminals' robbery (41.67%), six criminals drug trafficking (25%), five criminals fraud (20.83%).


For gathering data, Cooper Smith's self-esteem self-report questionnaire was used. At first, addicted participants were identified in prison. A list of their names was provided, then from this list, 24 participants was chosen and assigned to control and experimental groups randomly. The experimental group received 2-hourly intervention sessions which were weekly apart and last in 12 weeks.


Cooper smith's self-esteem (short form-revised) – This questionnaire has been designed by Coopersmith[14] based on long form of Coopersmith's self-esteem questionnaire. Coopersmith[14] in your research gained the reliability of this measure for different groups of students from 0.85 to 0.78 through Cranach's α (alpha) coefficient. In another study, Tabatabaei and Hoseynian[15] validated this measure for two groups; the first group contain 170 participants (100 = employed and 70 = unemployed) and the second group 177 (100 = employed and 77 = unemployed) at age range of 20–30-year-old in Tehran, Iran. His research results showed that Cranach's α coefficient for both groups was 0.80. Moreover, in addition, the rate of reliability of this measure was assessed through test-retest after 2 weeks that was 0.83.[15]


For analyzing data mean, and SD in descriptive level were utilized, and mixed-design ANOVA was used at the inference level (groups: integrated intervention and control groups, Assessments: pretest, posttest, and 3.5 months follow-up). [Table 1] shows the mean and SD of prisoner's self-esteem.{Table 1}

The result of mixed-design ANOVA showed that main effect of group (F(1,22)= 4.87, P = 0.038, η2 = 0.181), main effect of time (F(2,22)= 19.80, P < 0.001, η2 = 0.474), and interactional effect of group × time (F(2,22)= 20.03, P < 0.001, η2 = 0.477) are significant. Considering the mean index of prisoner's self-esteem which has been shown in [Table 1], and the main effect of group, time, and the interaction of group and time are significant; it could be concluded that the prisoners who had received integrated intervention got higher self-esteem.

For pairwise comparison, Bonferroni test was used as a post hoc test that indicated there is a significant difference between pretest and posttest scores (P = 0.002). In addition, there is a significant difference between pretest and follow-up scores (P < 0.001). However, there is no significant difference between posttest and follow-up scores (P = 0.10). These results showed that integrated group therapy effect has not been changed by passing the time. [Figure 1] displayed the changes in level of prisoners' self-esteem in integrated group therapy through diagram.{Figure 1}


The aim of this study was to examine the effectiveness of integrated group therapy on increasing self-esteem of the prisoners of Mashhad Central Prison. The results showed that the integrated group therapy has been effective on increasing the self-esteem of the prisoners. This effectiveness was sustainable by passing the time. That is, there was no significant difference between posttest and follow-up assessments. A plenty of studies related to the effectiveness of integrated intervention on improving individuals mental situations has been done that support the findings of this study.[7],[16],[17],[18],[19],[20],[21],[22],[23],[24]

Weiss et al.[19] stated that integrated group therapy could be effective on improving substance abuse successfully. Likewise, this method alongside group drug counseling would lead to better results. They also suggested that integrated group therapy had been effective on decreasing the depressive mood of those who suffer from bipolar disorder.

Cummings[16] through carrying out a study respected to the effectiveness of integrated group therapy on reducing the depression of 70 elderly residence of America found out that participants who received integrated intervention reported low depressive symptoms, had higher life satisfaction, and got more social support.

Sharifinia[18] a in a study sought the comparison of the effectiveness of integrated and cognitive group therapies on decreasing the offensive behaviors of prisoners of Qom Central Prison. They concluded that both integrated and cognitive group therapies had been effective on reducing the offensive behaviors of prisoners. However, the effect of integrated group therapy has been more than cognitive intervention.

Integrated group therapy likewise other treatments had a significant effect on decreasing the offensive behaviors and increasing the self-esteem of prisoners. Even, Sharifinia[18] in their study has mentioned that the effectiveness of integrated intervention was higher than cognitive intervention. Nevertheless, for increasing the prisoners' self-esteem, other interventions have been used that had high effective, as well.

In addition, Hasan-Abadi[25] in a research compared the effectiveness of three methods of group therapies (rational-emotive, existential-humanistic, and spiritual-religious) on increasing the prisoners' self-esteem. He found that existential-humanistic intervention had higher effectiveness rather than the other interventions. Hence, the comparison between existential-humanistic and integrated interventions could be useful for therapists and psychological experts.

Kelley et al.[5] reported that there is a direct relationship between crime and low self-esteem. He reach to this point that there is a relationship between high self-esteem and decreasing of offensive behaviors. By increasing self-esteem through therapeutically interventions such as integrated intervention, it could be possible to prevent the offensive behaviors to some extent. Limitations of this study included using the self-report measure and small size of the population sample. However, we suggest that these limitations should be treated and removed in future studies. In addition, we suggest that the effectiveness of this approach on other populations and psychological variables be investigated.


In order to discussion and results, it can be concluded that the integrated group therapy has effective influence on increasing the self-esteem of prisoners. Therefore, according to this finding, it is suggested that all prisoners receive group therapy sessions.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


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