Comparison of the Effectiveness of Emotion Regulation and Existential Psychotherapy in Enhancing Self-Esteem among Older Adults Living in a Nursing Home

Abstract

This study aimed to compare the effectiveness of emotion-regulation training and existential psychotherapy in enhancing self-esteem among older adults living in a nursing home. This applied study used a quasi-experimental pretest-posttest design with a control group and a three-month follow-up. The statistical population consisted of older adults aged 65 to 84 years residing in Aseman Nursing Home in Tehran in 2026. Based on G*Power estimation and allowance for possible attrition, 60 eligible participants were selected through convenience sampling and randomly assigned to three groups of 20: existential psychotherapy, emotion regulation, and control. The two intervention groups received eight 90-minute group sessions, whereas the control group received no specific intervention during the study period. Self-esteem was assessed using the Coopersmith Self-Esteem Inventory at pretest, posttest, and three-month follow-up. Data were analyzed using repeated-measures analysis of variance and Bonferroni-adjusted pairwise comparisons. The results showed a significant main effect of time on self-esteem, F = 36.32, p < 0.001, partial η² = 0.39. The main effect of group was not statistically significant, F = 1.57, p = 0.21, partial η² = 0.05; however, the time-by-group interaction was significant, F = 7.53, p = 0.010, partial η² = 0.21. Bonferroni comparisons indicated significant increases in self-esteem from pretest to posttest (MD = 1.36, p = 0.003), from pretest to follow-up (MD = 2.68, p < 0.001), and from posttest to follow-up (MD = 1.31, p < 0.001). Both emotion-regulation training and existential psychotherapy were associated with sustained improvements in self-esteem among older adults, although no definitive superiority of either intervention was established.