The purpose of this study was to investigate the effect of TA group-training on the self-esteem of imprisoned women. The results showed that the majority of female prisoners were at low levels of self-esteem before implementing the group-training program, which is consistent with the findings of many studies.
For example, a study among the addicted female prisoners in South of Iran represented that most prisoners had low self-esteem . Arefi reported that female prisoners, especially those with commission crimes, had low self-esteem .The similarity of these results with those of the present study can be due to the same research population and data collection tools.
Furthermore, a reason for the low level of self-esteem among the imprisoned women can be attributed to the prison conditions and environment. In addition, the prisoners’ isolation and being away from their families, fear of rejection in society, and lack of social protection during and after their sentence are among some other effective factors. Alavi showed that Iranian female prisoners had a moderate level of self-esteem. Alavi also introduced low self-esteem as a predictive factor of drug abuse, robbery, and prostitution . Moreover, Kamoyo reported that self-esteem was at a moderate level among the Kenyan female prisoners . The discrepancy between results of the above-mentioned studies and the present study can be probably due to the different cultures of various societies in accepting women, especially female prisoners as well as the different data collection tools.
Results of our study indicated that TA group-training significantly improved the self-esteem of intervention group from the “low” level to the “moderate” Level. Unfortunately, no published study has ever examined the effect of TA group-training as a strategy to improve self-esteem and psychological well-being of the imprisoned women with mental health issues.
Other studies reported TA as an effective reconsideration method in life, which helps the individuals to feel valuable and solve their problems successfully [16, 17, 29]. Another study on the impact of TA group-training indicated improvement of the self-confidence and the ability to endure failures  among members of the intervention group. In several studies, participants reported more success in family life and social relationships , reduced mental and psychological stresses , increased self-esteem, better control of personal conflicts, and more decisiveness in achieving the goals and ideals .The results of a study by Riaz et al. showed that cognitive behavioral therapy (CBT) group programs increased the prisoners’ self-acceptance and self-admission and reduced their risky behaviors .Furthermore, Khodayarifard et al. conducted the individual and group (combined) cognitive–behavioral interventions and showed improvement in the psychological well-being of the prisoners. Finally, they concluded that these strategies increased the female prisoners’ self-efficacy and self-esteem .Perhaps, the similarity between the results of these studies can be due to similar intervention methodology and participation in the group discussion. In group therapy sessions, participants are exposed to other participants’ experiences and contributions. Therefore, they start to analyze and scrutinize their own problems. In addition, the inmates can benefit from other individuals’ opinions and discuss about their problems.
We also found that the imprisoned women in Iran were highly aware of their own low self-esteem and had a tendency to express it through avoidance behaviors. These participants used more emotion-focused than problem-focused coping strategies to overcome their low self-esteem (e.g., active coping, planning, and instrumental support).
Considering that female prisoners in Iran suffer from low self-esteem, which leads into their avoidance behaviors, special group programs, such as TA trainings should be conducted for them by specialties. Consequently, the female prisoners can adapt themselves to the conditions in the community and return to their families by self-acceptance and self-admission.
Our study had a number of limitations. First, the imprisoned women had short-term leaves, family visits, communication with counselors, clinical psychologists, and social workers in prison. These factors could affect the results, but were out-of-control. Second, we could not find a precise instrument to assess the self-esteem of the imprisoned women, therefore, RSES was used. Third, the researchers had access to the prisoners for only 3 months and could conduct only one follow-up 1 month after theintervention. One month is a very short period to assess the impact of TA on a complex behavior such as self-estem. Fourth, the therapist was not permitted to conduct the therapeutic sessions in a separate room. The only available space was a room next to the jailer’s office. Furthermore, some security staff attended the ongoing sessions. These factors disturbed the privacy of the intervention group. Fifth, the results might have changed in the case that the control group received some kinds of training, such as strengthening the back muscles or excersizing. Sixth, since the differnce between the two groups was significant at the pre-test with regard to the self-esteem scores, future researchers are recommneded to select participants based on their pre-test mean scores of self-esteem, instead of a random allocation to the intervention and control groups. In this way, both groups would have women with comparable mean scores.
Therefore, further research are suggested using a valid and reliable tool to assess the self-esteem of the imprisoned women. Moreover, longitudinal studies should be conducted bycontroling the confounding variables.