REDEMPTION IN MENTAL HEALTH: A INTEGRATIVE REVIEW OF HOPE AND SELF-FORGIVENESS INTERVENTIONS IN DEPRESSION AND SUBSTANCE USE DISORDERS

Abstract

Hopelessness and toxic guilt are persistent barriers in the treatment of Major Depressive Disorder (MDD) and Substance Use Disorders (SUD). This integrative review synthesized empirical evidence (2020–2025) on psychotherapeutic interventions with structured hope or self-forgiveness components in these disorders. Conducted following Whittemore and Knafl (2005), with searches in PubMed, PsycINFO, and LILACS, PRISMA 2020 reporting, and thematic narrative synthesis, 19 studies were included. Hope Theory-based interventions significantly reduced depressive symptoms, mediated by increased personal agency. Self-forgiveness protocols were associated with reduced substance use and toxic shame, promoting identity reconstruction. Qualitative findings indicate both constructs operate as processes of "moral redemption," essential for recovery. Hope and self-forgiveness are structurable therapeutic mechanisms with growing empirical support, whose integration into clinical protocols may humanize and enhance MDD and SUD treatment by addressing the moral dimension of suffering. Registration: Open Science Framework, January 13, 2026.