The Effectiveness of Acceptance and Commitment Therapy on Psychological Flexibility and Anxiety Among Individuals Referred to Counseling Centers
Keywords:
Acceptance and Commitment Therapy, psychological flexibility, anxietyAbstract
The present study aimed to determine the effectiveness of Acceptance and Commitment Therapy on psychological flexibility and anxiety among individuals referred to counseling centers. The research method was quasi-experimental, using a pretest–posttest design with one experimental group and one control group. The statistical population included individuals referred to counseling centers in Tehran in 2025–2026. Using convenience sampling, 30 participants were selected and randomly assigned to two groups: an experimental group of 15 participants and a control group of 15 participants. Data were collected using psychological flexibility and anxiety questionnaires. The participants in the experimental group then received Acceptance and Commitment Therapy for eight weeks, with one 90-minute treatment session held each week, while the control group received no specific intervention. The findings showed that the mean scores of psychological flexibility and anxiety in the posttest phase of the experimental group were significantly different from the pretest scores. Therefore, Acceptance and Commitment Therapy has an effect on psychological flexibility and anxiety among individuals referred to counseling centers.
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References
1. Dugas MJ, Robichaud M. Cognitive-Behavioral Treatment for Generalized Anxiety Disorder: From Science to Practice: Routledge; 2007.
2. McLean CP, Anderson ER. Brave Men and Timid Women? A Review of the Gender Differences in Fear and Anxiety. Clinical Psychology Review. 2011;31(6):1041-51.
3. Whiting DL, Deane FP, Ciarrochi J, McLeod HJ, Simpson GK. Validating Measures of Psychological Flexibility in a Population with Acquired Brain Injury. Psychological Assessment. 2015;27(2):415-23.
4. Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. 2nd ed: Guilford Press; 2012.
5. Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy. Behavior Therapy. 2013;44(2):180-98.
6. Harris R. ACT Made Simple: An Easy-to-Read Primer on Acceptance and Commitment Therapy. 2nd ed: New Harbinger Publications; 2019.
7. Lee EB, Pierce BG, Twohig MP, Levin ME. Acceptance and Commitment Therapy. In: Wenzel A, editor. Handbook of Cognitive Behavioral Therapy: Overview and Approaches: American Psychological Association; 2021.
8. Howard LR, Earleywine M, DeCount TA, Forsyth JP. Acceptance and commitment therapy (ACT) for comorbid generalized anxiety disorder and premenstrual dysphoric disorder: A transdiagnostic approach. Clinical Case Studies. 2026;25(3):212-30. doi: 10.1177/15346501261421541.
9. Roberts MZ, Tifft ED, Forsyth JP, Boswell JF. Acceptance and Commitment Teletherapy for Mixed Anxiety and Depressive Symptoms During the COVID-19 Pandemic: A Case Study. Clinical Case Studies. 2025:15346501241283059.
10. Rad Y, Prudenzi A, Zernerova L. Effects of workplace acceptance and commitment therapy (ACT) programs on psychological flexibility subprocesses: A systematic review. Journal of Contextual Behavioral Science. 2025;37:100915. doi: 10.1016/j.jcbs.2025.100915.
11. Nallepalli V, Murugesan S. Enhancing Marital Resilience Through Psychological Flexibility: An Acceptance and Commitment Therapy-Based Case Study. 2025;3(1):25-32. doi: 10.4103/ijpmh.ijpmh_6_25.
12. Fazeli M, Ehteshamzadeh Hashemi Sheikh Shabani SE. The Effectiveness of Cognitive-Behavioral Therapy on Cognitive Flexibility in Depressed Individuals. Thought and Behavior. 2014;9(34).
13. Razaei M, Pourmohammad Ghouchani K, editors. Effectiveness of cognitive behavioral therapy and acceptance and commitment therapy on cognitive flexibility in adolescents with generalized anxiety disorder2025.
14. Zou Y, Wang R, Xiong X, Bian C, Yan S, Zhang Y. Effects of Acceptance and Commitment Therapy on Negative Emotions, Automatic Thoughts and Psychological Flexibility for Depression and Its Acceptability: A Meta-Analysis. BMC Psychiatry. 2025;25(1):602. doi: 10.1186/s12888-025-07067-w.
15. Wang D, Lin B, Du J, Liu W, Sun T, Li Q, et al. Acceptance and commitment therapy for nurses’ sleep, rumination, psychological flexibility, and it's neural mechanism: A randomized controlled fNIRS study. International Journal of Clinical and Health Psychology. 2025;25(1):100543.
16. Bektaş-Aydın C, Yüksel-Şahin F. Effectiveness of Acceptance and Commitment Therapy on Post-Traumatic Stress Symptoms, Psychological Inflexibility, and Self-Compassion in IPV Survivor University Women. Journal of Interpersonal Violence. 2025;41(5-6):1056-84. doi: 10.1177/08862605251318283.
17. Chen F, Xiao Z, Zhang Q, Xiong Y, Xia W, Yan M, et al. Effects of Acceptance and Commitment Therapy on Death Anxiety in Cancer Survivors: A Randomized Controlled Trial. Psycho-Oncology. 2026;35(6). doi: 10.1002/pon.70492.
18. Yaghoubi M, Ebrahimi F, Pour Mohammad Ghochani K, Noorouziani Z. A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy on Referential Thoughts, Cognitive Flexibility, and Distress Tolerance in Patients with Major Depression. Psychological Dynamics in Mood Disorders. 2026:1-18. doi: 10.1002/da.22878.
19. Yaqubi M, Ebrahimi F, Pourmohammad Ghouchani K, Norouziani Z. Comparison of cognitive behavioral therapy and acceptance and commitment therapy on referential thoughts, cognitive flexibility, and distress tolerance in patients with major depressive disorder. Psychological Dynamics in Emotional Disorders. 2026:1-18. doi: https://maherpub.com/pdmd/article/view/628.
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Copyright (c) 2026 Bita Golkarian (Author); Mozhgan Sadat Seyedi; Atena Martami , Mahsa Nakhlestani , Eshagh SamKhaniani (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
