---

Aim and Background: There is a relation between patients&#039; levels of physical functioning and their acceptance of chronic pain. However, this relation has not been examined amongst Iranian chronic pain patients. The purpose of this paper was to evaluate the relation between acceptance of chronic pain and physical disability. Methods and Materials: In a descriptive-correlational study, convenience sampling was used to select 245 chronic pain patients from pain clinics in Tehran, Iran during spring and summer of 2010. The participants completed the Chronic Pain Acceptance Questionnaire (CPAQ) and a demographic questionnaire. They also provided information about physical disability, pain intensity, and daily dysfunction. Data was analyzed using Pearson&#039;s correlation and multiple hierarchical regression models. Findings: There were significant relations between acceptance of pain and pain intensity and disability (P < 0.001). According to the regression model, acceptance of pain could predict a significant proportion of variance of disability scales (i.e. physical disability and daily dysfunction) (P < 0.0001). Therefore, it was a better predictor of disability compared to over pain intensity, gender, education, and pain duration. Conclusions: Chronic pain acceptance is an important factor in reducing the perceived disability in chronic pain patients. Therefore, acceptance-based treatment methods are helpful to decrease pain-related disability.

---

Acceptance- Based Behavior Therapies (ABBTs) is a new branch of psychological therapy that used Mindfulness-based therapy principles and techniques. Acceptance-based therapies came to be based on the assumption that psychopathology were trying to control or avoid negative thoughts and emotions. These therapies are believed people with mental impairment have been critical of these treatments on their emotions and they are judged based on their emotions. So try to avoid from these emotions and do actions to reduce their emotions or escape from them. Avoidance in the three levels of emotional, cognitive and behavioral may play an important role in continuing the psychopathology. ABBTs aim to alter individuals&rsquo; relationships with their internal experiences, reduce rigid experiential avoidance and increase action in valued directions.

---

Aim and Background: The purpose of this study was to determine the effect of treatment based on acceptance and commitment therapy (ACT) on depression and mental health in patients with diabetes. Methods and Materials: Experimental research method was used in this study. Statistical population consisted of diabetic patients from diabetes center in Isfahan, Iran. A total of 30 patients were randomly selected and assigned to either experimental or control groups. Beck Depression Inventory (BDI II) was completed before and after the intervention. Experimental group received 8 training sessions of ACT, with 120 minutes duration, in Diabetes Charitable Center of Isfahan. The control group received no training at all. Findings: Results showed that ACT significantly increased scores on the BDI II compared to the control group (P < 0.001). Conclusions: ACT may be considered to be an effective intervention approach for treating depression in diabetic patients.

---

Abstract: Aim and Background: The aim of present study the study of the efficacy of Acceptance Based Behavior Therapy and Integrative Behavioral Couple Therapy on women with distressed couples and General Anxiety Disorder. Methods and Materials: Six women with Generalized Anxiety Disorder and their spouses were selected using purposeful sampling. Non-congruent multiple baseline experimental single case study was used as the method of the present study. The efficacy of Acceptance Based Behavior Therapy and Integrative Behavioral Couple Therapy Protocol was carried out in three phase of intervention (Baseline, 16 session treatment and 3 month follow-up) by using the Pennsylvania State Worry Questionnaire (PSWQ) and Dyadic Adjustment Scale (DAS)evaluated. Data analyzed with visuals inspection, improvement percentage and reliable change index (RCI) strategies. Findings: Results showed that Acceptance Based Behavior Therapy and Integrative Behavioral Couple Therapy have positive efficient on treatment&#039;s target. Acceptance Based Behavior Therapy efficacy also showed more than Integrative Behavioral Couple Therapy in the Worry variable. Integrative Behavioral Couple Therapy efficacy also showed more than Acceptance Based Behavior Therapy in the Dyadic Adjustment Scale. Conclusions: Theoretical explanation of findings for effectiveness of therapy, suggest that Acceptance Based Behavior Therapy was efficient in Magnitude, Universally and stability of changes, but in Acceptability both of therapies were similar.

---

Aim and Background: Recently, “Third wave” behavioral and cognitive interventions have received extensive attention between researchers.To evaluation of the efficacy of one of these treatments, Acceptance and Commitment Therapy (ACT), This Study compares this treatment with Cognitive - Behavioral Therapy (CBT) in Obsessive- Compulsive Disorder (OCD).   methods and Materials: In this study a quasi- experimental design with pre - posttest was used. Implementation of this study was from February 2011 to October 2012 in the Parse`s center of Psychiatry and Psychology.The experimental groups were Acceptance and Commitment Therapy (n =13) and Cognitive-Behavior Therapy (n =13). Both groups received 10 two-hour treatment sessions once a week. In control group 12 patients participated (wait list). In order to assess the severity of OCD, psychological flexibility and depression, Yale Brown Obsessive- compulsive scale (YBOCS), Acceptance and Action Questionnaire (AAQ) and Beck Depression Inventory (BDI) were used. Data were analyzed using Multiple Analysis of Covariance in SPSS. Finding: Comparison of the treatment groups suggested that there was significant difference between ACT and wait list groups in all scales and this difference maintains in follow up (P=0.01). In addition, comparison of CBT group with wait list in posttest indicates that there was signifficant difference between two groups, except of psychological flexibility variabele, and these results maintain in follow up too (P=0.01). In post test, two groups show significant difference only in Acceptance and Action Questionnaire (P= 0.05) not in reduction of OCD symptoms and depression. ACT was more effective in increase of psychological flexibility and this superiority maintains in follow up (P= 0.01). Conclusions: Based on the results of this study, both Acceptance and Commitment Therapy and Cognitive-Behavior Therapy, made significant changes in OCD symptoms. So, current study provides an empirical support for Acceptance and Commitment Therapy in treatment of OCD.

---

Aim and Background: This study was performed to examine the effectiveness of mindfulness techniques training on life orientation, life satisfaction, and acceptance and action in addicted women undergoing rehabilitation. Methods and Materials: The present study was a semi-experimental research with pretest-posttest design and control group. The statistical population of this study included all addicted women who had undergone detoxification and at the time of the study were undergoing rehabilitation in the Parastoo Center in Najafabad, Iran. A total of 24 subjects were selected through convenience sampling and were randomly assigned to experimental or control groups (n = 12). The experimental group received 8 sessions of mindfulness techniques training over 2 months and each session lasted 2 hours, whereas the control group only received routine rehabilitation training. Both experimental and control groups completed the Life Orientation Test (LOT), Satisfaction with Life Scale, (SWLS) and Acceptance and Action Questionnaire-II (AAQ-II) before and after the intervention. Data were analyzed using multivariate analysis of variance. Findings: The controlling of pretest scores showed a significant difference between the groups in terms of the average scores of life orientation, life satisfaction, and acceptance and action in the posttest stage (P < 0.0001). Conclusions: It can be concluded that mindfulness techniques training had had a meaningful effect on the improvement of life orientation, life satisfaction, and acceptance and action. Thus, it can be used as an appropriate intervention in the treatment of addicted women undergoing rehabilitation.

---

Aim and Background: Experiential avoidance is a behavior pattern that increases binge eating among overweight and obese individuals. The objective of this study was to investigate the efficacy of acceptance and commitment therapy (ACT) on experiential avoidance among overweight and obese individuals in Isfahan, Iran. Methods and Materials: The present quasi-experimental research was conducted with a pretest-posttest, double-blind, and multicenter design with control group. The statistical population of the study consisted of all overweight and obese individuals a body mass index (BMI) of more than 25 referring to nutrition and diet therapy clinics in the winter of 2015. From among them, 40 individuals were selected through convenience sampling based on the study criteria and were randomly assigned to the experimental and control groups (each group = 20 individuals). Both groups completed the Acceptance and Action Questionnaire for Weight-Related Difficulties (AAQW) designed by Lillis and Hayes, at pretest, posttest, and follow-up stages (45 days after the intervention). The reliability of the AAQW was calculated using Cronbach&#039;s alpha coefficient (&alpha; = 0.91) and its content validity was confirmed by experts. The experimental group received 8 60-minute sessions of ACT. The control group, however, received no intervention. Data were analyzed using ANCOVA in SPSS software. Findings: There was a significant decrease in experiential avoidance among the experimental group participants (P < 0.05). Moreover, this effect was maintained until the follow-up stage. Conclusions: According to the results, ACT can be considered as an efficient intervention for the reduction of experiential avoidance in overweight and obese individuals. The reduction in experiential avoidance results in the increasing of psychological flexibility in these individuals. Therefore, ACT can be used in conjunction with other weight control interventions.

---

Aim and Background: Stress resulting from treatment in patients undergoing hemodialysis will cause psychological problems. Maladaptive schemas are important in the development of psychological problems and the effectiveness of acceptance and commitment therapy (ACT) on them has been approved. The aim of this study was to examine the effects of ACT on modification of early maladaptive schemas in patients undergoing hemodialysis in Isfahan, Iran, in 2015. Methods and Materials: This clinical trial was conducted with a control group. For the purpose of this study, 30 patients undergoing hemodialysis in Zahra Hospital in Isfahan were selected through convenience sampling and divided into control and experimental groups. The two groups were matched in terms of sex, education, and marital status. The data collection tool was the Young Schema Questionnaire-Short Form (YSQ-SF). A pretest was performed before the intervention, and posttest was conducted after 10 sessions (2 hours) of ACT. Findings: Repeated measures ANOVA showed that after the initial implementation of ACT sessions, a significant difference was observed in the experimental group in terms of maladaptive schemas. It was found that ACT was affective on the modification of early maladaptive schemas (disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, overvigilance and inhibition) in patients undergoing hemodialysis (P < 0.001). Conclusions: The findings indicate that ACT can be used to reduce early maladaptive schemas, and thus, psychological problems in patients undergoing hemodialysis.

---

Aim and Background: Acceptance and commitment therapy can decrease psychological problems of the patients with rheumatoid arthritis. The purpose of the present study was to determine the effectiveness of acceptance and commitment therapy on the pain intensity perception in the patients with rheumatoid arthritis in Isfahan, Iran. Methods and Materials: This semi-experimental study was conducted using pretest-posttest and control group, with follow-up of the patients. Therefore, 30 women were randomly selected from those who referred to rheumatology centers in Isfahan and were diagnosed with rheumatoid arthritis by a rheumatologist and met other inclusion criteria. They were randomly assigned into experimental group and control group (15 individuals in each group) and followed up for two months. The data was collected using Mc Gill&rsquo;s pain intensity perception questionnaire which was completed by the participants. Then the experimental group received eight 90-minute sessions of acceptance commitment therapy intervention. The data was analyzed using repeated measures ANOVA. Findings: Acceptance and commitment therapy had significant effect on the pain intensity perception in patients with rheumatoid arthritis in experimental group (P < 0.50). This result was also observed after a one-month follow-up (P < 0.05). Conclusions: It can be concluded that acceptance and commitment therapy can be used as an intervention to decrease pain intensity perception in patients with rheumatoid arthritis.

---

Aim and Background: The aim of the present study was to compare the efficacy of acceptance and commitment therapy (ACT) with exposure and response prevention (ERP) therapy in reducing the obsessions and compulsions of patients with obsessive-compulsive disorder (OCD). Methods and Materials: The present experimental study was conducted with a pretest-posttest design and a control group. The statistical population included all patients with OCD who were older than 18 years of age and referred to private counseling centers and urban and rural health centers in Rasht Province, Iran, in 2014. The statistical sample consisted of 45 patients with OCD selected from among those who referred to these centers. The subjects were randomly divided into experimental (ACT and ERP groups) and control groups. The experimental groups received 8 treatment sessions lasting 45 minutes. In order to assess the severity of obsession and compulsion, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was utilized. Findings: There were significant differences among the three groups in terms of post-test scores of obsession and compulsion (P ≤ 0.010). The results of Tukey&#039;s test showed that the mean ACT and ERP scores of both experimental groups were significantly lower than that of the control group (P ≤ 0.050). Conclusions: According to the results of this study, ACT causes a greater reduction in the severity of obsessions and compulsion. Thus, mental health experts can use ACT as a therapeutic option.

---

Aim and Background: Marital quality of couples is the most important aspect of families with optimal performance. The purpose of the present study was to compare the effectiveness of cognitive-behavioral couple therapy (CBCT) and couple therapy based on acceptance and commitment therapy (ACT) on the marital quality of conflicting couples. Methods and Materials: This quasi-experiment was conducted with a pretest-posttest design and control group. The statistical population of the study included all conflicting couples referring to consultation centers in the city of Isfahan, Iran, in 2016. The subjects (90 couples) were selected through voluntary sampling and were divided into CBCT (30 individuals), ACT (30 individuals), and control groups (30 individuals). The two experimental groups received 12 sessions of therapy (once a week). The data collection tools were a demographic characteristics form and the Revised Dyadic Adjustment Scale (RDAS). Data were analyzed using ANCOVA in SPSS software. Findings: CBCT and ACT made significant changes in marital quality at the posttest stage (P < 0.05). Furthermore, the results of the Bonferroni post hoc test implied that there was no significant difference between the effectiveness of CBCT and ACT on the couples’ marital quality (P > 0.05). Conclusions: According to the results of the study, both CBCT and ACT caused significant changes in marital quality and there was no significant difference between the effectiveness of these two therapeutic methods. Thus, the results of this study provide empirical support for increase in marital quality through both therapies.

---

Aim and Background: The purpose of the present study was to compare the effect of cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and pharmacotherapy on severity of trichotillomania (TTM) symptoms. Methods and Materials: The participants consisted of 8 women and 1 man of over 16 years of age with TTM. The subjects were chosen through convenience sampling and randomly divided into 3 groups of equal size (CBT, ACT, and pharmacotherapy groups). The present single-subject study was conducted using the A-B design. The baseline consisted of 3 sessions, and the intervention consisted of 10 weekly sessions of CBT and ACT once a week for 60 minutes and 10 pharmacotherapy sessions once every 2 weeks. One month after the intervention, the subjects participated in 3 follow-up sessions (once a month). Massachusetts General Hospital Hairpulling Scale (MGH-HPS) was used to collect data. Findings: The findings of this study were analyzed based on visual analysis and descriptive statistical indicators. The results demonstrated that CBT and ACT were, respectively, more effective on the reduction of TTM symptoms severity and pharmacotherapy was the least effective. Conclusions: Considering the effectiveness of CBT and ACT on severity of TTM symptoms, the use of these therapies to reduce TTM symptoms is recommended.

---

Aim and Background: The aim of this study was to compare the efficacy of cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) in reducing depression symptoms in patients with multiple sclerosis (MS). Methods and Materials: This experimental study was conducted with pretest-posttest design and control group. From among female patients with MS who referred to the MS Society in 2015 with depression symptoms, a sample of 45 individuals was selected. The subjects were randomly divided into 3 groups of CBT, ACT, and control (n = 15). Therapy sessions consisted of 8 sessions, each session was held for 45 minutes. Data were collected using the Beck Depression Inventory (BDI) and were analyzed using ANCOVA in SPSS software. Findings: The results showed that CBT and ACT were both effective in reducing depression symptoms in patients with MS (P < 0.001), but CBT was more effective compared to ACT. Conclusions: The results showed that CBT and ACT are effective methods of reducing depression in patients with MS. Due to the higher efficacy of CBT, it has been suggested as the preferential treatment for the reduction of depression symptoms in patients with MS.

---

Aim and Background: Healthy sexual function is a sign of physical and mental health and creates a mutual sense of pleasure among couples. Due to the importance of women's sexual and psychological processes, the aim of this study was to assess the effectiveness of acceptance and commitment therapy (ACT) on sexual function, sexual self-consciousness, and sexual assertiveness in women of 20-50 years of age in Isfahan, Iran. Methods and Materials: This study was conducted with pretest-posttest and 1 month follow-up. The study subjects were 20 married women who referred to women’s parturition and psychiatric clinics in Isfahan and had been diagnosed with sexual dysfunction based on the Diagnostic and Statistical Manual of Mental Disorders-5 th edition (DSM-5) in the spring of 2015. The subjects were assigned to two groups (n = 10). The experimental group received 10 sessions (each session lasted 45 minutes) of ACT and the control group did not receive any intervention. The data collection tools consisted of a demographic questionnaire, the Female Sexual Function Index (FSFI) (Rosen et al.), Sexual Self-Consciousness Scale (SSCS) (van Lankveld et al.), and Hurlbert Index of Sexual Assertiveness (HISA). Findings: ACT was effective on improvement of sexual function, sexual self-consciousness, and sexual assertiveness (P < 0.05). Conclusions: According to the results, ACT can be used for improvement of sexual function, sexual self-consciousness, and sexual assertiveness.

---

Aim and Background: Acceptance and commitment therapy (ACT) is a novel method for resolving interpersonal problems. The aim of the present study was to determine the effectiveness of ACT on interpersonal problems and experiential avoidance among female students with interpersonal problems. Methods and Materials: In this convenience clinical trial, the study population consisted of all female students in the Islamic Azad University of Gorgan, Iran, in the fields of nursing, midwifery, laboratory sciences, management, law, accounting, and architecture. The participants consisted of 66 individuals selected via purposive sampling. The study population was randomly categorized into intervention (ACT group) and control groups. The intervention consisted of 10 90-minute ACT sessions, which were held by a trained clinical psychologist according to a study by McKay, Lev, and Skeen (2012). The data collection tools included two short-form questionnaires, i.e., the Inventory of Interpersonal Problems (IIP-32) and Acceptance and Action questionnaire (AAQ-II). Pretest and posttest scores were analyzed using ANCOVA Findings: After controlling of pretest scores, a significant difference was observed between the groups in terms of the average scores of interpersonal problems (P < 0.001) and experiential avoidance (P < 0.001) in the posttest. Conclusions: Based on the findings, ACT can be effective on improvement of interpersonal problems and experiential avoidance.

---

Aim and Background: The aim of present study was investigating the efficacy of acceptance and commitment therapy (ACT) for couples on marital adjustment in men with bipolar II Disorder. Methods and Materials: Participants (3 couples) were selected using purposeful sampling. Nonconcurrent multiple baseline experimental single subject study was used as the method. The efficacy of couples’ ACT protocol was carried out in three phases of intervention (baseline, 12-session treatment and 3-month follow-up) by using dyadic adjustment scale (DAS). Data were analyzed by visuals analysis and percentage of non-overlapping data (PND) and percentage of overlapping data (POD) strategies. Findings: There was a significant difference between the mean values of the baseline and intervention scores. The effectiveness of couples-based ACT in men with bipolar II disorder was validated to improve the marital adjustment. Conclusions: ACT for couples can improve the marital adjustment in men with bipolar II disorder and decrease the rate of divorce.

---

Aim and Background: While Parents affect other members of the family, children also have effects on their parents with their own personal, behavioral and growth characteristics reciprocally. The behavioral disorder of one of the children, such as attention deficit hyperactivity disorder (ADHD), is usually conceived as a stressful element which can affect all aspects of family, including the relationship between mothers and their spouses. The aim of this study was to survey of stress management group training effectiveness, using acceptance and commitment therapy (ACT) method, on the relationship between mothers of ADHD children and their spouses. Methods and Materials: The research method was quasi-experimental, pre-test, post-test and 9-month follow-up with control group. The population of the research was included all mothers of children with ADHD in Esfahan who referred to clinics and psychologists offices in 2013. Thirty mothers which had highest score of stress in relationship with spouse from parenting stress index (PSI) were selected and assigned into two groups of test and control. Eight 90-minute sessions of acceptance and commitment stress management training was performed for the test group, while the control group had no intervention. PSI subscale of relationship with spouse from parent characteristics was used in order to review the hypothesis of the study, which was completed before and after intervention by mothers. Data were analyzed by covariance statistical methods using SPSS software. Findings: There was a considerable difference between scores of pre-test and post-test of the test group in comparison with control group (P = 0.001), reflecting the improvement of relationship with spouses in mothers. Conclusions: ACT-based stress management group training could improve the relationship between the mothers of ADHD children and their spouses.

---

Aim and Background: Addiction and its unpleasant consequences are one of the most important public health problems worldwide. Initial maladaptive schemas are related to addiction. The purpose of this study was to compare the effectiveness of admission and commitment therapy (ACT) and schema therapy on early maladaptive schemas in addicted people. Methods and Materials: The research method was pre-test, post-test experimental study with control group. The statistical population included 1500 people. A sample of 60 people was selected and randomly assigned to 3 groups, one control group (n = 20), and two experimental groups (n = 20, each). Young schema questionnaire short form (YSQ-SF) was used to measure early maladaptive schemas. The experimental groups participated in 12 sessions of the treatment group weekly for two 90-minute sessions. Descriptive statistics including mean and standard deviation, and inferential statistics were analyzed using covariance analysis, homogeneity and uniformity tests of variance and post hoc test. Findings: ACT and schema therapy were effective on the components of early maladaptive schemas. Conclusions: The group-based ACT and schema therapy have been able to reduce early maladaptive schemas and can be used in the treatment of patients with this disorder.

---

Aim and Background: Illness and disability in children is a major source of distress for parents, especially mothers. It frequently endangers their health and well-being. Therefore, the aim of present study was to investigate the effectiveness of the acceptance and commitment therapy (ACT) on the intolerance of uncertainty, worry and insomnia in mothers of children with autism spectrum disorder. Methods and Materials: In a quasi-experimental study, with pre and posttest and control groups, 16 mothers of children with autism spectrum disorder were selected by available sampling method and then randomly designed into two experimental and control groups. The experimental group participated in 8 sessions of ACT, while the control group was not in any treatment. The participants completed Penn-State worry questionnaire (PSWQ), intolerance of uncertainty scale (IUS) and insomnia severity index (ISI). Data were analyzed by SPSS software, using multivariate analysis of covariance (MANCOVA). Findings: Intolerance of uncertainty (P = 0.001), worry (P = 0.001) and insomnia (P = 0.001) average scores in the experimental group were significantly decreased in comparison with the control group at post-treatment. Conclusions: ACT might be an efficient way to decrease intolerance of uncertainty, worry and insomnia in mothers of children with autism spectrum disorder. Also, therapists can use this therapeutic approach for improving intolerance of uncertainty, worry and insomnia in mothers of children with autism spectrum disorder.

---

Aim and Background: Emotional disturbances are caused by various factors that include two general biological and cognitive components. Understanding the factors affecting emotional disturbances is important in improving the quality of life of individuals. This study was aimed to determine the role of acceptance, mindfulness, and the sensitivity of behavioral inhibition/activation systems in predicting emotional distress among university students. Methods and Materials: In this descriptive correlational research, the statistical population included all students in Tabriz Branch, Islamic Azad University, Iran. Among them, 380 subjects (190 girls and 190 boys) were selected through cluster random sampling. To collect the data, Carver and White's Behavioral Inhibition and Behavioral Activation Scale (BIS/BAS), Bond et al. Acceptance and Action Questionnaire-second version (AAQ-II), Baer et al. Five Facet Mindfulness Questionnaire (FFMQ), and Depression Anxiety and Stress Scale-21, were used. To analyze the data, Pearson Correlation Coefficient and Multiple Regression were used. Findings: The behavioral inhibition/activation systems, acceptance, and mindfulness could significantly predict about 45% of depression variance, 53% of anxiety variance, and 41% of stress variance related to emotional distress. Conclusions: According to the findings, it could be concluded that stress, anxiety, and depression as emotional distress are the result of the behavioral inhibition/activation systems, acceptance, and mindfulness effect. To emotion regulation, attention should be paid to behavioral inhibition/activation systems, and mindfulness.