Comparing the effectiveness of Acceptance and Commitment Therapy and Compassion Focused Therapy and Acceptance and Commitment Therapy enriched with Compassion on social adjustment of women with depression and marital conflict

Document Type : Research Paper

Authors

Department of Psychology, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran

Abstract

Introduction: This study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT) and Compassion Enriched Acceptance and Commitment Therapy on social adjustment of married women with depression and marital conflict.
Materials and Methods: The statistical population included married women suffering from depression and marital conflicts who referred to counseling centers in Mashhad city, Iran. The participant (n=60) were selected by purposive sampling and randomly divided into three experimental and control groups. The intervention was performed in eight 90-minute training sessions for the experimental groups and the control group did not receive any intervention. All four groups answered the Adult Bell Form (Social Adjustment) questionnaire before the intervention, at the end of the intervention and 30 days after the intervention. Data were analyzed by univariate analysis of covariance and analysis of variance for repeated measures.
 Results: There was a significant difference between the mean of pretest, posttest and follow-up of social adjustment in the group of treatment based on acceptance and commitment, treatment focused on compassion, acceptance and commitment enriched with compassion and control (P= 0.001). Also, there was a significant difference between social adjustment in the post-test stage of the mentioned groups and the group of acceptance and commitment enriched with compassion showed more difference.
 Conclusion: Therapies based on acceptance and commitment and focused on compassion and therapy based on acceptance and commitment enriched with compassion, are effective on social adjustment and the effect of therapy based on acceptance and commitment enriched with compassion is greater on social adjustment.
 

Keywords


1. Haghighi H. Comparison of marital conflict resolution styles between satisfied, conflicted and on the verge of
divorce couples in Bandar Abbas. MA. Dissertation. Hormozgan: University of Hormozgan, Faculty of
counseling; 2010. (Persian)
2. Rahmat EF, Fatehizade M, Ahmadi A. [The pathology of marital life]. Innovations in psychotherapy 2006;
11: 8-26. (Persian)
3. Long L, Young G. Counseling and therapy for couples. California: Thomson Brooks-Cole; 2006.
4. Johnson SM. The revolution in couple therapy: A practitioner‐scientist perspective. J Marit Fam Ther 2003;
29(3): 365-84.
5. Picco L, Yuan Q, Vaingankar JA, Chang S, Abdin E, Chua HC, et al. Positive mental health among health
professionals working at a psychiatric hospital. PloS One 2017; 12(6): 1-14.
6. Uebelacker LA, Courtnage ES, Whisman MA. Correlates of depression and marital dissatisfaction:
Perceptions of marital communication style. J Soc Pers Relat 2003; 20(6): 757-69.
7. Laurent HK, Kim HK, Capaldi DM. Longitudinal effects of conflict behaviors on depressive symptoms in
young couples. J Fam Psychol 2009; 23(4): 596-12.
8. Galinsky AM, Waite LJ. Sexual activity and psychological health as mediators of the relationship between
physical health and marital quality. J Gerontol B Psychol Sci Soc Sci 2014; 69(3): 482-92.
9. Proulx CM, Helms HM, Buehler C. Marital quality and personal well‐being: A meta‐analysis. J Marr Fam
2007; 69(3): 576-93.
10. Gehart DR. Mindfulness and acceptance in couple and family therapy. UK: Springer Science and Business
Media; 2012.
11. Wade TJ, Cairney J, Pevalin DJ. Emergence of gender differences in depression during adolescence: National
panel results from three countries. J Am Acad Child Adolesc Psychiatry 2002; 41(2): 190-8.
12. Hayes SC, Strosahl KD. A practical guide to acceptance and commitment therapy. New York: Springer
Science and Business Media Inc.; 2010.
13. Tavakoli M.B. [Investigating the relationship between mothers' employment and social adjustment and their
children's educational performance in primary school in Sanandaj in 1996-97]. MA. Dissertation. Tehran: Allameh
University, Faculty of Psychology and Education Science, 1997. (Persian)
14. Scholes-Balog KE, Hemphill SA, Evans-Whipp TJ, Toumbourou JW, Patton GC. Developmental trajectories
of adolescent cannabis use and their relationship to young adult social and behavioural adjustment: A longitudinal
study of Australian youth. Addict Behav 2016; 53(1): 11-18.
15. Lee MY, Wang HS, Chen CJ. Development and validation of the social adjustment scale for adolescents with
Tourette syndrome in Taiwan. J Pediatr Nurs 2020; 51(2): 13-20.
16. Batista R, Cunha M, Galhardo A, Couto M, Massano-Cardoso I. Psychological adjustment to lung cancer: the
role of self-compassion and social support. Eur Psychiatry 2015; 30(1): 1-10.
17. Khodayari Fard M, Hejazi E, Hoseininezhad N. [The effectiveness of acceptance and commitment
consultation (ACT) on self-efficacy and marital satisfaction substance using married women with children].
Quarterly journal of applied psychology researches 2015; 6(2): 61-75. (Persian)
18. Blackledge JT, Hayes SC. Emotion regulation in acceptance and commitment therapy. J Clin Psychol 2001;
57(2): 243-55.
19. Cope SR, Poole N, Agrawal N. Treating functional non-epileptic attacks–Should we consider acceptance and
commitment therapy? Epilepsy Behav 2017; 73(1): 197-203.
20. Ong CW, Lee EB, Twohig MP. A meta-analysis of dropout rates in acceptance and commitment therapy.
Behav Res Ther 2018; 104(1): 14-33.
21. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J
Pers Soc Psychol 2003; 84(4): 822-36.
22. Leaviss J, Uttley L. Psychotherapeutic benefits of compassion-focused therapy: An early systematic review.
Psychol Med 2015; 45(5): 927-45.
23. Gilbert P. Introducing compassion-focused therapy. Adv Psychiatr Treat 2009; 15(3): 199-208.
24. Seekis V, Bradley GL, Duffy AL. Does a Facebook-enhanced mindful self-compassion intervention improve
body image? An evaluation study. Body Image 2020; 34: 259-69.
25. Depue RA, Morrone-Strupinsky JV. A neurobehavioral model of affiliative bonding: Implications for
conceptualizing a human trait of affiliation. Behav Brain Sci 2005; 28(3): 313-49.
26. Carter CS. Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinology 1998;
23(8): 779-818.
27. Valizadeh M, Dortaj F, Delavar A, Hajializadeh K. [Evaluation of educational package focused on compassion
and mindfulness and its impact on self-efficacy activation]. Quarterly of educational measurement 2018; 9: 1-21.
(Persian)
28. Irons C, Lad S. Using compassion focused therapy to work with shame and self-criticism in complex trauma.
Clin Psychol (Aust Psychol Soc) 2017; 3(1): 17-43.
29. Kolts RL, Bell T, Bennett-Levy J, Irons C. Experiencing compassion-focused therapy from the inside out: A
self-practice/self-reflection workbook for therapists. New York: Guilford; 2018.
30. Neff KD, Beretvas SN. The role of self-compassion in romantic relationships. Self Identity 2013; 12(1): 78-
98.
31. Hematafza P, Sepehriyan Azar F, Soleymani E. [The effectiveness of acceptance and commitment therapy
(ACT) in social adjustment, psychotic disorder and self-determination of people with transgender disorder].
Journal of ethical research 2018; 9(1): 269-84. (Persian)
32. Ghasemzadeh M, Motamedi A, Sohrabi F. [The effectiveness of compassion focused therapy on improving
social adjustment and forgiveness in divorced women]. Women studies 2019; 10: 117-39. (Persian)
33. Saadati N, Rostami M, Darbani SA. [Comparing the effectiveness of Acceptance and Commitment Therapy
(ACT) and Compassion Focused Therapy (CFT) on improving self-esteem and post-divorce adaptation in
women]. Journal of family psychology 2017; 3(2): 45-58. (Persian)
34. Annunziata AJ, Green GD, Marx BP. Acceptance and commitment therapy for depression and anxiety.
Encyclopedia of Mental Health; 2016: 1-10.
35. Aghaee H, Yavari H. [The effectiveness of commitment and acceptance therapy on social adjustment and
compassion]. Journal of Islamic Azad University, Shahroud Branch 2017; 4(1): 39-50. (Persian)
36. Gollan, JK, Friedman MA, Miller IW. Couple therapy in the treatment of major depression. In: A. S. Gurman
AS, Jacobson NS. (editors). Clinical handbook of couple therapy. New York: Guilford; 2002: 653-76.
37. Motamed N, Zamani F. [Sample size in medical researches: an applied approach]. Tehran: Asre Roshanbini;
2016: 29-30. (Persian)
38. Fathi Ashtiani A, Dastani M. [Psychological tests: Personality and mental health evaluation]. Tehran: Besat;
2009. (Persian)
39. Fathi Ashtiani A, Dastani M. [Psychological tests, personality and mental health evaluation]. Tehran: Besat;
2013. (Persian)
40. Fathi Ashtiani A, Dastani M. [Psychological tests, personality and mental health evaluation]. Tehran: Besat;
2012. (Persian)
41. Beck AT, Steer RA, Cabin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years
of evaluation. Clin Psychol Rev 1988; 8(1): 77-100
42. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX:
Psychological; 1996.
43. Fata L, Birashk B, Atef V, Dobson KS. Meaning assignment structures schema, emotional states and cognitive
processing of emotional information: Comparing two conceptual framework. J Clin Psychiatry 2005; 11(1): 326-
31.
44. Dobson KS, Mohammad Khani P. [Psychometric properties of the Beck Depression Inventory-2 in patients
with major depressive disorder in partial remission period in patients with mental disorders]. Rehabilitation 1982;
8: 80-6. (Persian)
45. Barati T. The impact of marital conflict on interaction couple. MS. Dissertation. Roudehen Islamic Azad
University, 1996: 53-61. (Persian)
46. Sanaei B. Measures Scales of family of marriage. International journal of psychology and psychiatry 2013;
1(2): 35-42.
47. Sanaei B. [Family and marriage measurement scales]. Tehran: Besat Publications; 2010.
48. Dehghan F. [Comparison of marital conflicts between divorce applicants and women referred to marriage
counseling]. MS. Dissertation. Tehran: Tarbiat Moallem University, 2001. (Persian)
49. Russ H. ]Act made simple]. Aminzade A. )translator). 4th ed. Tehran: Arjmand; 2018: 302-32. (Persian)
50. Russ H. [ACT with love: Stop struggling, reconcile differences, and strengthen your relationship with
acceptance and commitment therapy]. Kkajepour M, Bahrami S, Feizi A. )translators). Tehran: Arjmand; 2020:
15-250. (Persian)
51. Matthew McKay. ]Acceptance and commitment therapy for couples]. Panahifar S.)translator). Tehran: Ebne-Sina; 2018: 23-330. (Persian)
52. Gilbert Paul.]Compassion focused therapy].Esbati M.Feyzi A.)translators). 3rd ed .Tehran:
Ebnesina;2010:212-32. (Persian)
53. Tirch DD, Schoendorff B, Silberstein LR. [The ACT practitioner's guide to the science of compassion: tools
for fostering psychological flexibility]. Daneshmandi S, Ezadi R, Abedi M. )translators). Isfehan: Kavoshyar;
2014: 23-221. (Persian)
54. Saadati N, Rostami M, Darbani SA. [Comparison of the effectiveness of acceptance and commitment-based
therapy (ACT) and compassion-focused therapy (CFT) in boosting women's self-esteem and post-divorce
adjustment]. Family Psychology 2016; 3(2): 45-58. (Persian)
55. Ashrafzadeh A, Porebrahimi F, Baran S , Hashemizadeh V, Manzari Tavakoli V. [The effectiveness of
training based on commitment and acceptance on social anxiety and social adjustment in male high school
students]. Educational researches 2018; 13: 1-16. (Persian)
56. Peterson BD, Eifert GH, Feingold T, Davidson S. Using acceptance and commitment therapy to treat distressed
couples: A case study with two couples. Cogn Behav Pract 2009; 16(4): 430-42.
57. Idrissi H. [The effectiveness of acceptance and commitment therapy on personal-social adjustment and mental
health of dissatisfied couples referred to counseling centers in Tehran]. Journal of new ideas in psychology 2020;
4(8): 1-13. (Persian)
58. Beilby JM, Byrnes ML, Yaruss JS. Acceptance and commitment therapy for adults who stutter: Psychosocial
adjustment and speech fluency. J Fluency Disord 2012; 37(4): 289-99.
59. Kazemi M. [The effectiveness of acceptance and commitment therapy on anxiety and social adjustment of
patients with breast cancer]. Scientific journal of social psychology 2020; 7: 115-24. (Persian)
60. Noori L, Moradi Shakib A, Ezazi Bojnourdi E, Adib F, Ashoori J. [Effectiveness of group therapy based on
acceptance and commitment on social and health adjustment of nursing students]. Avicenna journal of nursing
and midwifery care 2018; 25(5): 172-9. (Persian)
61. Block JA, Wulfert E. Acceptance or change: Treating socially anxious college students with ACT or CBGT.
Behavior Anal Today 2000; 1(2): 3.
62. Haywood K, Getchell N. Life span motor development. Human kinetics. Illinois: Champaign, IL; 2009: 5076-
6125.
63. Rajabi S, Yazdkhasti F. [The effectiveness of acceptance and commitment group therapy on anxiety and
depression in women with MS who were referred to the MS association]. Journal of clinical psychology 2014;
6(1): 29-38. (Persian)
64. Gilbert P. The origins and nature of compassion focused therapy. Br J Clin Psychol 2014; 53(1): 6-41.
65. Hutcherson CA, Seppala EM, Gross JJ. Loving-kindness meditation increases social connectedness. Emotion
2008; 8(5): 720.
66. Neff KD, Kirkpatrick KL, Rude SS. Self-compassion and adaptive psychological functioning. J Res Pers 2007;
41(1): 139-54.
67. Neff KD, Hsieh YP, Dejitterat K. Self-compassion, achievement goals, and coping with academic failure. Self
Identity 2005; 4(3): 263-87.
68. Paktinatan E, Chin Aveh M, Fereydouni S. [The effectiveness of acceptance and commitment group therapy
with a look at compassion therapy in cognitive regulation of negative emotions and social adjustment in patients
with major depressive disorder]. Scientific journal of social psychology 2020; 8: 73-86. (Persian)
69. Kolts Russell L. [CFT made simple: a clinician's guide to practicing compassion-focused therapy].
Golmohammadian M, Roghanchi M, Momeni KH, Voici S. )translators). Tehran: Arjmand; 2019. (Persian)
70. Gilbert P, Irons C. Focused therapies and compassionate mind training for shame and self-attacking.
71. Klatner D. The compassionate instinct. Greater good magazine. USA: UC Berkeley; 2004.
72. Feldman R, Weller A, Zagoory-Sharon O, Levine A. Evidence for a neuroendocrinological foundation of
human affiliation: plasma oxytocin levels across pregnancy and the postpartum period predict mother-infant
bonding. Psychol Sci 2007; 18(11): 965-70.
73. Yarnell LM, Neff KD. Self-compassion, interpersonal conflict resolutions, and well-being. Self Identity 2013;
12(2): 146-59.
74. Neff KD, Pommier E. The relationship between self-compassion and other-focused concern among college
undergraduate, community adults, and practicing mediators. Self Identity 2013; 12: 160-76.
75. Neff KD, Dahm KA. Self-compassion: What it is, what it does, and how it relates to mindfulness. Handbook
of mindfulness and self-regulation. New York, NY: Springer; 2015: 121-37.
76. Gilbert P. [Compassion focused therapy]. Esbati M, Feyzi A. (translators). Tehran; Ebn-e-Sina: 2018: 15-61.
(Persian)
77. Rezakhani R. [Comparison of the effectiveness of CFT-based compassion therapy and ACT-based therapy on
reducing symptoms in people with depressive disorder]. MA. Dissertation. Arsanjan: University of Arsanjan,
Faculty of psychology; 2017: 55-100. (Persian)
78. Gheibee A, Tajeri B, Kooshki S, Sobhi Gharamaleki N. [Comparison the effectiveness of acceptance and
commitment therapy and compassion therapy on components of subjective well-being (emotional, psychological
and social)]. Scientific journal of social psychology 2021; 9: 115-25. (Persian)
79. Rezaei AL, Sharifi T, Ghazanfari A, Aflaki E, Bahre Dar MJ. [Effectiveness of treatment based on acceptance
and commitment, compassion-based therapy and combination therapy on depression, anxiety quality of life in
patients with lupus]. Quarterly journal of health psycology 2020; 9: 127-44. (Persian)