Comparing the Effectiveness of Acceptance and Commitment Therapy and Cognitive Behavioral Therapy on Anxiety and Quality of Life in Patients with Chronic Pain

Abbasi , Mehri; Ahmadi, Vahid; Mami, Shahram; Soleimannejad , Homaira; Mihandoost , Zainab

Volume 15 - Articles-1404 MEJDS (2025) 15: 65 | Back to browse issues page

Research code: IR.IAU.ILAM.REC.1402.041

Ethics code: IR.IAU.ILAM.REC.1402.041

Clinical trials code: IR.IAU.ILAM.REC.1402.041

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Abbasi M, Ahmadi V, Mami S, Soleimannejad H, Mihandoost Z. Comparing the Effectiveness of Acceptance and Commitment Therapy and Cognitive Behavioral Therapy on Anxiety and Quality of Life in Patients with Chronic Pain. MEJDS 2025; 15 (0) :65-65
URL: http://jdisabilstud.org/article-1-3630-en.html

Comparing the Effectiveness of Acceptance and Commitment Therapy and Cognitive Behavioral Therapy on Anxiety and Quality of Life in Patients with Chronic Pain

Mehri Abbasi¹

, Vahid Ahmadi ^*¹

, Shahram Mami¹

, Homaira Soleimannejad¹

, Zainab Mihandoost¹

1- Department of Psychology, Ilam Branch, Islamic Azad University, Ilam, Iran

Abstract: (361 Views)

Abstract
Background & Objectives: Pain is classified based on its duration into two types: acute and chronic. Persistence of pain beyond three months is defined as chronic pain. Chronic pain is a debilitating condition in which the individual not only suffers from the distress caused by the pain itself but also faces numerous other stressors that affect various aspects of life. Anxiety and reduced quality of life are common problems among patients with chronic pain. Acceptance and commitment therapy is known to be one of the effective methods in reducing psychological problems of patients with chronic pain. Acceptance and commitment therapy (ACT) is a process–oriented approach that considers psychological damage to be caused by reduced psychological flexibility. Among the effective treatments in reducing psychological problems in patients with chronic pain is cognitive–behavioral therapy (CBT), which has a significant impact on managing these problems. Psychological interventions such as ACT and CBT may be effective in improving patients with chronic pain. So, the present study aimed to compare the effectiveness of ACT and CBT in reducing anxiety and improving quality of life in patients with chronic pain.
Methods: The present quasi–experimental study employed a pretest–posttest and a follow–up design with three groups (two experimental groups and one control group). The statistical population consisted of all patients with chronic pain who visited healthcare centers affiliated with Kermanshah University of Medical Sciences, as well as the offices of pain specialists and subspecialists in Kermanshah City, Iran, between March 2023 and March 2024. From this population, 69 eligible and willing participants (23 per group) were recruited using convenience sampling. The inclusion criteria were as follows: confirmed diagnosis of chronic pain, an age range of 25 to 55 years, ability to attend therapy sessions, and provision of informed consent, absence of acute or chronic psychiatric disorders, not receiving concurrent psychological treatment, and no use of psychiatric medication within the past three months. The exclusion criteria included lack of cooperation, failure to complete assigned homework during sessions, and absence from more than two sessions. Participants were randomly assigned to the two experimental groups and one control group, after which the pretest questionnaires were administered. The study instruments were the Pain Anxiety Symptoms Scale (McCracken & Dhingra, 2002) and the World Health Organization Quality of Life Questionnaire (WHOQOL, 1996). The first experimental group received ACT, as outlined in the protocol by Hayes et al. (2012), while the second experimental group received CBT, as outlined in the protocol by Rudd (2012), both delivered in eight 90–minute sessions. Data analysis included analysis of variance (ANOVA) and Chi–square test to assess group homogeneity, and repeated measures ANOVA with Bonferroni post hoc tests for outcome comparisons. Analyses were conducted using SPSS version 26 at a significance level of 0.05.
Results: The results indicated that the effect of time (p<0.001, η²=0.969), group (p<0.001, η²=0.931), and the interaction effect of time and group (p<0.001, η²=0.940) on pain anxiety were statistically significant. Similarly, the effect of time (p<0.001, η²=0.974), group (p<0.001, η²=0.923), and the interaction effect of time and group (p<0.001, η²=0.949) on quality of life were statistically significant. In the pretest stage, there were no significant differences among the three groups in the mean scores of pain, anxiety, and quality of life (p>0.05). However, in the posttest and follow–up stages, significant differences were observed in the mean scores of pain, anxiety, and quality of life between the ACT group and the CBT group compared to the control group (p<0.001). Nonetheless, there were no significant differences between the two therapy groups (p>0.05).
Conclusion: The results of this study indicated that both therapeutic approaches of ACT and CBT are significantly effective in reducing anxiety and improving the quality of life in patients with chronic pain, with neither method demonstrating statistically significant superiority over the other.

Keywords: Acceptance and commitment therapy, Cognitive behavioral therapy, Anxiety, Quality of life, Patients with chronic pain

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Type of Study: Original Research Article | Subject: Psychology

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