Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Obsessive–compulsive disorder is a common psychological disorder that causes severe problems in an individual's life. In general, obsessive–compulsive disorder is characterized by symptoms such as repetitive and recurrent thoughts, images, or urges that cause the person to feel disturbed or anxious. Cognitive avoidance is a common feature of people with obsessive–compulsive disorder. It refers to the tendency of people with obsessions to try to suppress or avoid thoughts related to their obsessions. Experiential avoidance is another common feature of obsessive–compulsive disorder. Experiential avoidance refers to the tendency of people with obsessions to avoid or escape unpleasant feelings or situations that trigger their obsessions or compulsions. Acceptance and commitment therapy is an effective treatment for people with obsessive–compulsive disorder. Acceptance and commitment therapy focuses on helping people accept their thoughts and feelings without judgment while committing to actions that align with their values. Therefore, this study aims to determine the effectiveness of acceptance and commitment therapy on cognitive and experiential avoidance in people with obsessive–compulsive disorder.
Methods: The current research was quasi–experimental with a pretest–posttest design using a control group and an experimental group. The statistical population of this research included people with obsessions who were referred to counseling and psychology clinics in Mashhad City, Iran, in 2022. From the statistical population, 30 qualified volunteers were included in the study and were randomly assigned to two treatment–schema and control groups (each group included 15 people). The inclusion criteria were as follows: obtaining a score higher than 16 on the Yale–Brown obsession scale, bearing at least a diploma level of education, and not participating in other therapeutic interventions simultaneously. The exclusion criteria were as follows: absence of more than three sessions and disobeying the rules was group therapy. This research observed ethical standards including obtaining informed consent and ensuring privacy and confidentiality. Also, when participating in the research, the participants were free to withdraw from the research at any time and provide individual information. The implementation method was such that after selecting the people of the sample group and before starting the treatment program, the Cognitive Avoidance Questionnaires (Sexton & Daga, 2008) and the Multidimensional Experiential Avoidance Questionnaire (Gámez et al., 2011) were distributed between both groups. After that, acceptance and commitment therapy was implemented in the experimental group (in the form of 8 sessions of 90 minutes, each session once a week), and the control group was not subjected to any treatment program. In the end, the posttest was done again from both groups. Also, after the end of the research, the treatment program was also implemented on the control group to maintain the ethical standards in the research. Data analysis was carried out in two parts: descriptive statistics and inferential statistics. Univariate covariance analysis was used at the level of descriptive statistics, mean and standard deviation and at the inferential statistics level. Data analysis was done using SPSS software version 24, and the significance level of the tests was considered to be 0.05.
Results: The results showed that the effect of acceptance and commitment therapy on cognitive avoidance subscales, including repression, thought substitution, attention redirection, situational avoidance, and image change, as well as experiential avoidance variable subscales, including behavioral avoidance, aversion to disturbance, procrastination, distraction/stopping, and disturbance tolerance, was significant in the experimental group of people with obsessive–compulsive disorder (p<0.001).
Conclusion: Based on research findings, acceptance, and commitment therapy is an effective therapeutic approach for reducing cognitive avoidance and experiential avoidance in people with obsessive–compulsive disorder.