Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: With the increasing life expectancy of patients with thalassemia major, children affected by this condition face greater educational needs. These students often exhibit lower academic performance compared to their peers, primarily due to frequent absences for medical treatment, heightened test anxiety, and reduced academic self–efficacy. This study aimed to evaluate the effectiveness of group therapy based on acceptance and commitment in improving academic self–efficacy and reducing test anxiety among students with thalassemia.
Methods: This quasi–experimental study employed a pretest–posttest and follow–up design with a control group. A sample of 60 first– and second–grade primary school students with thalassemia major was selected using a convenience sampling method and randomly assigned to either the experimental group (n=30) or the control group (n=30). The experimental group received eight 120–minute sessions of acceptance and commitment–based group therapy (28 participants completed the sessions), while the control group received no intervention (n=28 after excluding two participants). The Sarason Test Anxiety Scale and Gink & Morgan’s Academic Self–Efficacy Scale were administered at three time points: before the intervention, immediately after the intervention, and two months after the intervention. Data were analyzed using SPSS Version 20 at a significance level of 0.05, employing both descriptive and inferential statistics.
Results: The results indicated that the mean academic self–efficacy scores in the experimental group increased from the pretest to the posttest and remained elevated at follow–up. In contrast, the control group showed no significant changes across the three phases. Additionally, test anxiety scores in the control group did not differ significantly between the pretest and posttest. Repeated–measures analysis of variance revealed that the time factor significantly affected academic self–efficacy (p<0.001, effect size=0.907), and the interaction between time and group was also significant (p<0.001, effect size=0.920). Significant differences were observed between the pretest and posttest, as well as between the pretest and follow–up, and between the posttest and follow–up scores in academic self–efficacy. Overall, there was a significant difference between the two groups across all three assessment stages (p<0.001) for both academic self–efficacy and test anxiety.
Conclusion: Given the importance of effective psychological interventions in educational contexts, group therapy based on acceptance and commitment appears to be a promising approach for addressing academic challenges in students with thalassemia major.