Comparison of the Effectiveness of Acceptance and Commitment-Based Group Therapy and Quality of Life Therapy on Cognitive Fusion, Quality of Life, and Anxiety in Students with Diabetes
Keywords:
group therapy based on acceptance and commitment, quality of life therapy, cognitive fusion, quality of life, anxiety, diabetesAbstract
Purpose: The present study aimed to compare the effectiveness of acceptance and commitment-based group therapy and quality of life therapy on cognitive fusion, quality of life, and anxiety among students with diabetes.
Methods and Materials: This study employed a semi-experimental design with pre-test, post-test, and follow-up phases along with a control group. The statistical population consisted of all students with diabetes in Zahedan. Using convenience sampling, 45 participants who obtained scores above the average on measures of cognitive fusion, anxiety, and impaired quality of life were selected and randomly assigned into two experimental groups and one control group (15 participants in each group). The first experimental group received acceptance and commitment-based group therapy, while the second experimental group participated in quality of life therapy sessions. Both interventions were implemented in eight weekly two-hour sessions. Data collection instruments included the Cognitive Fusion Questionnaire developed by Gillanders and colleagues, the Revised Children’s Manifest Anxiety Scale developed by Reynolds and Richmond, and the Diabetes Quality of Life Questionnaire for Adolescents. Data were analyzed using multivariate analysis of covariance through SPSS-22 software.
Findings: The findings demonstrated that both acceptance and commitment-based therapy and quality of life therapy significantly improved cognitive fusion, quality of life, and anxiety compared with the control group in the post-test and follow-up stages (P<0.05). The multivariate covariance analysis indicated significant differences among the groups on the combined dependent variables in both post-test and follow-up phases. Furthermore, pairwise comparisons showed that acceptance and commitment-based therapy was significantly more effective than quality of life therapy in reducing cognitive fusion and increasing defusion, whereas quality of life therapy produced greater improvement in quality of life scores. No statistically significant difference was observed between the two interventions regarding anxiety reduction. The therapeutic gains remained stable during the follow-up phase, indicating the durability of treatment effects over time.
Conclusion: The results suggest that both acceptance and commitment-based group therapy and quality of life therapy are effective psychological interventions for improving cognitive fusion, quality of life, and anxiety in students with diabetes. Acceptance and commitment therapy appears to be particularly effective in modifying maladaptive cognitive fusion processes, while quality of life therapy demonstrates greater efficacy in enhancing perceived life satisfaction and well-being. Therefore, integrating these therapeutic approaches into psychological and educational support services for adolescents with diabetes may contribute substantially to their psychological adjustment and overall quality of life.
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Copyright (c) 2025 Habib Keykha (Author); Ali Farnam; Hossein Jenaabadi (Author)
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