A Comparison of the Effectiveness of Acceptance and Commitment Therapy and Compassion-Focused Therapy on Distress Tolerance among Women with Anxiety Symptoms

Abstract

Introduction: Distress tolerance, as a transdiagnostic construct, plays a pivotal role in the persistence of anxiety disorders. The present study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT) on distress tolerance among women with anxiety symptoms.

Methods:This was a quasi-experimental study employing a pretest–posttest control group design. The statistical population consisted of all women with anxiety symptoms referred to counseling centers in Bojnord, Iran, during 2025. A total of 45 participants were selected through convenience sampling and randomly assigned to three groups: ACT, CFT, and control (n=15 per group). The research instruments comprised the Beck Anxiety Inventory and the Distress Tolerance Scale. The experimental groups each received eight 90-minute weekly sessions of ACT and CFT, respectively, while the control group received no intervention.

Results: Analysis of covariance revealed statistically significant between-group differences in the distress tolerance (F=73/64, p=0/001) and all subscales (p<0/001). Effect sizes ranged from 0/32 to 0/78. Post-hoc comparisons indicated that both ACT and CFT produced significant improvements in the total score and all subscales of distress tolerance relative to the control group (p<0/001); however, no statistically significant difference was found between the two interventions (p>0/05).

Conclusion: ACT and CFT are equally effective and clinically viable transdiagnostic interventions for improving multiple dimensions of distress tolerance in women with anxiety symptoms. Clinicians may draw upon either protocol to enhance distress tolerance capacity in comparable clinical populations.