Comparing the Effectiveness of Acceptance and Commitment Therapy and Positive Psychotherapy on Perceived Stress and Health Anxiety in Women with Breast Cancer

Abstract

This study aimed to compare the effectiveness of Acceptance and Commitment Therapy and Positive Psychotherapy on perceived stress and health anxiety in women with breast cancer. This quasi-experimental study employed a pre-test, post-test, and follow-up design with two intervention groups and one control group. The statistical population consisted of women with breast cancer who referred to medical centers in Tehran, Iran, in 2023. A purposive sample of 45 eligible women was selected and randomly assigned to three groups: Acceptance and Commitment Therapy, Positive Psychotherapy, and control. Each intervention was delivered in ten 90-minute sessions. The Acceptance and Commitment Therapy protocol was based on Hayes et al.’s model, and the Positive Psychotherapy protocol was based on Seligman’s therapeutic approach. Data were collected using the Perceived Stress Scale and the Health Anxiety Inventory. Repeated measures analysis of variance and Bonferroni post hoc tests were used to analyze the data. Both Acceptance and Commitment Therapy and Positive Psychotherapy significantly reduced perceived stress and health anxiety in women with breast cancer at post-test and follow-up compared with the control group. The reductions were maintained at follow-up, indicating the stability of treatment effects. Comparative findings suggested that Acceptance and Commitment Therapy produced stronger reductions in perceived stress and health anxiety than Positive Psychotherapy. Acceptance and Commitment Therapy and Positive Psychotherapy are both effective psychological interventions for reducing perceived stress and health anxiety in women with breast cancer. However, Acceptance and Commitment Therapy may have a greater effect due to its emphasis on psychological flexibility, acceptance of distressing internal experiences, mindfulness, and value-based committed action. These findings support the integration of structured psychological interventions, particularly Acceptance and Commitment Therapy, into supportive care programs for women with breast cancer.