Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy on Death Anxiety and Feelings of Loneliness in Patients with Type 2 Diabetes
Keywords:
Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Death Anxiety, Feelings of Loneliness, Type 2 DiabetesAbstract
The present study aimed to determine the difference in the effectiveness of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on death anxiety and feelings of loneliness in patients with Type 2 diabetes. The present study employed a quasi-experimental pretest–posttest design with two experimental groups and one control group. The statistical population consisted of all female patients with Type 2 diabetes who were members of the Diabetes Association of Tehran in 2026. From among them, a sample of 45 eligible individuals was selected through convenience sampling and randomly assigned, while considering the inclusion and exclusion criteria, into three groups of 15 participants each (Cognitive Behavioral Therapy group, Acceptance and Commitment Therapy group, and control group). Data collection instruments included the Collett–Lester Death Anxiety Questionnaire (Collett & Lester, 1969), the Loneliness Questionnaire developed by Dehshiri et al. (Dehshiri et al., 2008), Cognitive Behavioral Therapy sessions (6 sessions of 60 minutes each), and Acceptance and Commitment Therapy sessions (8 sessions of 90 minutes each). Analysis of covariance (ANCOVA) was used to examine the research hypotheses. The findings indicated that both Cognitive Behavioral Therapy and Acceptance and Commitment Therapy significantly reduced death anxiety and feelings of loneliness in patients with Type 2 diabetes (P < 0.05). Furthermore, the results demonstrated that Acceptance and Commitment Therapy was more effective than Cognitive Behavioral Therapy in reducing death anxiety and feelings of loneliness (P < 0.05). It appears that ACT, by emphasizing acceptance of internal experiences, reduction of experiential avoidance, and enhancement of psychological flexibility, can facilitate patients’ psychological adjustment to the chronic conditions of the disease. Based on these findings, it can be concluded that the use of acceptance- and commitment-based interventions alongside medical care can play an effective role in improving the mental health of patients with Type 2 diabetes.
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Copyright (c) 2025 Parmida Soleimani; Zahra Shiri, Sima Farmanian , Sanaz Zeinali , Azam Faraji Zadkohan (Author)
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