A Comparison of the Effectiveness of Acceptance and Commitment Therapy and Cognitive Behavioral Interventions on Ego Development in Adolescent Girls with Suicidal Thoughts

Abstract

This study aimed to compare the effectiveness of Acceptance and Commitment Therapy and Cognitive Behavioral Therapy on ego development in adolescent girls with suicidal thoughts. This applied quasi-experimental study used a pretest–posttest design with two experimental groups and one control group. The statistical population included all female lower-secondary school students in Varamin during the 2023–2024 academic year who had suicidal thoughts. Using purposive sampling, 45 students who scored above 6 on the Beck Scale for Suicide Ideation and whose suicidal ideation was confirmed through diagnostic interviews were selected. Participants were then randomly assigned to three equal groups: the Cognitive Behavioral Therapy group, the Acceptance and Commitment Therapy group, and the control group, with 15 participants in each group. The research instruments included the Beck Scale for Suicide Ideation and Loevinger’s Ego Development Test. The two experimental groups received eight intervention sessions, held twice weekly, with each session lasting 90 minutes, whereas the control group received no intervention during the study period. Data were analyzed using analysis of covariance and Bonferroni post hoc comparisons. The results of analysis of covariance indicated a significant intervention effect on the total score of ego development. Bonferroni pairwise comparisons showed that the Cognitive Behavioral Therapy group had significantly higher ego development scores than the control group. Similarly, the Acceptance and Commitment Therapy group demonstrated significantly higher ego development scores compared with the control group. However, no statistically significant difference was found between the Acceptance and Commitment Therapy and Cognitive Behavioral Therapy groups in terms of ego development. These inferential findings indicate that both interventions were effective compared with the control condition, while neither intervention showed superior effectiveness over the other. The findings suggest that both Cognitive Behavioral Therapy and Acceptance and Commitment Therapy are effective approaches for improving ego development among adolescent girls with suicidal thoughts. However, the absence of a significant difference between the two interventions indicates that both approaches may have comparable therapeutic value for this population.