The Effectiveness of Acceptance and Commitment-Based Stress Management Training on Relapse Prevention and Cognitive Ability in Individuals with Substance Use Disorder

Abstract

This study aimed to determine the effectiveness of Acceptance and Commitment-based stress management training on relapse prevention and cognitive ability in individuals with substance use disorder. This applied study employed a quasi-experimental pretest–posttest design with a control group. The statistical population consisted of individuals with substance use disorder undergoing treatment at Parseh Substance Use Treatment Center in Qom in 2024–2025. Using purposive sampling, 64 eligible participants were selected and randomly assigned to an experimental group (n=32) and a control group (n=32). Data were collected using the Prediction of Relapse Scale (PRS) and the Cognitive Ability Questionnaire (CAQ). The experimental group received an eight-session Acceptance and Commitment-based stress management intervention, whereas the control group received no structured educational intervention during the study period. Data were analyzed using multivariate analysis of covariance (MANCOVA) and univariate analysis of covariance (ANCOVA) in SPSS version 27. The MANCOVA results indicated a statistically significant difference between the experimental and control groups in the combined dependent variables of relapse prevention and cognitive ability after controlling for pretest scores (p<0.001), with a strong overall intervention effect. The univariate ANCOVA results further demonstrated that Acceptance and Commitment-based stress management training had significant effects on both relapse prevention and cognitive ability (p<0.001). Specifically, the group effect accounted for 71.1% of the variance in relapse prevention and 61.1% of the variance in cognitive ability, indicating substantial intervention effects on both study outcomes. Acceptance and Commitment-based stress management training may effectively enhance relapse prevention and cognitive functioning among individuals with substance use disorder by strengthening acceptance of internal experiences, cognitive defusion, mindfulness, psychological flexibility, and value-based committed action. Accordingly, this intervention can be incorporated as a complementary psychological approach alongside routine substance use disorder treatment and rehabilitation programs to improve treatment outcomes and reduce vulnerability to relapse.