Comparing the Effectiveness of Acceptance and Commitment Therapy and Compassion-Focused Therapy on Psychological Well-Being in Mothers of Children with Educable Intellectual Disability
Keywords:
Acceptance and Commitment Therapy, Compassion-Focused Therapy, Psychological Well-Being, Mothers, Educable Intellectual DisabilityAbstract
Purpose: This study aimed to compare the effectiveness and durability of Acceptance and Commitment Therapy and Compassion-Focused Therapy on psychological well-being in mothers of children with educable intellectual disability.
Methods and Materials: The study employed a quasi-experimental pretest–posttest design with a follow-up stage and included two experimental groups and one control group. The statistical population consisted of mothers of students with educable intellectual disability in Lordegan during the 2024–2025 academic year. Using purposive sampling, 45 eligible mothers were selected and randomly assigned to three groups: Acceptance and Commitment Therapy, Compassion-Focused Therapy, and control, with 15 participants in each group. The first experimental group received nine weekly 90-minute sessions of Acceptance and Commitment Therapy, and the second experimental group received eight weekly 90-minute sessions of Compassion-Focused Therapy. The control group remained on a waiting list. Data were collected using Ryff’s Psychological Well-Being Scale at pretest, posttest, and follow-up. Data were analyzed using mixed-design repeated measures analysis of variance and Bonferroni post-hoc test in SPSS version 24.
Findings: The results showed a significant main effect of time on psychological well-being, F = 29.60, p = .0001, η² = .413. The interaction effect of time and group was also significant, F = 16.15, p = .0001, η² = .435, indicating that changes in psychological well-being differed significantly across groups. The between-group effect was significant as well, F = 3.96, p = .027, η² = .159. Bonferroni comparisons showed significant differences between Acceptance and Commitment Therapy and Compassion-Focused Therapy, between Acceptance and Commitment Therapy and control, and between Compassion-Focused Therapy and control. The posttest–follow-up difference was not significant, indicating stability of treatment effects.
Conclusion: Both interventions significantly improved psychological well-being in mothers of children with educable intellectual disability, but Acceptance and Commitment Therapy demonstrated greater effectiveness than Compassion-Focused Therapy, and the therapeutic gains remained stable at follow-up.
Downloads
References
Apanasionok, M. M., Paris, A., Griffin, J., Hastings, R. P., Finch, E., Austin, D., & Flynn, S. (2025). Digital Psychological Wellbeing Interventions for Family Carers of Children and Adults With Intellectual and Developmental Disabilities: A Systematic Review. Journal of Applied Research in Intellectual Disabilities, 38(4). https://doi.org/10.1111/jar.70081
Arnold, D. L., & McPherson, S. (2023). A Systematic Review on the Mental Health of Parents of Individuals With Learning Disabilities. Human Systems Therapy Culture and Attachments, 4(2), 59-75. https://doi.org/10.1177/26344041231217104
Bourne, J., Harrison, T. L., Wigham, S., Morison, C. J., & Hackett, S. (2021). A Systematic Review of Community Psychosocial Group Interventions for Adults With Intellectual Disabilities and Mental Health Conditions. Journal of Applied Research in Intellectual Disabilities, 35(1), 3-23. https://doi.org/10.1111/jar.12919
Branjerdporn, G., Hussain, B., Roberts, S., & Creedy, D. (2022). Uncovering the Model and Philosophy of Care of a Psychiatric Inpatient Mother-Baby Unit in a Qualitative Study With Staff. International journal of environmental research and public health, 19(15), 9717. https://doi.org/10.3390/ijerph19159717
Cross, M., Abdul-Karim, Y., Johnson, A. R., Victor, C., & Rosenfeld, A. (2024). Healing Together: A Narrative Review on How Psychiatric Treatment for Parental Depression Impacts Children. International journal of environmental research and public health, 21(3), 367. https://doi.org/10.3390/ijerph21030367
D'Abaco, E., Khano, S., Giles-Kaye, A., Dhaliwal, J., Haslam, R., Prakash, C., & Hiscock, H. (2024). Impact of a Collaborative Model on Community Clinician Confidence in Child and Adolescent Mental Health Care, Wellbeing, and Access to Child Psychiatry Expertise. PLoS One, 19(9), e0310377. https://doi.org/10.1371/journal.pone.0310377
Davis, J., Ohan, J. L., Bear, N., Gibson, L., Silva, D., Prescott, S. L., & Finlay‐Jones, A. (2023). “Stop, Pause and Take a Break”: A Mixed Methods Study of the Longer- Term Outcomes of Digital Emotional Wellbeing Training for Perinatal Women. https://doi.org/10.21203/rs.3.rs-3294358/v1
Desiningrum, D. R., Suminar, D. R., & Surjaningrum, E. R. (2021). Husband’s Social Support, Emotional Competence and Compassionate Love in Mother of Children With Autism Spectrum Disorder. https://doi.org/10.2991/assehr.k.210423.039
Finucane, A., Hulbert‐Williams, N. J., Swash, B., Spiller, J., Lydon, B., & Gillanders, D. (2022). Research Evaluating Staff Training Online for Resilience (RESTORE): Protocol for a Single-Arm Feasibility Study of an Online Acceptance and Commitment Therapy Intervention to Improve Staff Wellbeing in Palliative Care Settings. Amrc Open Research, 3, 26. https://doi.org/10.12688/amrcopenres.13035.2
Francis, J., Vella‐Brodrick, D., & Chyuan-Chin, T. (2021). Effectiveness of Online, School-Based Positive Psychology Interventions to Improve Mental Health and Wellbeing: A Systematic Review. International Journal of Wellbeing, 11(4), 44-67. https://doi.org/10.5502/ijw.v11i4.1465
Henrichs, J., & Witteveen, A. B. (2022). Commentary: Promoting Positive Mental Health During Pregnancy—reflections on Lähdepuro Et al. (2023). Journal of Child Psychology and Psychiatry, 64(5), 817-819. https://doi.org/10.1111/jcpp.13727
Howard, L. R., Earleywine, M., DeCount, T. A., & Forsyth, J. P. (2026). Acceptance and Commitment Therapy (ACT) for Comorbid Generalized Anxiety Disorder and Premenstrual Dysphoric Disorder: A Transdiagnostic Approach. Clinical Case Studies. https://doi.org/10.1177/15346501261421541
Hunter, S., & Dickson, C. (2024). Women's Experiences of the Transition to Motherhood and Self-Compassion. Journal of Family and Child Health, 1(1), 28-39. https://doi.org/10.12968/jfch.2024.1.1.28
Jalongo, M. R., & Guth, L. J. (2022). Animal-Assisted Counseling for Young Children: Evidence Base, Best Practices, and Future Prospects. Early Childhood Education Journal, 51(6), 1035-1045. https://doi.org/10.1007/s10643-022-01368-5
Kertesz, M., Humphreys, C., Fogden, L., Scott, K., Laslett, A. M., & Tsantefski, M. (2022). KODY, an All-of-Family Response to Co-Occurring Substance Use and Domestic Violence: Protocol for a Quasi-Experimental Intervention Trial. BMC public health, 22(1). https://doi.org/10.1186/s12889-022-12529-x
Kirby, J. N., Hoang, A., & Ramos, N. (2023). A Brief Compassion Focused Therapy Intervention Can Help Self‐critical Parents and Their Children: A Randomised Controlled Trial. Psychology and Psychotherapy Theory Research and Practice, 96(3), 608-626. https://doi.org/10.1111/papt.12459
Lau‐Zhu, A., & Vella, L. (2023). A Compassion-Focused Therapy Group for Young People Who Live in Foster, Adoptive or Kinship Care: Initial Development, Reflections, and Ways Forward. Adoption & Fostering, 47(4), 400-414. https://doi.org/10.1177/03085759231207397
Layard, R., & Neve, J. E. D. (2023). Wellbeing. https://doi.org/10.1017/9781009298957
Leadbitter, K., Harrison, L., Langhorne, S., Ellis, C., Smallman, R., Pearson, A., Hackett, L., Kroll, L., Dunkerley, A., Beach, H. H. A., Gilbert, J., Gils, A. v., Hutton, T., Green, J., & Bee, P. (2024). The Development, Feasibility and Acceptability of Empower-Autism: A New Psychoeducational and Psychotherapeutic Programme for Caregivers of Children Recently Diagnosed With Autism. Autism, 29(2), 367-381. https://doi.org/10.1177/13623613241274566
Leadbitter, K., Smallman, R., James, K., Shields, G., Ellis, C., Langhorne, S., Harrison, L., Hackett, L., Dunkerley, A., Kroll, L., Davies, L., Emsley, R., Bee, P., Green, J., Ahmed, S. B., Beach, H. H. A., Butter, C., Gilbert, J., Goldie, C., . . . Gils, A. v. (2022). REACH-ASD: A UK Randomised Controlled Trial of a New Post-Diagnostic Psycho-Education and Acceptance and Commitment Therapy Programme Against Treatment-as-Usual for Improving the Mental Health and Adjustment of Caregivers of Children Recently Diagnosed With Autism Spectrum Disorder. Trials, 23(1). https://doi.org/10.1186/s13063-022-06524-1
Lloyd-Collins, T. M., Fitzallen, G. C., & Kirby, J. N. (2025). A Compassion-Focused Approach to Support Parents After Preterm Birth. Clinical Child and Family Psychology Review. https://doi.org/10.1007/s10567-025-00549-z
Martin, J., Robertson, K., Richards, C., Scerif, G., Baker, K. S., & Tye, C. (2023). Experiences of Parents of Children With Rare Neurogenetic Conditions During the COVID-19 Pandemic: An Interpretative Phenomenological Analysis. BMC psychology, 11(1). https://doi.org/10.1186/s40359-023-01205-3
Millard, L. A., & Wittkowski, A. (2023). Compassion Focused Therapy for Women in the Perinatal Period: A Summary of the Current Literature. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1288797
Murfield, J., Moyle, W., & O’Donovan, A. (2021). Mindfulness- And Compassion-Based Interventions for Family Carers of Older Adults: A Scoping Review. International journal of nursing studies, 116, 103495. https://doi.org/10.1016/j.ijnurstu.2019.103495
Nica, A. (2025). From Family Estrangement to Empowered Exits: New Emotional Developments. Frontiers in Sociology, 10. https://doi.org/10.3389/fsoc.2025.1663618
O'Boyle-Finnegan, Ú., Graham, C. D., Doherty, N., & Adair, P. (2022). Exploring the Contribution of Psychological Flexibility Processes and Self-Compassion to Depression, Anxiety and Adjustment in Parents of Preterm Infants. Journal of Contextual Behavioral Science, 24, 149-159. https://doi.org/10.1016/j.jcbs.2022.05.002
Patterson, C. W., & Golightly, M. (2022). Adults With Intellectual Disabilities and Third‐wave Therapies: A Systematic Review and meta‐ethnography. Journal of Applied Research in Intellectual Disabilities, 36(1), 13-27. https://doi.org/10.1111/jar.13045
Perkins, A., Meiser‐Stedman, R., Spaul, S. W., Bowers, G., Perkins, A. G., & Pass, L. (2022). The Effectiveness of Third Wave Cognitive Behavioural Therapies for Children and Adolescents: A Systematic Review And meta‐analysis. British Journal of Clinical Psychology, 62(1), 209-227. https://doi.org/10.1111/bjc.12404
Prest, K. (2026). Feasibility of an Adapted Participatory Group Programme for Caregivers of Children With Complex Neurodisability in the United Kingdom: Results From the Encompass-2 Study. https://doi.org/10.64898/2026.02.11.26346106
Rawlings, G. H., Wright, K., Rolling, K., & Beail, N. (2021). Telephone-Delivered Compassion-Focused Therapy for Adults With Intellectual Disabilities: A Case Series. Advances in Mental Health and Intellectual Disabilities, 15(2/3), 89-103. https://doi.org/10.1108/amhid-12-2020-0035
Roy, R., Leadbitter, K., Shields, G., Taylor, C., Aldred, C., Juneja, M., Gulati, S., Vajaratkar, V., Davies, L., Emsley, R., Patel, V., Divan, G., Green, J., & Team, C. (2023). A Randomised Controlled Trial of Clinical and Cost-Effectiveness of the PASS Plus Intervention for Young Children With Autism Spectrum Disorder in New Delhi, India: Study Protocol for the COMPASS Trial. https://doi.org/10.21203/rs.3.rs-2353521/v1
Shaw, K. L., & Bridgman, G. (2023). Creating Appreciation and Community Support for Mothers Caring for a Child With an Anxiety Disorder. https://doi.org/10.34074/mono.097
Skovbjerg, S., Sumbundu, A., Kolls, M. L., Kjærbye-Thygesen, A., & Fjorback, L. O. (2023). The Effect of an Adapted Mindfulness-Based Stress Reduction Program on Mental Health, Maternal Bonding and Birth Outcomes in Psychosocially Vulnerable Pregnant Women: A Study Protocol for a Randomized Controlled Trial in a Danish Hospital-Based Outpatient Setting. BMC Complementary Medicine and Therapies, 23(1). https://doi.org/10.1186/s12906-023-04194-3
Tan-Ho, G., Choo, P. Y., Patinadan, P. V., Low, X. C., & Ho, A. H. Y. (2020). Blessings or Burdens: An Interpretative Phenomenological Analysis (IPA) Study on the Motivations and Their Impact on End-of-Life Caregiving Among Asian Family Caregivers. BMC Palliative Care, 19(1). https://doi.org/10.1186/s12904-020-00638-6
Vereijken, F. R., Giesbers, S. A. H., Jahoda, A., & Embregts, P. J. C. M. (2021). Homeward Bound: Exploring the Motives of Mothers Who Brought Their Offspring With Intellectual Disabilities Home From Residential Settings During the COVID‐19 Pandemic. Journal of Applied Research in Intellectual Disabilities, 35(1), 150-159. https://doi.org/10.1111/jar.12930
Willems, L., Vacaru, S. V., Hokke, H., & Sterkenburg, P. S. (2022). A Scoping Literature Review on Compassion-Focused Therapy for Individuals With Intellectual Disability. Obm Integrative and Complementary Medicine, 07(03), 1-19. https://doi.org/10.21926/obm.icm.2203037
Wren, B., Launer, J., Music, G., Reiß, M., & Swanepoel, A. (2020). Can an Evolutionary Perspective Shed Light on Maternal Abuse of Children? Clinical Child Psychology and Psychiatry, 26(1), 283-294. https://doi.org/10.1177/1359104520974418
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Jamileh Gholami Tolmarani (Author); Tayebeh Sharifi (Corresponding author); Fariba Kiani (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
