A Comparison of the Effectiveness of Reality Therapy and Acceptance and Commitment Therapy on Meaning in Life Among Elderly Clients Attending day Rehabilitation Centers in Tehran

Authors

    Somayeh Azimi Department of Psychology, Ilam Branch, Islamic Azad University, Ilam, Iran.
    Satar Keikhavani Department of Psychology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
    Vahid Ahmadi * Department of Psychology, Ilam Branch, Islamic Azad University, Ilam, Iran Vahid_ahmadi20@yahoo.com
    Sareh Mirshekar Department of Psychology, Ilam Branch, Islamic Azad University, Ilam, Iran.

Keywords:

Acceptance and commitment therapy, elderly, meaning of life, reality therapy

Abstract

Objective: This study aimed to compare the effectiveness of Reality Therapy and Acceptance and Commitment Therapy (ACT) on the meaning in life among elderly individuals attending day rehabilitation centers in Tehran.

Methodology: A semi-experimental design with pre-test, post-test, and follow-up stages including a control group was applied. Ninety elderly participants (aged 65–80) were selected via purposive sampling and randomly assigned to three groups: Reality Therapy, ACT, and control (30 each). Experimental groups received 8 weekly 90-minute group therapy sessions based on Glasser’s and Hayes’ respective therapeutic models. Data were collected using the Meaning in Life Questionnaire (Steger et al., 2006) and analyzed with repeated measures ANOVA.

Findings: Findings showed significant increases in both “presence of meaning” and “search for meaning” in the post-test and follow-up stages for both treatment groups compared to the control group (P<0.05). There was no significant difference between the two experimental groups in their impact on meaning in life (P>0.05), suggesting that both interventions were equally effective in enhancing the sense of life meaning among the elderly.

Conclusion: Reality Therapy and Acceptance and Commitment Therapy are both effective interventions for improving meaning in life in the elderly population and are recommended for psychological interventions in rehabilitation centers.

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References

Asgari, S., & Shafiee, H. (2017). Prediction of elderly quality of life based on internal coherence, mindfulness and spiritual intelligence. Positive Psychology Research, 3(3), 61-74. https://doi.org/10.22108/ppls.2018.110352.1384

Azizpour, A., Azmoudeh, M., Ayromlou, H., & Hoseini Nasab, S. D. (2025). The effectiveness of acceptance and commitment therapy and compassion-focused therapy on death anxiety and fear of falling in patients with multiple sclerosis: A quasi-experimental study [Research]. Journal of Rafsanjan University of Medical Sciences, 23(8), 677-690. https://doi.org/10.61186/jrums.23.8.677

Bahrami, L., Mohammadi-Shahboulaghi, F., Rahgoy, A., & Biglarian, A. (2021). Predicting coping strategies based on spiritual health and resilience in the elderly in Tehran [Research]. Journal of nursing education, 9(1), 56-65. http://ijpn.ir/article-1-1740-fa.html

Behzadi, S., Tajeri, B., Sodagar, S., & Shariati, Z. (2021). The comparison of the effectiveness of acceptance, commitment, and reality therapy on life satisfaction and self-care behaviors of the elderly with type II diabetes. Applied Family Therapy Journal (AFTJ), 2(4), 483-501. https://journals.kmanpub.com/index.php/aftj/article/view/827

Borawski, D., Siudak, A., Pawelec, A., Rozpara, B., & Zawada, M. (2021). The interplay between loneliness, mindfulness, and presence of meaning. Does search for meaning matter? Personality and individual differences, 172, 110580. https://doi.org/10.1016/j.paid.2020.110580

Bowins, B. (2021). Chapter 11 - Acceptance and commitment therapy. In B. Bowins (Ed.), States and Processes for Mental Health (pp. 107-114). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-323-85049-0.00011-8

Chin, F., & Hayes, S. C. (2017). Chapter 7 - Acceptance and Commitment Therapy and the Cognitive Behavioral Tradition: Assumptions, Model, Methods, and Outcomes. In S. G. Hofmann & G. J. G. Asmundson (Eds.), The Science of Cognitive Behavioral Therapy (pp. 155-173). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-12-803457-6.00007-6

Chockalingam, A., Singh, A., & Kathirvel, S. (2024). Chapter 12 - Healthy aging and quality of life of the elderly. In S. Kathirvel, A. Singh, & A. Chockalingam (Eds.), Principles and Application of Evidence-based Public Health Practice (pp. 187-211). Academic Press. https://doi.org/10.1016/B978-0-323-95356-6.00007-0

Crego, A., Yela, J. R., Gómez-Martínez, M. Á., Riesco-Matías, P., & Petisco-Rodríguez, C. (2021). Relationships between mindfulness, purpose in life, happiness, anxiety, and depression: Testing a mediation model in a sample of women. International journal of environmental research and public health, 18(3), 1-15.

de Almeida Roediger, M., de Fátima Nunes Marucci, M., Duim, E. L., Santos, J. L. F., de Oliveira Duarte, Y. A., & de Oliveira, C. (2019). Inflammation and quality of life in later life: findings from the health, well-being and aging study (SABE). Health and Quality of Life Outcomes, 17(1), 26. https://doi.org/10.1186/s12955-019-1092-2

Delkhah, Z., Alivandi Vafa, M., & Moheb, N. (2024). The Relationship of Meaning in Life, Self-compassion, and Perceived Social Support With Fear of Aging: The Mediating Role of Spiritual Well-being [Research]. Salmand: Iranian Journal of Ageing, 18(4), 570-587. https://doi.org/10.32598/sija.2023.3576.1

Emamdoost, Z., Teimory, S., Khoynezhad, G. R., & Rajaei, A. R. (2020). Comparison of effectiveness of mindfulness based cognitive therapy and reality therapy in attitudes of parents toward their children in mothers of children with Autism spectrum disorders. medical journal of mashhad university of medical sciences, 62(5.1), 722-731. https://doi.org/10.22038/mjms.2020.15582

Fotoukian, Z., Mohammadi Shahboulaghi, F., & Fallahi Khoshknab, M. (2013). Analytical on empowerment interventions in older people with chronic disease: A review literature [Research]. Journal of Health Promotion Management, 2(4), 65-76. http://jhpm.ir/article-1-239-fa.html

Glasser, C. (2019). A choice theory psychology guide to happiness: How to make yourself happy (the choice theory in action series). In. Independently published.

Glasser, W. (2001). Counseling with Choice Theory. Harper Perennial. https://books.google.ch/books/about/Counseling_with_Choice_Theory.html?id=8pgapP2X9_AC&redir_esc=y

Glasser, W. (2003). For Parents and Teenagers: Dissolving the Barrier Between You and Your Teen. Harper Perennial. https://books.google.ch/books/about/For_Parents_and_Teenagers.html?id=av_HzgEACAAJ&redir_esc=y

Glasser, W. (2013). Take charge of your life: How to get what you need with Choice Theory Psychology. IUniverse Publishing.

Habibi, K., Alimohammadzadeh, K., & Hojjati, H. (2018). The effect of group reality therapy on the coping of spouses of veterans with post-traumatic stress disorder [Research]. Journal of Health Promotion Management, 6(6), 1-7. https://doi.org/10.21859/jhpm-07041

Hayes, S. C., Strosahl K, Wilson KG. (2012). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

He, X.-X., Wang, X.-q., Steger, M. F., Ji, L.-J., Jing, K., Liu, M.-f., & Ye, B.-j. (2023). Meaning in life and psychological distress: A meta-analysis. Journal of research in personality, 104, 104381. https://doi.org/10.1016/j.jrp.2023.104381

Jafari, A., & Hesampour, F. (2017). Predicting Life Satisfaction Based On Spiritual Intelligence and Psychological Capital in Older People [Applicable]. Salmand: Iranian Journal of Ageing, 12(1), 90-103. https://doi.org/10.21859/sija-120190

Javanbakht, Z., & Manshey, G. (2017). The Effectiveness of Acceptance and Commitment Based Treatment on Meaning of Life and Feeling Lonely of Adolescents in the Alternative Care Center [اثربخشی درمان مبتنی بر پذیرش و تعهد بر معنای زندگی و احساس تنهایی نوجوانان مراکز شبه خانواده]. socialwm, 5(4), 39. http://socialworkmag.ir/article-1-165-fa.html

Khorani, J., Ahmadi, V., Mami, S., & Valizadeh, R. (2020). The Effects of Acceptance and Commitment Therapy on the Meaning of Life, Life Satisfaction, Cognitive Flexibility, and Suicidal Ideation in Individuals with Depression [Original Research Article]. Middle Eastern Journal of Disability Studies­­­, 10(1), 1-10. http://jdisabilstud.org/article-1-1813-fa.html

Klimczak, K. S., & Levin, M. E. (2023). Acceptance and commitment therapy. In H. S. Friedman & C. H. Markey (Eds.), Encyclopedia of Mental Health (Third Edition) (pp. 1-9). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-323-91497-0.00121-1

Koosha, M., Hezarjaribi, J., Allameh, H., Panahi, M. A., & Lalegani, A. (2025). Designing a Policy Model for Enhancing Social Health of the Elderly. Archives of Gerontology and Geriatrics Plus, 2(2), 1-10. https://doi.org/10.1016/j.aggp.2025.100149

Lennon, B. (2019). A Choice Theory Psychology Guide to Stress: Ways of Managing Stress in Your Life. Independently published. https://books.google.ch/books/about/A_Choice_Theory_Psychology_Guide_to_Stre.html?id=Ld_ZxQEACAAJ&redir_esc=y

Malakouti, S. K., Javan-Noughabi, J., Yousefzadeh, N., Rezapour, A., Mortazavi, S. S., Jahangiri, R., & Moghri, J. (2021). A Systematic Review of Potentially Inappropriate Medications Use and Related Costs Among the Elderly. Value Health Reg Issues, 25, 172-179. https://doi.org/10.1016/j.vhri.2021.05.003

Mazaheri Tehrani, F., Kokali, M., Savabi Niri, V., & Bikas Yekani, M. (2022). The Effectiveness of Reality Therapy on Cognitive Flexibility and Self-Differentiation in Mothers with Children with Special Learning Disorders [Research]. Quarterly Journal of Child Mental Health, 9(1), 84-99. https://doi.org/10.52547/jcmh.9.1.7

Moini, J., Akinso, O., Ferdowsi, K., & Moini, M. (2023). Chapter 8 - Elderly health. In J. Moini, O. Akinso, K. Ferdowsi, & M. Moini (Eds.), Health Care Today in the United States (pp. 171-191). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-323-99038-7.00028-X

Mottaghi, R., Maredpour, A., & Karamin, S. (2022). A Comparison Study on the Effectiveness of Acceptance and Commitment Therapy and Sleep Hygiene Education on Sleep Quality and Physiological Parameters in Older Adults [Research]. Salmand: Iranian Journal of Ageing, 17(2), 170-185. https://doi.org/10.32598/sija.2022.1438.3

Naghiyaee, M., Bahmani, B., & Asgari, A. (2020). The psychometric properties of the Meaning in Life Questionnaire (MLQ) in patients with life-threatening illnesses. Scientific World Journal, 2020(1), 1-8. https://doi.org/10.1155/2020/8361602

Pruchno, R. (2021). Chapter 19 - Successful Aging: An Obscure but Obvious Construct. In K. W. Schaie & S. L. Willis (Eds.), Handbook of the Psychology of Aging (Ninth Edition) (pp. 301-318). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-12-816094-7.00008-8

Robey, P., Burdenski, T. K., Britzman, M., Crowell, J., & Cisse, G. S. (2011). Systemic Applications of Choice Theory and Reality Therapy: An Interview With Glasser Scholars. The Family Journal, 19(4), 427-433. https://doi.org/10.1177/1066480711415038

Rudnicka, E., Napierała, P., Podfigurna, A., Męczekalski, B., Smolarczyk, R., & Grymowicz, M. (2020). The World Health Organization (WHO) approach to healthy ageing. Maturitas, 139, 6-11. https://doi.org/10.1016/j.maturitas.2020.05.018

Sepas, L., Shaker Dioulag A, Khademi A. (2022). Comparison of the effectiveness of acceptance-based therapy and reality therapy on reducing anxiety sensitivity in women with MS in Urmia. Counseling Culture and Psycotherapy, 13(51), 85-113. https://doi.org/10.22054/qccpc.2022.64043.2808

Shahsavari, F., ansary, m., & elmimanesh, N. (2025). The Effectiveness of Reality Therapy on the Life Adjustment after Divorce and Meaning of Life in Divorced Heads of Household Women in Isfahan City. Knowledge & Research in Applied Psychology, 98(25), 175-190. https://doi.org/10.30486/jsrp.2023.1978995.3673

Shishefar, S., Kazemi F, Pezeshk Sh. (2017). The effectiveness of reality therapy training to increase happiness and responsibility in the mothers of children with Autism disorder. Psychology of Exceptional Individuals, 7(27), 53-77. https://doi.org/10.22054/jpe.2018.18761.1487

Steger, M. F., Frazier, P., Oishi, S., & Kaler, M. (2006). The meaning in life questionnaire: Assessing the presence of and search for meaning in life. Journal of counseling psychology, 53(1), 80-93. https://doi.org/10.1037/0022-0167.53.1.80

Steger, M. F., Kawabata, Y., Shimai, S., & Otake, K. (2008). The meaningful life in Japan and the United States: Levels and correlates of meaning in life. Journal of research in personality, 42(3), 660-678. https://doi.org/10.1016/j.jrp.2007.09.003

Steger, M. F., Oishi, S., & Kashdan, T. B. (2009). Meaning in life across the life span: Levels and correlates of meaning in life from emerging adulthood to older adulthood. The Journal of Positive Psychology, 4(1), 43-52. https://doi.org/10.1080/17439760802303127

Whittingham, K., & Coyne, L. W. (2019). Chapter 14 - Integrating Acceptance and Commitment Therapy with other interventions. In K. Whittingham & L. W. Coyne (Eds.), Acceptance and Commitment Therapy (pp. 377-402). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-12-814669-9.00014-X

Wubbolding, R. E. (2012). Reality Therapy (Theories of Psychotherapy) (1st ed.). American Psychological Association.

Zandi, A., Dinpanah-Khoshdarehgi, H., Ebrahim-Madahi, M., & Jamehri, F. (2023). Comparison of the effect of acceptance and commitment therapy and reality therapy on the self-care of diabetes type II patients. J Educ Health Promot, 12, 364. https://doi.org/10.4103/jehp.jehp_1174_22

Zolfaghari, M., Ghorban Shirodi S. (2019). The effectiveness of group mindfulness training on the resilience and anxiety of mothers with low vision and blind children referred to Sanandaj health centers. Journal of Excellence in counseling and psychotherapy, 8(29), 77-89. https://ensani.ir/fa/article/438108/

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Published

2025-06-08

Submitted

2025-03-05

Revised

2025-04-10

Accepted

2025-04-28

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How to Cite

A Comparison of the Effectiveness of Reality Therapy and Acceptance and Commitment Therapy on Meaning in Life Among Elderly Clients Attending day Rehabilitation Centers in Tehran. (2025). Journal of Psychological Dynamics in Mood Disorders, 137-152. https://maherpub.com/pdmd/article/view/459