Effectiveness of acceptance and commitment therapy on anxiety and depression of razi psychiatric center staff
Open accessAbstract
AIM: Considering the key role of human resources as the main operator of organisations, the present research aimed to determine the effectiveness of acceptance and commitment therapy for anxiety and depression of Razi Psychiatric Center staff. MATERIALS AND METHODS: This research follows a quasi-experimental type with pre-test, post-test plans, and control group. Accordingly, 30 people were selected through volunteered sampling among Razi Psychiatric Center staff. Then, they were randomly placed into two groups of 15 (experimental and control) and evaluated using research tools. Research tools consisted of Beck Anxiety and Depression Inventories whose reliability and validity have been confirmed in several studies. Research data were analysed using the analysis of covariance (ANCOVA). Results: The statistical analysis confirmed the difference in the components of anxiety and depression in the experimental group, which had received acceptance and commitment therapy compared to the group that had not received any therapy in this regard (control group) (p < 0.05). CONCLUSION: Acceptance and commitment therapy reduces anxiety and depression. © 2018 Mostafa Heydari, Saideh Masafi, Mehdi Jafari, Seyed Hassan Saadat, Shima Shahyad.
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Written from the paper’s full text.
TL;DR
This quasi-experimental study tested acceptance and commitment therapy (ACT) among Razi Psychiatric Center staff and found significant reductions in anxiety and depression compared with a no-treatment control group. The authors conclude that ACT reduced both outcomes, with effects maintained at a two-month follow-up.
Key findings
- Anxiety was significantly lower in the ACT group than the control group after controlling for pretest scores (p = 0.000, F = 119.955), and this difference remained at follow-up (p = 0.000, F = 81.072).
- Depression was also significantly lower in the ACT group after controlling for pretest scores (p = 0.000, F = 152.302), with follow-up results remaining significant (p = 0.000, F = 30.413).
- The abstract reports that the statistical analysis confirmed differences in anxiety and depression components between the experimental and control groups at p < 0.05.
Methods
- The design was quasi-experimental with pretest, posttest, and control group. Thirty volunteers from Razi Psychiatric Center staff in 2015–16 were randomly assigned to two groups of 15; the experimental group received eight 90-minute ACT sessions, while the control group received no intervention.
- Measures were the Beck Anxiety Inventory (21 items, scores 0–63) and the Beck Depression Inventory-II (21 items, scored 0–3 per item), with reliability and validity cited from prior studies.
- Data were analyzed using analysis of covariance (ANCOVA), with pretest scores as covariates; the text notes that homogeneity of variances was outside criteria for some components, so an alpha of 0.025 was used.
Limitations
- Stated by the authors: findings rely on self-report data, the sample size was small, and further studies with larger samples are recommended to clarify results and examine all aspects of ACT on anxiety and depression.
- Evident from the text: the use of volunteer sampling and a quasi-experimental design limits generalizability and causal inference, and the control group received no intervention, with no blinding or treatment-fidelity procedures reported.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Claims the paper makes
0 of 12 cited sources checked · 0 supported · 0 flagged
- Findingown data
In the experimental group compared with the control group, anxiety posttest scores differed significantly after adjusting for pretest scores (p = 0.000, F = 119.955).
“there is a significant difference in the experimental and control groups among anxiety (p = 0.000, F = 119.955).”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Findingown data
The depression treatment effect remained significant at follow-up after adjusting for pretest scores (p = 0.000, F = 30.413).
“The follow-up results showed that treatment was stable by eliminating the effect of pretest (p = 0.000, F = 30.413).”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Findingown data
The anxiety treatment effect remained significant at follow-up after adjusting for pretest scores (p = 0.000, F = 81.072).
“The follow - up results showed that treatment was stable by eliminating the effect of pretest (p = 0.000, F = 81.072).”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Interpretationown data
ACT reduces depression in the post-test in this sample.
“In general, it can be said that acceptance and commitment therapy in post-test reduces depression.”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Interpretationown data
ACT reduces anxiety.
“Acceptance and commitment therapy reduces anxiety and depression.”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Rests on an assumption: Two months after the intervention is a sufficient period to assess long-term effects.
- Rests on an assumption: The volunteer sample is representative of Razi Psychiatric Center staff.
- Interpretationown data
ACT significantly reduces anxiety in the long term in this sample.
“Therefore, it can be said that acceptance and commitment therapy significantly reduces anxiety in the long term.”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Rests on an assumption: Two months after the intervention is a sufficient period to assess long-term effects.
- Interpretationown data
ACT significantly reduces depression in the long term in this sample.
“Therefore, it can be said that acceptance and commitment therapy significantly reduces depression in the long term.”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Rests on an assumption: Two months after the intervention is a sufficient period to assess long-term effects.
- Interpretationown data
ACT reduces anxiety in the post-test in this sample.
“In general, it can be said that acceptance and commitment therapy in post-test reduces anxiety.”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Study design and conductreasoning
The study had a small sample size.
“Secondly, the lack of large sample size of the population could be mention as other potential limitation.”
Quote in the paperNot a substantial claim
- The quote only partly states this claim. 2
- Classified as probably not a substantial claim. 10
- May combine two claims. 5
The quote only partly states this claim.
Findingown dataIn the experimental group compared with the control group, depression posttest scores differed significantly after adjusting for pretest scores (p = 0.000, F = 152.302).
“there is a significant difference in the experimental and control groups among depression (p = 0.000, F = 152.302).”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationLang et al. found improvement in emotional distress among veterans following ACT.
“They found improvement following treatment in the whole sample across a variety of measures, including general distress and functioning and moderate to high levels of satisfaction with treatment [13].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [13]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn ACT, depression is conceptualized as emotions tied to past events such as death or loss, hindering typical responses and adjustment to stressful life events.
“In acceptance and commitment therapy, depression conceptualisation is emotions related to past events such as death or losing something, which prevents normal reactions and adaptation to stressful life events.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductown dataParticipants were randomly assigned to experimental and control groups.
“The sample was selected through the voluntarily sampling method and randomly divided into two groups, the experimental group, and the control group.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationThe current findings are consistent with previous studies.
“These results are consistent with findings of previous studies [16][11].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [16]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [11]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationHosseinaei et al. found that group ACT-based training decreased job stress but had no considerable effect on job burnout.
“Hosseinaei et al. demonstrated Group acceptance and commitment therapy (ACT) - based training decreases job stress but has no considerable effect on job burnout [12].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [12]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationExperimental avoidance plays a key role in the development and persistence of psychological trauma and in worsening depression.
“To explain depression, it can be said that Acceptance and Commitment Therapy according to theorists is an important factor in creating and maintaining psychological trauma and increasing depression is an experimental avoiding.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationNariman et al. found that ACT training decreased social anxiety in students with specific learning disorder.
“Nariman et al. showed that Acceptance/ Commitment Training have a positive effect on decreasing the social anxiety in students with specific learning disorder (SLD) [11].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Study design and conductcitationThe Beck Depression Inventory has confirmed reliability and validity in several studies, including Iranian populations.
“Several studies have been conducted in Iran to measure the psychometric properties of BDI - II which its reliability was 0.78 and its validity were varied from 0.70 to 0.90 [9][10].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [9]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [10]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe Beck Anxiety Inventory has confirmed reliability and validity in several studies, including Iranian populations.
“In a study on Iranian population, the Cronbach’s alpha coefficient was 0.90 [6]. Also, the validity, reliability and internal consistency of the Beck Anxiety Inventory on Iranian population recorded as 0.72, 0.83, and 0.92, respectively [7].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [6]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Study design and conductown dataMost assumptions for ANCOVA were confirmed; homogeneity of variances was violated for some components, so alpha was set at 0.025.
“Surveying data for the analysis of covariance showed that most of the assumptions are confirmed. Only the homogeneity of variances in some of the components was outside the criteria for which they have considered the alpha as much as 0.025.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationDefusion counteracts cognitive fusion and mediates depression outcomes by helping individuals clear their thoughts and act according to their values.
““Defusion” is against the cognitive fusion, which mediates the consequences of depression, in which the visitors learn to clear their thoughts and make their actions are based on values [5].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe findings are based on self-report data.
“First, these findings are based on self - reporting of people.”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
InterpretationreasoningACT reduces depression.
“It can be said that Acceptance and Commitment Therapy could reduce anxiety and depression.”
Quote in the paperSubstantial claim- Rests on an assumption: The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
- Rests on an assumption: Two months after the intervention is a sufficient period to assess long-term effects.
- Rests on an assumption: The volunteer sample is representative of Razi Psychiatric Center staff.
The paper relies on this without support.
The experimental and control groups were equivalent at baseline on anxiety, depression, and other relevant variables.
“The sample was selected through the voluntarily sampling method and randomly divided into two groups, the experimental group, and the control group.”
The paper relies on this without support.
Two months after the intervention is a sufficient period to assess long-term effects.
“Two months after the end of the session, a meeting was conducted on two groups, and their anxiety and depression were measured and recorded.”
The paper relies on this without support.
The volunteer sample is representative of Razi Psychiatric Center staff.
“The sample was selected through the voluntarily sampling method”
The paper relies on this without support.
New interventions for occupational issues have been less considered in Iran.
“Moreover, the new interventions regarding the occupation issues were less considered in Iran.”
The paper relies on this without support.
The ACT intervention was delivered with adequate fidelity.
“The experimental group members participate in eight 90 minutes’ sessions per week.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The finding that ACT decreased anxiety, cognitive avoidance, and increased empathy is consistent with the research results of Moradzadeh and Pirkhaefi [20], Khoramnia et al. [31], and Heydari et al. [32].
“This finding is consistent with the research results of Moradzadeh and Pirkhaefi [20], Khoramnia et al. [31], and Heydari et al. [32].”
From Effectiveness of Acceptance and Commitment Therapy on Anxiety, Cognitive Avoidance, and Empathy of Couples Visiting Counseling Centers in Ahvaz City, Iran (2021) · cites this paper as [32]
The Discussion reports that ACT reduced anxiety among Razi Psychiatric Center staff. The Methods identify anxiety and depression as the measured outcomes; although the Discussion describes reducing experiential avoidance as an aim of ACT, this study does not report a measured decrease in cognitive avoidance or an increase in empathy. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAll studies except five (Daltry et al., 2015; Glover et al., 2016; Heydari et al., 2018; Malmir et al., 2017; Tamannaei et al., 2017) give information regarding intervention adherence.
“All of the studies except five (Daltry et al., 2015; Glover et al., 2016; Heydari et al., 2018; Malmir et al., 2017; Tamannaei et al., 2017) give information regarding intervention adherence.”
From Acceptance and commitment therapy versus cognitive behavioral therapy in the treatment of substance use disorder with incarcerated women (2014) · cites this paper as Heydari et al., 2018
Others determined presence of anxiety/depression using different screening instruments (Heydari et al., 2018; Livheim et al., 2015; Malmir et al., 2017; Zettle et al., 2011) or because of presence of a previous diagnosis (Folke et al., 2012).
“Others determined the presence of anxiety/depression using different screening instruments (Heydari et al., 2018; Livheim et al., 2015; Malmir et al., 2017; Zettle et al., 2011) or because of the presence of a previous diagnosis (Folke et al., 2012).”
From Acceptance and commitment therapy versus cognitive behavioral therapy in the treatment of substance use disorder with incarcerated women (2014) · cites this paper as Heydari et al., 2018
Research findings in the literature show that acceptance is effective on stress and anxiety.
“Given the specific research findings in the literature showing the effectiveness of acceptance on stress and anxiety, this result might be expected (Avdagic et al., 2014;Heydari et al., 2018;Livheim et al., 2015).”
From Exploring anxiety, uncertainty perception, treatment experiences and coping strategies: An interpretative phenomenological analysis. (2025) · cites this paper as Heydari et al., 2018
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“…on variables such as work stress (Brinkborg et al., 2011; McConachie et al., 2014; Montaner et al., 2021, 2021a), anxiety and depression (Heydari et al., 2018), resilience maintenance (Lamb & Cogan, 2016), self-care (Wardley et al., 2014), work engagement, positive well-being or burnout…”
The Effects of Acceptance and Commitment Therapy (ACT) on Depression in TB-HIV Co-infection Patients
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“Other researchers have further stipulated that ACT has been presented to be useful in handling anxiety, depression and substance abuse (Bohlmeijer et al., 2011; Heydari et al., 2018).”
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Postpartum Depression from the Perspective of Third-Wave Psychotherapies
Hamarat, H., Fidantek, H., Özdem, M., & Ertürk, İ. Ş. (2025) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1636688
“…treating various psychopathologies, including depression (Karlin et al. 2013, Zemestani and Mozaffari 2020), anxiety (Mohabbat - Bahar et al. 2015, Heydari et al. 2018), generalized anxiety disorder (Wetherell et al. 2011), social anxiety disorder (Khoramnia et al. 2020), panic disorder (Meuret…”
- Authors
- Heydari, M., Masafi, S., Jafari, M., Saadat, S. H., & Shahyad, S.
- Affiliations
- Islamic Azad University, Tehran (IR)
- Taleghani General Hospital (IR)
- Baqiyatallah University of Medical Sciences (IR)
- Venue
- Open Access Macedonian Journal of Medical Sciences
- Published
- 2018-02-08
- Volume
- 6
- Issue
- 2
- Pages
- 410-415
- ISSN
- 1857-9655 (ISSN-L)
- PMC
- PMC5839459
- OpenAlex
- W2791315085
- Semantic Scholar
- b5a883fe8547979f57984feffb219119a0834714
- Cited by
- 36
- References
- 7
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 4 · 2022: 10 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 2
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Open Access Macedonian Journal of Medical Sciences (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion, cc-by-nc)
- PubMed Central (submittedVersion, cc-by-nc)
- Open Access Macedonian Journal of Medical Sciences (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Sociology and Political Science › Mental Health and Well-being
- Keywords
- acceptance and commitment therapy, anxiety, depression, mental health professionals, psychological intervention, Beck Anxiety Inventory, Beck Depression Inventory
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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