The Effectiveness of Acceptance and Commitment Therapy on Cognitive Flexibility, Rumination and Negative Automatic Thoughts in Students with Self-Harming Behaviors

Document Type : Original Article

Authors

1 Department of Psychology, Islamic Azad University, Hamedan Branch, Hamedan, Iran.

2 Department of Educational Sciences, Faculty of Education, Farhangian University, Hamedan, Iran.

Abstract

This study aimed to examine the effectiveness of Acceptance and Commitment Therapy (ACT) on cognitive flexibility, rumination, and negative automatic thoughts in adolescent girls engaging in deliberate self-harm in Kermanshah. The present research employed a quasi-experimental design with a pretest-posttest and control group. The statistical population included all adolescent girls aged 16 to 18 years in Kermanshah in 2025-2026. 40 participants scoring average or above on the Deliberate Self-Harm Inventory (Gratz, 2001) were randomly selected and assigned to either the experimental (20) or control group (20) following parental consent. The experimental group received 10 weekly 90-minute sessions of ACT, including exercises in acceptance, cognitive defusion, mindfulness, values clarification, self-compassion, and committed action (Turrell, Bell & Wilson, 2016). Research instruments included the Deliberate Self-Harm Inventory (DSI), the Cognitive Flexibility Inventory (CFI), the Ruminative Responses Scale (RRS), and the Negative Automatic Thoughts Questionnaire (NATQ). Data were analyzed using multivariate analysis of covariance (MANCOVA) in SPSS version 26. ACT significantly reduced self-harming behaviors, negative automatic thoughts, and rumination, while increasing cognitive flexibility compared to the control group. The findings indicate that ACT is an effective intervention for improving cognitive flexibility, reducing rumination, and decreasing negative automatic thoughts in adolescent girls engaging in deliberate self-harm, highlighting its potential utility in school and clinical settings.

Keywords

Main Subjects

References

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History

  • Receive Date: 19 December 2025
  • Revise Date: 04 March 2026
  • Accept Date: 12 March 2026
  • Publish Date: 01 March 2026

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