Comparing the Effectiveness of Barlow’s Unified Transdiagnostic Treatment and Acceptance and Commitment Therapy on Cognitive Emotion Regulation and Psychological Flexibility in Women Bereaved by COVID-19

Authors

    Mansoreh Eslami * Ph.D student, Department of Psychology, Naein Branch, Islamic Azad University, Naein, Iran. m.islami2019@gmail.com
    Hassan khoshakhlagh Assistant Professor, Department of Psychology, Naein Branch, Islamic Azad University, Naein, Iran.
    Sedigheh Rezaei Dehnavi Associate professor, Department of Psychology, Payame Noor university, Tehran, Iran.
    Mohammad Zare Neyestanak Assistant Professor, Department of Psychology, Naein Branch, Islamic Azad University, Naein, Iran.

Keywords:

Psychological flexibility, Emotion regulation, Unified Transdiagnostic Treatment, Acceptance and Commitment Therapy, COVID-19

Abstract

Objective: The present study aimed to compare the effectiveness of Barlow’s Unified Transdiagnostic Treatment (UTT) and Acceptance and Commitment Therapy (ACT) on cognitive emotion regulation and psychological flexibility in women who lost their spouses due to COVID-19. Method: This study employed a quasi-experimental design with a pretest-posttest and a 2-month follow-up, including a control group. The statistical population consisted of women who experienced spousal bereavement due to COVID-19 and were referred to Imam Khomeini Hospital in Tehran in 2022. Using purposive sampling, 51 participants were selected and randomly assigned to three groups of 17. Due to attrition in the ACT group, one participant was randomly removed from each of the other two groups to equalize group sizes. Consequently, data from 16 participants in each group were analyzed. The first experimental group received Acceptance and Commitment Therapy based on the protocol of Hayes et al. (2004), and the second experimental group received Barlow’s Unified Protocol over nine weekly 90-minute sessions. The research instruments included the Cognitive Emotion Regulation Questionnaire (Garnefski & Kraaij, 2007) and the Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010). Data were analyzed using repeated measures ANOVA. Results: The findings indicated that both interventions significantly improved cognitive emotion regulation and psychological flexibility in women bereaved by COVID-19, and these treatment effects remained stable at follow-up (p < .001). Furthermore, no significant difference was observed between the two interventions in improving emotion regulation; however, ACT was significantly more effective than UTT in enhancing psychological flexibility. Conclusion: Both Acceptance and Commitment Therapy and Barlow’s Unified Transdiagnostic Treatment can be considered effective interventions for improving cognitive emotion regulation and psychological flexibility in women who have lost their spouses to COVID-19.

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References

References

Alizadeh Asli, A., & Jafar Nezhad Langroudi, Z. (2018). The Effectiveness of Schema Therapy Based on Acceptance and Mindfulness in Intimacy, Adaptation and Resiliency in Persons with Marital Conflicts in Couples of City Karaj [case report]. Alborz University Medical Journal, 7(3), 248-256. https://doi.org/10.29252/aums.7.3.248

Ashby, J. S., Noble, C., & Gnilka, P. B. (2012). Multidimensional Perfectionism, Depression, and Satisfaction With Life: Differences Among Perfectionists and Tests of a Stress‐Mediation Model. Journal of College Counseling, 15(2), 130-143. https://doi.org/10.1002/j.2161-1882.2012.00011.x

Beheshtinejad, S., Khayatan, F., & Manshaei, G. R. (2022). A Comparison between the Effectiveness of Mindfulness and Imagotherapy on Intimacy and Commitment among Couples Having Spouses with Attention Deficit Hyperactivity Disorder. https://www.sid.ir/paper/1031753/en

Burkitt, W. T. (2024). Perfectionism and Self-Esteem: The Mediating Role of Basic Psychological Needs. Psychological Reports. https://doi.org/10.1177/00332941241303402

Fatima, L. B. (2024). Literature Review: The Effects of Attachment Styles and Perfectionism on Life Satisfaction. Journal of Education Humanities and Social Sciences, 26, 760-765. https://doi.org/10.54097/pjx50g32

Ghasedi , M. (2019). The Effectiveness of Mindfulness-Based Cognitive Therapy on forgiveness, emotional regulation, and marital intimacy of women injured with infidelity. Scientific Journal of Social Psychology, 52(7), 41-50. http://sanad.iau.ir/fa/Article/924831

Ghasedi, M., Bagheri, F., & Kiamanesh, A. (2019). Comparing the effectiveness of two group therapy methods based on mindfulness and based on acceptance and commitment on forgiveness, emotion regulation and marital intimacy. Akhlāq-i zīstī, 8(29), 87-98. https://doi.org/10.22037/bioeth.v8i29.22576

Gnilka, P. B., Ashby, J. S., & Noble, C. M. (2013). Adaptive and Maladaptive Perfectionism as Mediators of Adult Attachment Styles and Depression, Hopelessness, and Life Satisfaction. Journal of Counseling & Development, 91(1), 78-86. https://doi.org/10.1002/j.1556-6676.2013.00074.x

Hamedani, K. H., Majzoobi, M. R., & Forstmeier, S. (2024). The Relationship Between Perfectionism and Marital Outcomes: A Systematic Review and Meta-Analysis. Frontiers in psychology, 15. https://doi.org/10.3389/fpsyg.2024.1456902

Karami, T., Behbodi, M., & Jahangir, P. (2023). Modeling the Effect of Approach Motives, Self-Compassion and Mindfulness on Sexual Intimacy of Married Nurses With the Mediating Role of Alexithymia. Jarac, 5(3), 78-86. https://doi.org/10.61838/kman.jarac.5.3.11

Khalifian, C. E., & Barry, R. A. (2016). Trust, Attachment, and Mindfulness Influence Intimacy and Disengagement During Newlyweds’ Discussions of Relationship Transgressions. Journal of Family Psychology, 30(5), 592-601. https://doi.org/10.1037/fam0000194

Kim, S., & Park, E.-M. (2024). The Relationship Between Perfectionism and Life Satisfaction in Young Adults: The Double Mediating Effects of the Savoring Belief and the Emotional Perception Clarity. Korean Association for Learner-Centered Curriculum and Instruction, 24(17), 227-247. https://doi.org/10.22251/jlcci.2024.24.17.227

Lin, C. Y., Potenza, M. N., Broström, A., Blycker, G. R., & Pakpour, A. H. (2019). Mindfulness-Based Cognitive Therapy for Sexuality (MBCT-S) Improves Sexual Functioning and Intimacy Among Older Women With Epilepsy: A Multicenter Randomized Controlled Trial. Seizure, 73, 64-74. https://doi.org/10.1016/j.seizure.2019.10.010

Mahmoudpour, A., Dehghanpour, S., Yoosefi, N., & Ejade, S. (2020). Predicting women's marital intimacy based on mindfulness, conflict resolution patterns, perceived social support, and social well-being. Social Psychology Research, 10(39), 102-183. http://www.socialpsychology.ir/article_120662_en.html?lang=en

Matte, M., & Lafontaine, M. F. (2012). Assessment of Romantic Perfectionism. Measurement and Evaluation in Counseling and Development, 45(2), 113-132. https://doi.org/10.1177/0748175611429303

Regas, S. (2019). Infidelity, self-differentiation, and intimacy: The mindful differentiation model of couple therapy. In Integrative couple and family therapies: Treatment models for complex clinical issues. (pp. 71-90). American Psychological Association. https://doi.org/10.1037/0000151-004

Samkhaniyani, I., Mansouri, S., Amiri Moghaddam, D. M., Shabazi, G., Qavadi, D., & Jafari, N. (2020). Effectiveness of Cognitive Therapy Based on Mindfulness on Forgiveness and Marital Intimacy in Couples.

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Published

2025-04-15

Submitted

2024-10-27

Revised

2025-04-13

Accepted

2025-04-16

Issue

In Press

Section

Articles

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Copyright (c) 2025 Mansoreh Eslami (Author); Hassan khoshakhlagh (Corresponding Author); Sedigheh Rezaei Dehnavi, Mohammad Zare Neyestanak (Author)

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

How to Cite

Eslami, M. ., khoshakhlagh, H., Rezaei Dehnavi, S. ., & Zare Neyestanak, M. . (2025). Comparing the Effectiveness of Barlow’s Unified Transdiagnostic Treatment and Acceptance and Commitment Therapy on Cognitive Emotion Regulation and Psychological Flexibility in Women Bereaved by COVID-19. Applied Family Therapy Journal (AFTJ) . https://journals.kmanpub.com/index.php/aftj/article/view/3867