The Effectiveness of an Integrated Acceptance and Commitment Therapy and Compassion-Focused Therapy Intervention on Resilience and Anger Control in Women with Marital Conflict

Ali. Babaei1*, Fatemeh. Dadvand2

1 Department of Psychology and Counselling, Farhangian University, P.O. Box 14665-889, Tehran, Iran

2 PhD Student, Department of Educational Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran

* Corresponding author email address: Babaeiali2060@cfu.ac.ir

Round 1

Reviewer 1

Reviewer:

The literature review provides extensive discussion of ACT and CFT independently; however, the conceptual rationale for integrating the two approaches remains underdeveloped. In the paragraph beginning with “Although ACT and CFT have independently demonstrated considerable effectiveness…,” the authors should more explicitly articulate the synergistic therapeutic mechanisms underlying the integration. For example, clarification is needed regarding whether the intervention targets psychological flexibility and self-compassion sequentially, simultaneously, or interactively. A conceptual integration model or schematic framework would substantially improve theoretical coherence.

In the Methods section, the sentence “participants who were absent for more than two sessions were excluded from the research process” raises concerns regarding attrition management and potential bias. The manuscript does not report whether any participants were excluded after randomization, nor does it provide CONSORT-style participant flow information. The authors should report recruitment numbers, dropout rates, reasons for attrition, and whether intention-to-treat analysis was considered. Failure to report attrition procedures weakens internal validity assessment.

The statistical analysis section is underdeveloped and does not adequately justify the use of MANCOVA. Although the authors state that assumptions such as “linearity, multicollinearity, homogeneity of variances, and homogeneity of regression slopes” were examined, no actual test statistics or diagnostic results are reported. The manuscript should provide Box’s M test results, Levene’s test values, tolerance/VIF indices, and regression slope homogeneity statistics to demonstrate that MANCOVA assumptions were empirically satisfied.

Table 1 presents pretest means for marital conflict but does not include posttest values for that variable, despite marital conflict being conceptually central to the study. This omission creates ambiguity regarding whether marital conflict was treated solely as a screening criterion or whether it was also considered an outcome variable. The authors should clarify the analytical role of marital conflict and explain why posttest scores were not reported.

Authors revised and uploaded the document.

Reviewer 2

Reviewer:

The sampling strategy described as “convenience sampling with the assistance of counseling centers” may introduce substantial selection bias. The manuscript would benefit from additional details regarding the counseling centers involved, recruitment advertisements, referral procedures, and whether participants were self-referred or clinician-referred. Without this information, it is difficult to evaluate sample representativeness and the extent to which treatment motivation may have influenced outcomes.

The inclusion criteria specify that participants were “not using psychiatric medications” and “not being under psychiatric supervision,” but the manuscript does not indicate how psychiatric status was assessed. It is essential to clarify whether structured diagnostic interviews, psychiatric screening instruments, or clinical records were used to determine psychiatric eligibility. Reliance solely on self-report could substantially affect sample validity and confound interpretation of emotional regulation outcomes.

The intervention protocol description is insufficiently detailed for replication purposes. In the paragraph beginning “For the experimental group, the integrated protocol of Acceptance and Commitment Therapy and Compassion-Focused Therapy was implemented…,” the authors list several therapeutic techniques but do not provide session-by-session content organization, therapeutic objectives, homework assignments, or intervention sequencing. A detailed intervention table summarizing each session’s ACT and CFT components is strongly recommended to improve methodological transparency and reproducibility.

The manuscript repeatedly refers to “self-compassion” when discussing the integrated intervention, including the sentence “the effectiveness of the integrated intervention based on Acceptance and Commitment Therapy and self-compassion on the resilience of women with marital conflict.” This terminology is conceptually imprecise because self-compassion is a construct rather than a psychotherapeutic modality. The authors should consistently distinguish between Compassion-Focused Therapy as an intervention and self-compassion as a psychological mechanism or outcome variable.

Authors revised and uploaded the document.

Revised

Editor’s decision after revisions: Accepted.

Editor in Chief’s decision: Accepted.