Investigating the Effectiveness of Acceptance and Commitment Therapy with Compassion on Perceived Illness, Negative Mood, Hope, and Social Adjustment in Young Girls with Type 1 Diabetes Mellitus

Diabetes is a chronic, progressive, and common disease in Iran and the world. Its control and treatment are costly and rank the fourth leading cause of death in most developed countries. There are two main types of diabetes: type 1 and type 2. People with type 1 diabetes have very little or no insulin production. Girls with diabetes see their illness as a stigma that leads to psychological damage. They misbelieve that they should not get married or would never have children after marriage. These wrong thoughts will lead to avoidance and problems in the social adjustment of girls with diabetes.
Social adjustment can be achieved by adapting to the environment or changing the environment to meet the needs, both resulting in increased hope. When people lose their hope, they develop an inflexible mindset. They could not solve their problems and constantly evaluate their experiences negatively and incorrectly. They expect tormenting consequences for their problems and thus experience more negative moods such as depression and anxiety. Increased depression and anxiety will lead to faulty perception of the disease and the observance of care instructions. If people acquire misconceptions about their illnesses, they may employ abnormal adaptation strategies, which can have detrimental effects on the life and experience of the disease.
The effectiveness of acceptance and commitment therapy and compassion therapy have been confirmed on different psychological problems of diabetics. Also, many researchers recommended the combination of these two therapies. However, this combination therapy has not been studied yet. Therefore, the present study was conducted to investigate the effectiveness of integrated treatment of acceptance and commitment with compassion on disease perception, negative mood, hope, and social adjustment of young girls with type 1 diabetes.

This quasi–experimental study employed a pretest–posttest design with a control group. The statistical population consisted of all young girls (18 to 25 years old) with type 1 diabetes, members of the Najafabad Diabetes Association, Najafabad City, Iran, in 2018. The sample consisted of 30 girls with type 1 diabetes randomly selected and assigned to the control (n = 15) and the experimental group (n = 15). The inclusion criteria were as follows: having type 1 diabetes (confirmed by a specialist), being single, being literate, gaining the lowest acceptable scores from research questionnaires, being 18 to 25 years old, lacking any acute or chronic mental disorders (confirmed by the clinical psychologist of the Associate), not taking part in a simultaneous psychological treatment, and not taking psychiatric medications in the last three months. The exclusion criteria were as follows: non–cooperation, failing their tasks, and absence of more than two sessions from the intervention.
The experimental group had 10 sessions of 90 minutes. Combined treatment received acceptance and commitment with compassion. The study instruments were the Brief Illness Perception Questionnaire (B–IPQ) (Broadbent et al., 2006), Beck Depression Inventory (BDI–II) (Beck et al., 1996) , Beck Anxiety Inventory (BAI) (Beck et al.,1988), Schneider’s Life Expectancy Inventory (SLEQ) (Schneider et al., 1991) and The California Personnel Questionnaire (CTP) (Thorpe et al.,1953). Statistical analysis was performed using univariate analysis of covariance in SPSS software. The significance level was considered 0.05.

By adjusting the pretest scores, significant differences are observed between the experimental and control groups in the posttest scores of illness perception, negative mood, hope, and social adjustment of young girls with type 1 diabetes (p< 0.05). In other words, the combined treatment of acceptance and commitment with compassion improved the perception of the disease, negative mood, hope, and social adjustment of young girls with type 1 diabetes (p<0.05).

Therapists are recommended to use the combined treatment of acceptance and commitment with compassion to improve the perception of the disease, reduce negative mood, and increase hope and social adjustment of young girls with type 1 diabetes.