Comparison of the Effectiveness of Compassion-Focused Acceptance and Commitment Therapy and Schema-Integrated Acceptance and Commitment Therapy on Body Image and Sexual Relationship Quality in Women with Breast Cancer in Hamadan
Keywords:
Breast Cancer, Body Image, Sexual Relationship Quality, Acceptance and Commitment Therapy, Compassion, Schema TherapyAbstract
Purpose: This study aimed to compare the effectiveness of Compassion-Focused Acceptance and Commitment Therapy and Schema-Integrated Acceptance and Commitment Therapy on body image and sexual relationship quality in women with breast cancer in Hamadan.
Methods and Materials: This applied quasi-experimental study employed a pretest–posttest design with a two-month follow-up, two experimental groups, and one active control group. The statistical population consisted of women with breast cancer attending the Health Donors Association of Hamadan Province during 2025–2026. Sixty eligible women were selected through convenience sampling and randomly assigned to three groups of 20 participants. Following attrition, the final sample comprised 50 women, including 17 in the Compassion-Focused Acceptance and Commitment Therapy group, 16 in the Schema-Integrated Acceptance and Commitment Therapy group, and 17 in the control group. The experimental groups received 10 weekly 90-minute group sessions of their respective interventions, while the control group received five weekly 60-minute health and life-skills education sessions. Data were collected using the Objectified Body Consciousness Scale and the Sexual Quality of Life–Female Questionnaire. Data were analyzed in SPSS version 26 using multivariate and univariate analyses of covariance and Bonferroni-adjusted pairwise comparisons.
Findings: Multivariate analysis showed a significant overall effect of treatment condition on the combined dependent variables, Pillai’s Trace = 0.592, F(4, 90) = 9.468, p < 0.001, partial η² = 0.296. Significant group effects were found for body image, F(2, 45) = 20.691, p < 0.001, partial η² = 0.482, and sexual relationship quality, F(2, 45) = 16.250, p < 0.001, partial η² = 0.419. Bonferroni comparisons indicated that both interventions were significantly more effective than the control condition on both outcomes. Compassion-Focused Acceptance and Commitment Therapy was also significantly more effective than Schema-Integrated Acceptance and Commitment Therapy for body image, p = 0.006, and sexual relationship quality, p = 0.031.
Conclusion: Both interventions were effective in improving body image and sexual relationship quality among women with breast cancer, although Compassion-Focused Acceptance and Commitment Therapy demonstrated greater effectiveness and may therefore be particularly useful in psycho-oncological rehabilitation following breast cancer treatment.
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Copyright (c) 2025 Elahe Afshari (Author); Mohammad Ismail Ebrahimi; Nasrin Matinnia (Author)
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