Effect of Acceptance and Commitment Therapy on Emotional Flexibility and Spiritual Distress of Women With Chronic Back Pain

Background and Objectives: Chronic back pain imposes a heavy burden on individuals, families, societies, and governments from medical, psychological, social, and economic perspectives, and is a common, recurrent, and costly problem worldwide. Therefore, the present study aimed to determine the effect of acceptance and commitment therapy on emotional flexibility and spiritual distress in women with chronic back pain. Methods: This quasi-experimental study used a pre-test-post-test design with a control group. The research population included all women suffering from chronic back pain who were referred to the super-specialized pain clinics of Razavi and Imam Reza hospitals in Mashhad City, Iran, in 2023, of whom 20 qualified participants volunteered to participate in the study. They were selected using convenience sampling and randomly assigned to two groups (ten in the experimental and ten in the control group). The experimental group underwent eight 90-minute face-to-face sessions over two months, and the control group received the usual intervention. The data collection tools included the Emotional Flexibility questionnaire by Rashid and Bayat (2018) and the Spiritual Distress questionnaire by Ko et al. (2010). Data were analyzed using SPSS software version 24 employing multivariate and univariate analysis of covariance at a significance level of α=0.05. Results: after controlling for the pre-test effect, there was a significant difference between the post-test means of emotional flexibility (positive emotional regulation, negative emotional regulation, and emotional communication) and spiritual distress (communication with self, communication with others, communication with God, and facing death) in the experimental and control groups (P<0.01). Conclusion: Acceptance and commitment-based treatment significantly increased emotional flexibility (positive emotional regulation, negative emotional regulation, and emotional communication) and improved spiritual distress (communication with self, communication with others, communication with God, and facing death) in women with chronic back pain.