The Effectiveness of Acceptance and Commitment Therapy (ACT) on Emotional Self-Efficacy and Suicidal Thoughts in Patients With Borderline Personality Disorder

Authors

    Mohammad Reza Yekta * PhD candidate in counseling, Department of Counseling, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran. mohammadrezayekta@gmail.com
    Faride Ranjbar Neysiani MA Student, Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
    Mahtab Kachouei MA Student, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran.
    Masoumeh Khorramdashti MA Student, Department of Psychology, Safahan Non-Profit Higher Education Institute, Isfahan, Iran.
    Vida Tavassoli MA Student, Department of psychology, Naein Branch, Islamic Azad University,Naein,Isfahan,Iran.

Keywords:

Acceptance and Commitment Therapy, Emotional Self-Efficacy, Suicidal Thoughts, Borderline Personality Disorder

Abstract

The objective of the study was to evaluate whether Acceptance and Commitment Therapy improves emotional self-efficacy and reduces suicidal thoughts in individuals diagnosed with borderline personality disorder. A quasi-experimental pretest–posttest design with a control group was used. The sample included 30 patients with borderline personality disorder who were selected through purposive sampling and randomly assigned to experimental and control groups. The experimental group received eight 90-minute sessions of group-based ACT, while the control group received no intervention. Emotional self-efficacy and suicidal ideation were measured, and data were analyzed through repeated-measures ANOVA. The results indicated significant improvement in emotional self-efficacy and a significant reduction in suicidal thoughts in the experimental group compared with the control group. Significant time effects and time-by-group interaction effects confirmed the stability of treatment outcomes during follow-up. Acceptance and Commitment Therapy is an effective therapeutic approach for enhancing emotional regulation skills and decreasing suicidal ideation in patients with borderline personality disorder. It can be considered a practical and beneficial intervention in clinical settings.

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References

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological review, 84(2), 191-215. https://doi.org/10.1037/0033-295X.84.2.191

Barnes, S. M., & Smith, T. (2021). ACT for life: Using acceptance and commitment therapy for recovery from suicidal crises. Journal of Contextual Behavioral Science, 20(4), 223-231. https://doi.org/10.1016/j.jcbs.2021.02.003

Caprara, G. V., Di Giunta, L., Eisenberg, N., Gerbino, M., Pastorelli, C., & Tramontano, C. (2008). Assessing regulatory emotional self‐efficacy in three countries. European Journal of Psychological Assessment, 24(2), 115-121. https://doi.org/10.1027/1015-5759.24.2.115

Casellas-Pujol, E., & Soler, J. (2024). Contextual-compassion training for borderline personality disorder: A randomized controlled trial. Journal of personality disorders, 38(1), 45-58. https://doi.org/10.1521/pedi_2023_38_456

Colmenero-Navarrete, L., & García-Banda, G. (2022). Relationship between emotion regulation and suicide risk: A meta-analytic review. Journal of affective disorders, 315, 1-9. https://doi.org/10.1016/j.jad.2022.07.045

Crowe-Delgado, E., & Watson, R. (2020). Comparing the contribution of affect, emotion regulation, and self-efficacy in borderline personality disorder. Behavioral Psychology Review, 28(3), 310-328. https://www.behavioralpsycho.com/wp-content/uploads/2020/10/01.Crespo-Delgado_28-2oa-1.pdf

Domenech, P., & Jimenez, A. (2024). Emotion regulation and self-efficacy: The mediating role of affective control. Frontiers in Psychiatry, 15, 1384. https://www.mdpi.com/2076-328X/14/3/206

Ducasse, D., René, E., Béziat, S., Guillaume, S., Courtet, P., & Olié, E. (2014). Acceptance and commitment therapy for management of suicidal patients: A pilot study. Psychotherapy and psychosomatics, 83(6), 374-376. https://doi.org/10.1159/000365974

El-Sayed, M., Abd Elhay, S., Taha, S., Mahmoud, K., Feby, S., Attalla, M., & El-Ashry, A. (2023). Efficacy of acceptance and commitment therapy on impulsivity and suicidality among clients with bipolar disorders: A randomized control trial. BMC Nursing, 22(271). https://doi.org/10.1186/s12912-023-01199-3

El-Sayed, M. M., Mohamed, F. E., & Hassan, A. (2023). Efficacy of acceptance and commitment therapy on impulsivity and suicidality among clients with bipolar disorders: A randomized control trial. BMC Nursing, 22, 271. https://doi.org/10.1186/s12912-023-01443-1

García-Rubio, C. (2024). Acceptance and commitment therapy on suicidal behavior: A systematic review. Revista de Psiquiatría y Salud Mental, 17(2), 103-112. https://doi.org/10.1016/j.rpsm.2023.09.001

Ghorbani, M., & Amiri, S. (2023). The effectiveness of acceptance and commitment therapy on suicidal thoughts and emotional regulation in adolescents. Contemporary Psychology Journal, 18(2). http://frooyesh.ir/browse.php?a_id=2524&sid=1&slc_lang=en

Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181-192. https://doi.org/10.1016/j.jcbs.2020.09.007

Gratz, K. L., & Tull, M. T. (2022). The prospective relation between borderline personality disorder symptoms and suicide risk: The role of emotion regulation difficulties. Personality Disorders: Theory, Research, and Treatment, 13(1), 1-10. https://doi.org/10.1037/per0000509

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The process and practice of mindful change. Guilford Press. https://books.google.com/books?hl=fa&lr=&id=og28CwAAQBAJ&oi=fnd&pg=PP1&dq=Acceptance+and+Commitment+Therapy:+The+process+and+practice+of+mindful+change&ots=-8PWTK6Dpn&sig=ASz2l_4g-Pa4-az8udjGIGtphtY

Jiao, Y., & Wang, W. (2025). The efficacy of cognitive behavioral therapy on reducing suicidal ideation and deliberate self-harm: A systematic review. Frontiers in psychology, 16, 1672957. https://doi.org/10.3389/fpsyg.2025.1672957

Jiao, Y., & Zhang, W. (2025). The efficacy of cognitive behavioral therapy on reducing suicidal ideation and deliberate self-harm: A systematic review. Frontiers in psychology, 16, 1672957. https://doi.org/10.3389/fpsyg.2025.1672957

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press. https://books.google.com/books?hl=fa&lr=&id=UZim3OAPwe8C&oi=fnd&pg=PA3&dq=Cognitive-behavioral+treatment+of+borderline+personality+disorder&ots=qEVw3r_qH8&sig=r6R_V3DhHPeGku9VvfpIGoFgLtA

Magsoudi, Z. (2019). The effectiveness of acceptance and commitment therapy (ACT) in improving emotional distress and reducing suicidal thoughts among students. Quarterly Journal of Clinical Psychology Research, 9(2), 55-72. https://jbrms.medilam.ac.ir/article-1-740-en.pdf

Morton, J., Snowdon, S., Gopold, M., & Guymer, E. (2012). Acceptance and commitment therapy group treatment for symptoms of borderline personality disorder: A public sector pilot study. Cognitive and Behavioral Practice, 19(4), 527-540. https://doi.org/10.1016/j.cbpra.2012.02.005

Nadri, F., & Asadi, R. (2020). The effectiveness of acceptance and commitment therapy on psychological flexibility and mental well-being in patients with emotional disorders. Research in Clinical Psychology, 12(1), 75-92. https://sjms.shmu.ac.ir/index.php/ijhs/article/view/827/638

Olié, E., & Courtet, P. (2025). Acceptance and commitment therapy reduces perceived stress and suicidal ideation in patients with a history of suicide attempts: A randomized controlled trial. Psychiatry research, 320, 114100. https://doi.org/10.1016/j.psychres.2023.114100

Ortas-Barajas, F., & García-Rubio, C. (2024). Acceptance and commitment therapy on suicidal behavior: A systematic review. Revista de Psiquiatría y Salud Mental, 17(2), 103-112. https://doi.org/10.1016/j.rpsm.2023.09.001

Reese-Ortiz, M. A., & Sainz, J. (2020). Clinical efficacy of a combined acceptance and commitment therapy and dialectical behavioural therapy adaptation for borderline personality disorder. Psychiatric Services, 71(9), 978-986. https://pubmed.ncbi.nlm.nih.gov/31246370/

Rogante, E., & Gazzillo, F. (2024). The role of emotion dysregulation in understanding suicidal behavior: Implications for treatment. Journal of Clinical Psychology, 80(5), 1234-1245. https://doi.org/10.1002/jclp.23012

Street-Mattox, C., & Barlow, D. H. (2025). Exploring barriers to compassionate acts in individuals with borderline personality disorder: A critical literature review. Psychiatry research, 325, 115132. https://doi.org/10.1016/j.psychres.2023.115132

Tak, J. H., & Kim, Y. H. (2023). Effectiveness of acceptance and commitment therapy for suicidality: A systematic review and meta-analysis. Acta Neuropsychiatrica, 35(4), 175-185. https://doi.org/10.1017/neu.2022.34

Taku, J., & colleagues. (2020). Systematic review and meta-analysis of acceptance and commitment therapy for suicidal ideation and behaviors. Clinical psychology review, 82, 101932. https://www.cambridge.org/core/journals/european-psychiatry/article/systematic-review-of-acceptance-and-commitment-therapy-in-suicide-prevention-in-adults-current-perspective/C036A5624B00B2D46DF1AAFECDD71F52

Teige, J. (2018). Efficacy of acceptance and commitment therapy for suicidality: A review of clinical trials. Cognitive therapy and research, 42(6), 878-890. https://karger.com/pps/article/doi/10.1159/000548398/934911/Efficacy-of-Acceptance-and-Commitment-Therapy-for

Tighe, J., & McKenna, S. (2018). Efficacy of acceptance and commitment therapy in reducing suicidal ideation and deliberate self-harm: A systematic review. Jmir Mental Health, 5(2), e10732. https://doi.org/10.2196/mental.10732

Yu, T., Niu, X., Fu, L., & Qian, L. (2025). The relationship between borderline personality features and self-efficacy: The mediating role of school adjustment and the moderating role of social support. Borderline personality disorder and emotion dysregulation, 12(1), 1-9. https://doi.org/10.1186/s40479-024-00276-x

Yuan, J., Li, H., Zhang, Y., & Zhou, X. (2024). Effect of acceptance and commitment therapy on emotion regulation in adolescent patients with nonsuicidal self-injury. Frontiers in psychology, 15, 1189. https://doi.org/10.5152/alphapsychiatry.2024.231324

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Published

2026-03-21

Submitted

2025-06-24

Revised

2025-11-10

Accepted

2025-11-26

Issue

Section

مقالات

How to Cite

Yekta, M. R., Ranjbar Neysiani, F. ., Kachouei, M. . ., Khorramdashti, M. ., & Tavassoli, V. . . (1405). The Effectiveness of Acceptance and Commitment Therapy (ACT) on Emotional Self-Efficacy and Suicidal Thoughts in Patients With Borderline Personality Disorder. Journal of Cognition, Behavior, Learning, 1-15. https://journalcbl.com/index.php/jcbl/article/view/326

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