Comparison of the Effectiveness of Reality Therapy and Acceptance and Commitment Therapy on Psychological Flexibility in Older Adults Attending Day Rehabilitation Centers in Tehran

Abstract

The present study aimed to compare the effectiveness of Reality Therapy and Acceptance and Commitment Therapy (ACT) on psychological flexibility in older adults attending day rehabilitation centers in Tehran. This study employed a quasi-experimental design with a pretest, posttest, and follow-up, along with a control group. The statistical population comprised all older adults attending day rehabilitation centers in Tehran during the first half of 2024. From this population, 90 individuals who met the inclusion and exclusion criteria were selected through purposive sampling and randomly assigned to three groups of 30 participants each: two experimental groups (Reality Therapy and ACT) and one control group. Participants completed the Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010) at pretest, posttest, and follow-up stages. The Reality Therapy protocol was based on the principles outlined by Glasser (2003) and was implemented over eight 90-minute sessions across two months. The ACT protocol was developed based on the principles proposed by Hayes et al. (2012) and was also conducted in eight 90-minute sessions over two months. Data were analyzed using repeated measures analysis of variance. The results indicated a significant difference between the Reality Therapy and ACT groups compared to the control group at both the posttest and follow-up stages (P < 0.05), demonstrating the effectiveness of both interventions in enhancing psychological flexibility. Additionally, a significant difference was observed between the two experimental groups in the posttest and follow-up stages (P > 0.05), with mean comparisons indicating greater effectiveness for ACT.