Improve the Psychological Well-Being of Patients with Irritable Bowel Syndrome with Acceptance and Commitment Therapy (ACT)

Improve the Psychological Well-Being of Patients with Irritable Bowel Syndrome with Acceptance and Commitment Therapy (ACT)


By John M. de Castro, Ph.D.


physical and psychological symptoms of IBS were more effectively managed by people practicing mindfulness meditation than in support group therapy.” – Bill Hendrick


Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging from 9–23%. In the U.S. the rates generally in the area of 10–15% affecting between 25 and 45 million people. IBS is not life threatening but it is very uncomfortable producing changes in bowel movement patterns, bloating and excess gas, and pain in the lower belly. It is also a major source of absenteeism both at work and in school. IBS is also associated with a marked reduction in the individual’s health quality of life, with disruption of the physical, psychological and social routines of the individuals. At present, there are no known cures for IBS and treatments involve symptomatic relief, often with fairly radical dietary changes.


The cause(s) of IBS are not known. But emotion dysregulation is suspected to be involved. It is clear that psychological stress exacerbates the illnesses and anxiety amplifies the symptoms. This suggests that mindfulness training might be helpful as mindfulness is known to reduce the psychological and physical responses to stress and to improve emotion regulation. In addition, It has been shown that meditation and yoga can help relieve IBS symptoms.


A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. So, it would make sense to further investigate the effectiveness of ACT for Irritable Bowel Syndrome (IBS).


In today’s Research News article “The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome.” (See summary below or view the full text of the study at:, Mirsharifa and colleagues recruited adult patients with Irritable Bowel Syndrome (IBS) and randomly assigned them to either receive 6 sessions of Acceptance and Commitment Therapy (ACT) or to treatment as usual. They were measured before and after treatment for depression and psychological capital, including hope, tolerance, optimism and self-efficiency.


They found that in comparison to baseline and to the control group, the IBS patients who received Acceptance and Commitment Therapy (ACT) had significantly lower depression scores and significantly higher scores on psychological capital. The effect sizes were very large indicating that ACT was a potent therapy to improve the psychological well-being of patients with irritable bowel syndrome, improving their mood and making them more hopeful and optimistic and increasing their tolerance and belief in being able to improve their own well-being.


So, improve the psychological well-being of patients with irritable bowel syndrome with acceptance and commitment therapy (ACT).


A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches.” – Sebastián Sánchez


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+ and on Twitter @MindfulResearch


Study Summary


Mirsharifa, S. M., Mirzaian, B., & Dousti, Y. (2019). The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome. Open access Macedonian journal of medical sciences, 7(3), 421–427. doi:10.3889/oamjms.2019.076




Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, worldwide. Psychological disorders are common among patients with IBS.


This study aims to investigate the efficacy of acceptance and commitment therapy (ACT) matrix on depression and psychological capital of patients with IBS.


In a quasi-experimental study, a total number of 30 patients with IBS were selected using convenience sampling. Those patients who meet the inclusion criteria were randomly assigned to control and experimental groups (15 patients in each group). Data were collected using the Beck Depression Inventory (BDI) and the Psychological Capital Questionnaire (PCQ). The experimental group was subjected to the acceptance and commitment therapy (ACT) amtrix, but the control group do not receive this treatment. Questionnaires were completed before (pre-test) and after (post-test) the intervention by patients in two groups. All patients in two groups responded to the questionnaires and returned them to the researcher. Data were analyzed using chi-square test, independent t-test, analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA).


Analyzing the data showed that there were significant differences regarding depression and psychological capital between experimental and control group, before and after the study (p < 0.05).


Using ACT matrix is a useful modality to improve the depression and psychological capital among patients with IBS.


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