Comparison of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy on Enhancing Resilience, Cognitive Flexibility, and Distress Tolerance in Adolescents with Obsessive-Compulsive Disorder

Objective: The aim of the present study was to compare the effects of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on improving resilience, cognitive flexibility, and distress tolerance in adolescents diagnosed with Obsessive-Compulsive Disorder (OCD). Methods and Materials: This study employed a quasi-experimental pre-test–post-test design with a control group. The statistical population consisted of all adolescents diagnosed with OCD who were referred to psychological service centers in Mashhad in 2025. Using convenience sampling, 45 participants were selected and randomly assigned to three groups: CBT, ACT, and control. To collect data, the Connor-Davidson Resilience Scale (2003), the Cognitive Flexibility Inventory by Dennis and Vander Wal (2010), and the Distress Tolerance Scale by Simons and Gaher (2005) were administered. The CBT intervention was based on the Wilhelm and Steketee (2006) protocol and delivered over eight 90-minute sessions. The ACT intervention followed the protocol developed by Dahl et al. (2014), also implemented in eight sessions. The control group was placed on a waitlist. After the interventions, a post-test was administered to all groups. Data were analyzed using multivariate analysis of covariance (MANCOVA) with SPSS version 24 in both descriptive and inferential sections. Findings: The results of the analysis indicated that both Cognitive Behavioral Therapy and Acceptance and Commitment Therapy had statistically significant effects on improving resilience, cognitive flexibility, and distress tolerance in adolescents with Obsessive-Compulsive Disorder. Conclusion: Based on the findings, both Cognitive Behavioral Therapy and Acceptance and Commitment Therapy are recommended for enhancing resilience, cognitive flexibility, and distress tolerance in adolescents suffering from OCD.