Comparative Efficacy of Acceptance and Commitment Therapy versus Schema Therapy for Irrational Beliefs and Death Anxiety in Elderly Women: A Randomized Study

Introduction: Irrational beliefs and death anxiety are prevalent psychological concerns among elderly women, significantly impacting their mental well-being and quality of life. This study aimed to compare the efficacy of Acceptance and Commitment Therapy (ACT) and Schema Therapy (ST) in reducing these psychological constructs in elderly women. Methods: This randomized controlled trial utilized a pre-test, post-test, and follow-up design with two experimental groups and one control group. In 2023, 45 elderly women from Sabzevar, Iran, were selected via convenience sampling and then randomly assigned into three groups (ACT, ST, or waiting-list control), each with 15 participants. The ACT and ST groups received 8 weekly, 90-minute intervention sessions following standardized protocols, while the control group received no immediate intervention. Data were collected using the Irrational Beliefs Questionnaire and Collett–Lester Fear of Death Scale. Repeated measures ANOVA, followed by post-hoc tests, was conducted using SPSS (version 27). Results: Both ACT and ST significantly reduced irrational beliefs (ACT: η² = 0.77; ST: η² = 0.75) and death anxiety (ACT: η² = 0.77; ST: η² = 0.76) compared to the control group (p < 0.001). No statistically significant differences were found between the two interventions. Conclusion: ACT and ST are effective interventions for reducing irrational beliefs and death anxiety in elderly women, highlighting their value in enhancing psychological well-being in this population.