Comparison of the Effectiveness of Hypnotherapy and Acceptance and Commitment Therapy on Chronic Fatigue Symptoms in Patients with Fibromyalgia in Tehran

Leila  Rasti; Alireza  Maredpour

Authors

Leila Rasti PhD Student, Department of Psychology, Yasuj Branch, Islamic Azad University, Yasuj, Iran Author https://orcid.org/0009-0008-1077-2561
Alireza Maredpour Assistant professor, Department of Psychology,Yasuj Branch, Islamic Azad University, yasuj, Iran Corresponding author https://orcid.org/0000-0002-4698-1890

Keywords:

Acceptance and Commitment Therapy, Hypnotherapy, Chronic Fatigue, Fibromyalgia

Abstract

Purpose: This study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and hypnotherapy in reducing chronic fatigue symptoms among patients with fibromyalgia in Tehran.

Methodology: The research employed a semi-experimental, randomized design with a pre-test, post-test, and three-month follow-up, including two intervention groups (ACT and hypnotherapy) and one control group. A total of 45 patients with fibromyalgia were selected through convenience sampling and randomly assigned to the three groups (15 per group). Participants in the intervention groups received eight sessions of ACT or ten sessions of hypnotherapy, respectively, while the control group received no psychological intervention and continued with standard pharmacological treatment. Chronic fatigue symptoms were assessed using the Jason Chronic Fatigue Syndrome Questionnaire at all three time points. Data analysis was conducted using multivariate analysis of covariance (MANCOVA), repeated measures ANOVA, and Bonferroni post-hoc tests via SPSS-26 software.

Findings: The MANCOVA results revealed a significant difference in chronic fatigue symptoms between the three groups at both the post-test (F = 168.32, p < 0.001, η² = 0.88) and follow-up stages (F = 46.19, p < 0.001, η² = 0.79). Bonferroni post-hoc analysis showed that both ACT and hypnotherapy groups had significantly lower fatigue scores than the control group at post-test (p < 0.001), with no significant difference between ACT and hypnotherapy (p = 0.338). However, at follow-up, ACT remained significantly more effective than hypnotherapy (p < 0.001), indicating a more sustained impact.

Conclusion: These findings highlight the importance of psychological therapies in managing complex somatic symptoms in chronic conditions.

Downloads

Download data is not yet available.

References

Bowker, E., & Dorstyn, D. (2014). Hypnotherapy for Disability-Related Pain: A Meta-Analysis. Journal of Health Psychology, 21(4), 526-539. https://doi.org/10.1177/1359105314530452

Christie, D., Hood, D., & Griffin, A. (2006). Thinking, Feeling and Moving: Drama and Movement Therapy as an Adjunct to a Multidisciplinary Rehabilitation Approach for Chronic Pain in Two Adolescent Girls. Clinical Child Psychology and Psychiatry, 11(4), 569-577. https://doi.org/10.1177/1359104506067878

Creed, F. (2023). Psychiatric Disorders and the Onset of Self-Reported Fibromyalgia and Chronic Fatigue Syndrome: The Lifelines Cohort Study. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2023.1120250

Elkins, G., Jensen, M. P., & Patterson, D. R. (2007). Hypnotherapy for the Management of Chronic Pain. International Journal of Clinical and Experimental Hypnosis, 55(3), 275-287. https://doi.org/10.1080/00207140701338621

Elkins, G., Johnson, A. K., & Fisher, W. (2012). Cognitive Hypnotherapy for Pain Management. American Journal of Clinical Hypnosis, 54(4), 294-310. https://doi.org/10.1080/00029157.2011.654284

Fang, P., Tan, L., Cui, J., & Yu, L. (2023). Effectiveness of Acceptance and Commitment Therapy for people with advanced cancer: A systematic review and meta-analysis of randomized controlled trials. Journal of Advanced Nursing, 79(2), 519-538. https://doi.org/10.1111/jan.15543

Ford, A. C., Quigley, E. M. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., Soffer, E. E., Spiegel, B. M. R., & Moayyedi, P. (2014). Effect of Antidepressants and Psychological Therapies, Including Hypnotherapy, in Irritable Bowel Syndrome: Systematic Review and Meta-Analysis. Official journal of the American College of Gastroenterology | ACG, 109(9), 1350-1365. https://doi.org/10.1038/ajg.2014.148

Hartini, S., Nisa, N., Pranata, S., Oktiningrum, M., & Kristiawati, S. P. (2025). Effect of Hypnotherapy on Paediatric Cancer Pain Management in Indonesia: A Quasi-Experimental Study. Bangabandhu Sheikh Mujib Medical University Journal, 18(1), e75339. https://doi.org/10.3329/bsmmuj.v18i1.75339

Hutomo, Y. (2024). Case Study : Observation of Reducing Heartburn Pain in Gastroesophageal Reflux Disease (Gerd) With Hypnotherapy. Jurnal Syntax Admiration, 5(10), 767-773. https://doi.org/10.46799/jhs.v5i10.1379

Irani, S. P., Soleimankhani, H., Shalamzari, A. M., & Sayyad, S. (2019). The Effectiveness of Cognitive Hypnotherapy on Reduction of Intrusive Thoughts, Avoidance, Hyper Arousal and Pain Intensity and Improvement of Quality of Life in Women With Breast Cancer. Biannual Journal of Contemporary Psychology, 13(2), 99-108. https://doi.org/10.29252/bjcp.13.2.99

Javadi, T. H. S., Masjedi, M. A., Hamzehloo, E., Chehraghi, M. J., Razavi, L., Rahmani, S., & Nejati, S. (2021). Effectiveness of Group Therapy Based on Acceptance and Commitment on the Severity of Fatigue and Depression with the Moderating role of Alexithymia in Multiple Sclerosis Patients. International Clinical Neurosciences Journal, 8(1), 37-43. https://doi.org/10.34172/icnj.2021.08

Karimi, M., Narenji Thani, F., Naghsh, Z., & Ghazaghi, T. (2022). Comparing the effectiveness of acceptance and commitment-based therapy with cognitive-behavioral therapy in improving fatigue in patients with multiple sclerosis. Iranian journal of psychiatry and behavioral sciences, 16(1), 117-131. https://doi.org/10.5812/ijpbs.107467

Li, H., Wong, C. L., Jin, X., Chen, J., Chong, Y. Y., & Bai, Y. (2021). Effects of Acceptance and Commitment Therapy on health-related outcomes for patients with advanced cancer: A systematic review. International journal of nursing studies, 115, 103876. https://doi.org/10.1016/j.ijnurstu.2021.103876

Mosher, C. E., Secinti, E., Wu, W., Kashy, D. A., Kroenke, K., Bricker, J. B., Helft, P. R., Turk, A. A., Loehrer, P. J., Sehdev, A., Al‐Hader, A., Champion, V. L., & Johns, S. A. (2022). Acceptance and Commitment Therapy for Patient Fatigue Interference and Caregiver Burden in Advanced Gastrointestinal Cancer: Results of a Pilot Randomized Trial. Palliative Medicine, 36(7), 1104-1117. https://doi.org/10.1177/02692163221099610

Nazari, A., Saedi, S., & Abdi, M. (2023). Comparing the effectiveness of schema therapy and acceptance and commitment therapy on chronic fatigue syndrome in patients with multiple sclerosis. Journal of Personality and Psychosomatic Research (JPPR), 1(1), 25-28. https://doi.org/10.61838/kman.jppr.1.1.6

Pizova, N. V. (2024). Mental Fatigue and Chronic Fatigue Syndrome in Clinical Practice. Meditsinskiy Sovet = Medical Council(3), 185-192. https://doi.org/10.21518/ms2024-150

Qiu, D., He, J., Li, Y., Li, R., Ouyang, F., Li, L., Luo, D., & Xiao, S. (2022). Stressful Life Events and Chronic Fatigue Among Chinese Government Employees: A Population-Based Cohort Study. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.890604

Roshandel, Z., Ghaffari, A., Kazemi, R., & Nadermohammadi, M. (2022). Effectiveness of Acceptance and Commitment based Therapy on Pain Severity, Fatigue, and Alexithymia in Female Patients with Rheumatic Diseases. Applied Family Therapy Journal (AFTJ), 3(5), 84-100. https://doi.org/10.61838/kman.aftj.3.5.6

Rostami, M., Bulut, S., Coelho, O., & Riyono, B. (2024). Living with Fibromyalgia: A Phenomenological Study of Pain, Fatigue, and Coping. Journal of Personality and Psychosomatic Research (JPPR), 2(1), 16-23. https://doi.org/10.61838/kman.jppr.2.1.4

Sakkaki, S., Naderi, F., & Hafezi, F. (2023). Causal relationship between Depression and Health-related quality of life through chain mediation of Chronic Fatigue and Treatment Adherence in women with uterine cancer. Applied Family Therapy Journal (AFTJ), 4(1), 512-533. https://doi.org/10.61838/kman.aftj.4.1.25

Sampalli, T., Berlasso, E., Fox, R. A., & Petter, M. (2009). A Controlled Study of the Effect of a Mindfulness-Based Stress Reduction Technique in Women With Multiple Chemical Sensitivity, Chronic Fatigue Syndrome, and Fibromyalgia. Journal of Multidisciplinary Healthcare, 53. https://doi.org/10.2147/jmdh.s5220

Segura‐Jiménez, V., Borges-Cósic, M., Soriano‐Maldonado, A., Estévez‐López, F., Álvarez‐Gallardo, I. C., Herrador‐Colmenero, M., Fernández, M. D., & Ruiz, J. R. (2015). Association of Sedentary Time and Physical Activity With Pain, Fatigue, and Impact of Fibromyalgia: The Al‐Ándalus Study. Scandinavian Journal of Medicine and Science in Sports. https://doi.org/10.1111/sms.12630

Taylor, D. A., & Genkov, K. A. (2019). Hypnotherapy for the Treatment of Persistent Pain: A Literature Review. Journal of the American Psychiatric Nurses Association, 26(2), 157-161. https://doi.org/10.1177/1078390319835604

Valian, S., Akbari, H., & Mirani, A. (2024). The Effectiveness of Cognitive Hypnotherapy on Subjective Pain and Guilt in Individuals With a History of Suicide. Jayps, 5(9), 8-14. https://doi.org/10.61838/kman.jayps.5.9.2

Vincent, A., Benzo, R., Whipple, M. O., McAllister, S. J., Erwin, P. J., & Saligan, L. N. (2013). Beyond Pain in Fibromyalgia: Insights Into the Symptom of Fatigue. Arthritis Research & Therapy. https://doi.org/10.1186/ar4395

Yusefi, R., Hafezi, F., Bakhtiarpoor, S., & Makvandi, B. (2022). Comparing the effectiveness of cognitive- behavioral hypnotherapy and mindfulness therapy on pain perception and self-efficacy in women with breast cancer in Gorgan. Applied Family Therapy Journal (AFTJ), 3(5), 209-227. https://doi.org/10.61838/kman.aftj.3.5.13

Zhang, Y., Ding, Y., Chen, X., Li, Y., Li, J., & Hu, X. (2023). Effectiveness of acceptance and commitment therapy on psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer: A meta-analysis of randomized controlled trials. Worldviews on Evidence-Based Nursing, 00, 1-11. https://doi.org/10.1111/wvn.12652