Comparison of Acceptance and Commitment Therapy and Cognitive Behavior Therapy: Managing Psychological Distress and Its Multifaceted Impact on Stigmatization, Psychological Wellbeing, Social Support and Treatment Adherence in HIV/AIDS Patients

Background \& Rationale: HIV/AIDS is a chronic condition with significant psychological burden. People living with HIV/AIDS experience high levels of depression, anxiety, stress, and stigma, which affect treatment adherence and quality of life. Both Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are evidence-based interventions for psychological distress, but their comparative effectiveness in HIV/AIDS patients in Pakistan has not been evaluated. This study aims to compare ACT and CBT for managing psychological distress and improving stigma, wellbeing, social support, and medication adherence. Objective: To compare the effectiveness of brief Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) in reducing psychological distress and improving stigmatization, psychological wellbeing, social support, and medication adherence among HIV/AIDS patients. Study Design: Randomized Controlled Trial with single-blind design. Participants will be allocated to three groups using a computer-generated randomization sequence: 1. CBT group (n=24): Standard care + 8 weeks of brief CBT 2. ACT group (n=24): Standard care + 8 weeks of brief ACT 3. Control group (n=24): Standard care only, no specific psychological intervention A pilot study with 15 participants will be conducted prior to the main trial. Participants: * Inclusion: Adults aged 18-40 years with a documented HIV/AIDS diagnosis, receiving ART, actively seeking treatment at Sheikh Zayed Hospital, and providing informed consent. * Exclusion: Severe cognitive impairment, severe psychiatric conditions requiring specialized care, or prior participation in similar CBT/ACT interventions for HIV/AIDS. Intervention: Both ACT and CBT will be delivered as once-weekly sessions of 35-40 minutes for 8 weeks. * ACT focuses on acceptance, mindfulness, values, committed action, and cognitive diffusion. * CBT focuses on identifying/challenging negative thoughts, behavioral activation, and coping strategies. Interventions will be culturally adapted and delivered by therapists with at least a Master's degree and training in CBT/ACT. Outcome Measures: Assessments at baseline, post-intervention, and 6-month follow-up using: * DASS-21: Depression, Anxiety, Stress Scale * Psychological Well-Being Scale (PWB): 6 domains of wellbeing * HIV Stigma Scale: To measure perceived stigma * Multidimensional Perceived Social Support Scale (MPSS): Urdu version * General Medication Adherence Scale (GMAS): Urdu version * Mini-Mental State Examination (MMSE): For cognitive screening Data Collection \& Analysis: Data will be collected using self-report questionnaires. Ethical approval will be obtained from the IRB of Sheikh Zayed Hospital. Informed consent, confidentiality, and voluntary participation will be ensured. Data analysis will compare outcomes across the three groups to evaluate effectiveness. Ethics: The study complies with ethical standards for human research. Institutional approval and ongoing informed consent will be maintained. Participant anonymity and data protection will be rigorously enforced. Duration: Study duration is not specified in the excerpt, but involves 8-week intervention plus 6-month follow-up. Institution: Department of Applied Psychology, The Islamia University Bahawalpur. Principal Investigator: Sadia Batool, Ph.D. Applied Psychology