Comparison of the Effectiveness of Mentalization-Based Therapy (MBT) and Acceptance and Commitment Therapy (ACT) in Reducing Impulsivity and Suicidal Ideation and Enhancing Resilience and Cognitive Flexibility in Adolescents with a History of Suicide Attempt in Shiraz
Determining and Comparing the Effectiveness of Mentalization-Based Therapy and Acceptance and Commitment Therapy on Reducing Impulsivity and Suicidal Ideation and Enhancing Resilience and Cognitive Flexibility in Adolescents with a History of Suicide Attempt
Design
A randomized, three-arm parallel-group clinical trial with a control group involving 60 adolescents with a history of suicide attempt. Participants will be randomly assigned to the Mentalization-Based Therapy group (n=20), Acceptance and Commitment Therapy group (n=20), or control group (n=20) using the RAND function in Microsoft Excel. This Phase 2 clinical trial will evaluate the effectiveness of the interventions.
Settings and conduct
Shiraz, Ibn Sina Hospital – Psychotherapy
Participants/Inclusion and exclusion criteria
Inclusion Criteria: Adolescents aged 13 to 18 years with at least one previous suicide attempt; ability to participate in therapy sessions; suitability for interventions confirmed by licensed clinical psychologists; parental or legal guardian informed consent; relative stability of psychiatric medication status (if applicable); and absence of concurrent structured psychotherapy.
Exclusion Criteria: Immediate suicide risk requiring hospitalization; severe psychiatric disorders (e.g., active psychosis or mania), severe personality disorders, or conditions interfering with treatment; substance use disorder; severe cognitive impairment or intellectual disability
Intervention groups
Group 1: Participants will receive 10 sessions of Mentalization-Based Therapy (MBT).
Group 2: Participants will receive 10 sessions of Acceptance and Commitment Therapy (ACT)
Main outcome variables
Reduction in impulsivity, reduction in suicidal thoughts, increased resilience, increased cognitive flexibility.
General information
Reason for update
Acronym
MBT-ACT
IRCT registration information
IRCT registration number:IRCT20260713070174N1
Registration date:2026-08-12, 1405/05/21
Registration timing:prospective
Last update:2026-08-12, 1405/05/21
Update count:0
Registration date
2026-08-12, 1405/05/21
Registrant information
Name
Mohammd Ranjbar
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 71 3272 8290
Email address
mohammad.ranjbar271174@gmail.com
Recruitment status
recruiting
Funding source
Expected recruitment start date
2026-09-20, 1405/06/29
Expected recruitment end date
2026-11-20, 1405/08/29
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Comparison of the Effectiveness of Mentalization-Based Therapy (MBT) and Acceptance and Commitment Therapy (ACT) in Reducing Impulsivity and Suicidal Ideation and Enhancing Resilience and Cognitive Flexibility in Adolescents with a History of Suicide Attempt in Shiraz
Public title
Comparison of the Effectiveness of Mentalization-Based Therapy and Acceptance and Commitment Therapy in Adolescents with a History of Suicide Attempt
Purpose
Education/Guidance
Inclusion/Exclusion criteria
Inclusion criteria:
Having a history of at least one previous suicide attempt
Having sufficient psychological stability to participate in the study
Being literate and able to complete the study questionnaires
Not receiving similar psychotherapy during the study intervention period
Providing written informed consent from both the participant and their parent or legal guardian
Exclusion criteria:
Emergence of an immediate risk of suicide or severe intensification of suicidal thoughts.
Severe psychiatric disorders (such as active psychosis, or bipolar disorder in a manic or hypomanic phase)...
Suffering from acute physical illnesses or serious medical conditions that prevent regular attendance at therapy sessions.
Withdrawal of the participant or their parent/legal guardian from further participation, as well as the emergence of any new psychiatric or medical condition that renders continued participation in the study ethically or therapeutically inappropriate.
Age
From 13 years old to 19 years old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size:
60
Randomization (investigator's opinion)
Randomized
Randomization description
Simple Randomization Method: Following the confirmation of eligibility criteria and the acquisition of informed consent, participants are randomly assigned—using a random number table or computer-generated random numbers—with equal probability to one of two groups: Mentalization-Based Treatment (MBT) or Acceptance and Commitment Therapy (ACT). The allocation process ensures that each participant has an equal chance of being assigned to either group. The control group receives no treatment.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics Committee of Arsenjan Branch, Islamic Azad University
Street address
Islamic Azad University, Arsanjan Branch, Daneshgah St., Arsanjan, Fars Province, Postal Code: 7376153161
City
ارسنجان
Province
Fars
Postal code
۷۳۷۶۱۵۳۱۶۱
Approval date
2026-04-22, 1405/02/02
Ethics committee reference number
IR.IAU.A.REC.1405.004
Health conditions studied
1
Description of health condition studied
Suicide
ICD-10 code
T14.91
ICD-10 code description
Suicide attempt
Primary outcomes
1
Description
Impulsivity
Timepoint
before the intervention, after the intervention, and two months after the intervention endedIf you want, I can also give you a more formal academic version.
Method of measurement
Barratt Impulsiveness Scale (Barratt et al., 1995)
2
Description
Suicidal Ideation
Timepoint
before the intervention, after the intervention, and two months after the intervention ended
Method of measurement
Beck Scale for Suicide Ideation (BSSI)
3
Description
Resilience
Timepoint
before the intervention, after the intervention, and two months after the intervention ended
Method of measurement
Connor-Davidson Resilience Scale (CD-RISC, 2003)
4
Description
Cognitive Flexibility
Timepoint
before the intervention, after the intervention, and two months after the intervention ended
Method of measurement
Cognitive Flexibility Inventory (CFI; Dennis & Vander Wal, 2010)
Secondary outcomes
empty
Intervention groups
1
Description
Intervention group:Intervention group: In this study, the first intervention group received Mentalization-Based Treatment (MBT) based on the protocol developed by Malberg (2021). The intervention was structured over 10 sessions with the aim of enhancing participants’ ability to understand their own and others’ thoughts, emotions, and behaviors. In the initial sessions, the fundamental concepts of mentalization, emotional awareness, difficulties related to mind-reading, impulsivity, and interpersonal sensitivity were introduced, enabling participants to gain greater insight into their internal states and those of others. During the middle sessions, skills related to emotion regulation, effective communication, mentalization practice, and the exploration of individual difficulties within a group context were taught. Furthermore, through clarification and a focus on participants’ emotional experiences, the therapist facilitated the development of interpersonal trust and relational understanding. In the final session, the therapeutic process was reviewed, and participants’ feelings regarding treatment termination and their achieved outcomes were explored.
Category
Behavior
2
Description
Intervention group: In this study, the second intervention group received Acceptance and Commitment Therapy (ACT) based on Hayes’ (2004) protocol over eight sessions. The intervention was designed to enhance psychological flexibility, promote acceptance of internal experiences, and facilitate engagement in value-consistent behaviors. In the initial sessions, the therapeutic relationship, treatment contract, psychoeducation, exploration of personal experiences, the ineffectiveness of excessive control strategies, and the concept of creative hopelessness were addressed. During the middle sessions, cognitive defusion techniques, self-as-context, mindfulness practices, and changing individuals’ relationships with their thoughts and emotions were introduced and practiced. In the final sessions, participants explored personal values, developed commitment to purposeful actions, and established behavioral patterns aligned with their values, enabling them to respond more effectively to internal experiences and life challenges.
Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
No - There is not a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
The data relating to the study participants is confidential and will be used solely for statistical analysis.
When the data will become available and for how long
The data from this study will be accessible for a period of 6 months after the publication of the research results in the form of scholarly articles.
To whom data/document is available
The data will be accessible to the researchers, including Dr. Mohammad Ranjbar, Dr. Ali Mohammad Rezaei, and Dr. Akbar Rezaei Fard, and the published articles will be made available to them.
Under which criteria data/document could be used
The statistical analysis output will be available.
From where data/document is obtainable
Applicants can contact via email at mohammad.ranjbar271174@gmail.com or WhatsApp at 09174137101.
What processes are involved for a request to access data/document
After the completion of the research and publication of the extracted articles, it will be available for a maximum of 6 months.