The Effectiveness of Internet-Based Cognitive Behavioral Therapy on Psychological Flexibility, Distress Tolerance, and Alexithymia in Female Students with High-Risk Behaviors
Keywords:
Internet-Based Cognitive Behavioral Therapy, Psychological Flexibility, Distress Tolerance, Alexithymia, High-Risk Behaviors, Female StudentsAbstract
The present study aimed to investigate the effectiveness of internet-based Cognitive Behavioral Therapy on psychological flexibility, distress tolerance, and alexithymia among female students with high-risk behaviors. This study employed a quasi-experimental design with pre-test, post-test, control group, and a two-month follow-up phase. The statistical population consisted of female high school students with high-risk behaviors in Ahvaz during the 2025-2026 academic year. Forty participants were selected using purposive sampling and randomly assigned to experimental and control groups. The experimental group received ten 90-minute sessions of internet-based Cognitive Behavioral Therapy, while the control group remained on a waiting list. Data collection instruments included the Acceptance and Action Questionnaire-II, the Distress Tolerance Scale, and the Toronto Alexithymia Scale. Data were analyzed using repeated measures ANOVA and Bonferroni post hoc tests in SPSS-27. The results of repeated measures ANOVA indicated significant effects of time, group, and time-by-group interaction for psychological flexibility, distress tolerance, and alexithymia (P<0.001). Bonferroni post hoc comparisons revealed significant differences between pre-test and post-test as well as pre-test and follow-up stages for all variables, whereas no significant differences were found between post-test and follow-up stages. The findings demonstrated that internet-based Cognitive Behavioral Therapy significantly improved psychological flexibility and distress tolerance while reducing alexithymia among students with high-risk behaviors, and these effects remained stable during follow-up. The findings suggest that internet-based Cognitive Behavioral Therapy can be considered an effective and accessible intervention for improving emotional and cognitive functioning among female students with high-risk behaviors. By enhancing emotional regulation skills, modifying maladaptive cognitions, and promoting psychological adaptation, this therapeutic approach may play an important role in reducing adolescents’ psychological vulnerability.
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