Background and Objectives: Suicide is a public health concern. Suicide prevention is an integral part of the World Health Organization's first psychotherapy program. Therefore, this study aimed to determine and compare the effectiveness of reality therapy and acceptance and commitment therapy on suicidal tendencies and anxiety in adolescents.
Materials and Methods: The present study employed a quasi-experimental design with a pretest-posttest setup, including two experimental groups and one control group. The population consisted of female high school students in Yazd during the 2023–2024 academic year. From this population, 45 students were selected through cluster random sampling and assigned to three groups of 15 participants each. Data were collected using the Beck Scale for Suicidal Ideation (1961) and the Beck Anxiety Inventory (1988). The Acceptance and Commitment Therapy (ACT) and Reality Therapy sessions were conducted for the experimental groups over 8 sessions, each lasting 60 minutes, while the control group received no intervention. Data were analyzed using multivariate analysis of covariance (MANCOVA).
Results: The findings indicated that both Reality Therapy and Acceptance and Commitment Therapy significantly reduced suicidal ideation and anxiety compared to the control group (p<0.001). However, no significant differences were observed between the two therapeutic approaches in reducing suicidal ideation and anxiety.
Conclusion: The results demonstrate the effectiveness of both therapeutic approaches in reducing suicidal ideation and anxiety. Therefore, therapists and mental health professionals can utilize these methods to improve health-related outcomes, particularly in reducing suicidal tendencies and anxiety, and they are recommended as part of preventive and mental health promotion programs for adolescent girls.
Keywords: Acceptance and commitment therapy, Reality therapy, Suicide, Anxiety, Adolescents

Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics Committee of Lorestan University approved the study (IR.LUMS.REC.1403.22).
Authors' contributions:
- Conceptualization: Farzaneh Sadat Razavi
- Methodology: Farzaneh Sadat Razavi, Mohammad Esmaeil Ebrahimi
- Data collection: Farzaneh Sadat Razavi, Ali Nazari
- Formal analysis: Farzaneh Sadat Razavi, Ali Nazari
- Supervision: Mohammad Esmaeil Ebrahimi, Ali Nazari
- Project administration: Mohammad Esmaeil Ebrahimi, Farzaneh Sadat Razavi
- Writing – original draft: Mohammad Esmaeil Ebrahimi, Farzaneh Sadat Razavi