en General پژوهشي Research Article <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><strong>Background:</strong> Migraine, a chronic neurological disorder, significantly impacts women&#39;s quality of life through psychological distress. Acceptance and commitment therapy (ACT) enhances distress tolerance and cognitive flexibility by promoting acceptance and value-driven action. Compassion-focused therapy (CFT) fosters self-compassion, reducing self-criticism to alleviate distress and support cognitive flexibility.<br> <strong>Objectives: </strong>The objective of this study was to compare the effectiveness of ACT and CFT in enhancing distress tolerance and cognitive flexibility in women with migraine.<br> <strong>Methods: </strong>This quasi-experimental study employed a pre-test-post-test design with a 3-month follow-up and a control group. The statistical population included women diagnosed with migraine in Ahvaz, Iran, in 2023. A sample of 108 participants was selected via convenience sampling from patients attending the Labkhande Zendegi Counseling Center and randomly assigned to three groups (ACT, CFT, and waitlist control; n = 36 per group) using computer-generated random numbers. The experimental groups received 8 weekly 90-minute sessions of either ACT or CFT, while the control group remained on a waitlist. Data were collected using the Distress Tolerance Scale (DTS) and Cognitive Flexibility Inventory (CFI) and analyzed using repeated measures analysis of variance with a significance level of 0.05.<br> <strong>Results: </strong>Both ACT and CFT significantly improved distress tolerance (ACT: From 29.70 &plusmn; 4.13 to 50.40 &plusmn; 4.72; CFT: From 30.00 &plusmn; 3.99 to 49.35 &plusmn; 4.25) and cognitive flexibility (ACT: From 46.06 &plusmn; 5.28 to 78.12 &plusmn; 5.88; CFT: From 46.60 &plusmn; 4.92 to 68.00 &plusmn; 5.43) compared to the control group (P < 0.001), with effects maintained at follow-up. The ACT showed a significantly greater improvement in cognitive flexibility compared to CFT (mean difference: 10.12, P < 0.001), but no significant difference was observed for distress tolerance (P = 0.325).<br> <strong>Conclusions:</strong> The findings indicate that both ACT and CFT are effective in improving distress tolerance and cognitive flexibility in women with migraine, with ACT showing a relative advantage in enhancing cognitive flexibility. These results suggest that clinicians can select either approach based on patient needs, potentially improving psychological management of migraine-related distress.</span></span></div> Migraine Disorders,Psychological Distress,Cognitive Flexibility,Acceptance and Commitment Therapy, Compassion-Focused Therapy 0 0 http://mcj.bums.ac.ir/browse.php?a_code=A-10-1-320&slc_lang=en&sid=1 Farima Foroughi 10031947532846006332 0009-0000-6479-7205 No Department of Counseling, Ahv.C., Islamic Azad University, Ahvaz, Iran Maryam Gholamzadeh Jofreh 10031947532846006333 10031947532846006333 Yes Department of Counseling, Ahv.C., Islamic Azad University, Ahvaz, Iran. Email: maryam.jofreh@iau.ac.ir Kobra Kazemian Moghadam 10031947532846006334 10031947532846006334 No Department of Psychology, Dez.C., Islamic Azad University, Dezful, Iran Parvin Abedi 10031947532846006335 10031947532846006335 No Department of Midwifery, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran