The Effect of Acceptance and Commitment Therapy-Based Psychoeducation on Self-Esteem and Interpersonal Problem-Solving Skills in Youth With Social Media Addiction
Phase: NA
Conditions: Social Media Addiction, Self Esteem, Interpersonal Problem, Problem-solving
Sponsor: Kahramanmaras Sutcu Imam University

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
1 
 
Official Title: 
The Effect of Acceptance and Commitment Therapy–Based Psychoeducation on Self-Esteem and 
Interpersonal Problem-Solving Skills in Youth with Social Media Addiction 
 
Brief Title: 
ACT-Based Psychoeducation for Youth with Social Media Addiction 
 
Acronym: 
ACT-SM 
 
Institution: 
Kahramanmaraş Sütçü İmam University 
 
Principal Investigator: 
Prof. Dr. Döndü Çuhadar 
 
Co-Investigator / Researcher: 
Zeynep Kekeç, Research Assistant 
 
Study Type: 
Interventional (Clinical Trial) 
 
Ethics Committee Approval: 
Kahramanmaraş Sütçü İmam University Non-Interventional Clinical Research Ethics Committee 
Approval Number: 2025/15-04 
 
Document Type: 
Study Protocol 
 
 
2025 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
2 
 
THE EFFECT OF ACCEPTANCE AND COMMITMENT THERAPY-BASED 
PSYCHOEDUCATION ON SELF-ESTEEM AND INTERPERSONAL PROBLEM-
SOLVING SKILLS IN YOUTH WITH SOCIAL MEDIA ADDICTION  
 
Brief Summary 
 
While social media offers opportunities for connection and self-expression, it also brings 
significant challenges, particularly social media addiction, characterized by excessive and 
uncontrolled use. Although not officially recognized as a diagnostic category, its inclusion among 
behavioral addictions reflects its growing impact on mental health. Social media addiction may 
lead to psychological symptoms such as family and social conflicts, stress due to unmet 
responsibilities, anxiety, and irritability. This problem has become especially critical among young 
people. A 2025 meta-analysis found the prevalence of social media addiction among university 
students to be 18.4% and reported negative effects on academic achievement. Research also shows 
that social media addiction is associated with decreased self-esteem, emotion regulation 
difficulties, and dysfunctional interpersonal relationships. Social comparison tendencies and 
idealized digital identity presentations further harm young individuals' self-perceptions, 
contributing to low self-esteem and social anxiety. 
Interpersonal difficulties experienced in relationships are defined as "interpersonal problems," 
while the cognitive-behavioral processes used to resolve these difficulties are called "interpersonal 
problem solving". These skills are essential for effective conflict resolution, social adaptation, 
relationship quality, and overall well-being. Social media shapes both the emergence and resolution 
of interpersonal problems; however, current knowledge in this area is limited. Excessive use 
contributes to interpersonal conflicts, deterioration of relationships, and reduced face-to-face 
communication. Thus, social media addiction may impair interpersonal problem-solving skills by 
disrupting daily functioning. 
Although the literature includes correlational studies on social media addiction, self-esteem, and 
interpersonal functioning, research testing Acceptance and Commitment Therapy (ACT)-based 
psychoeducation remains scarce. This study offers a theoretical contribution by applying a third-
wave therapy approach to the psychosocial challenges of the digital age. It aims to evaluate the 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
3 
 
effects of an ACT-based psychoeducation program developed for young individuals with social 
media addiction on self-esteem and interpersonal problem-solving skills. Given the limited number 
of such programs in Türkiye, this study is original and aims to fill an important gap in the literature. 
Detailed Description  
The widespread use of technology and early access to digital devices have significantly increased 
in recent years. Continuous connectivity, mobility, and affordability allow users to interact freely 
with social media. Young individuals often integrate mobile devices into daily routines, spend 
excessive time online, and keep devices nearby even during sleep. While social media allows 
relationship-building and self-expression, excessive and uncontrolled use may lead to social media 
addiction. Although not officially recognized in psychiatric diagnostic systems, its classification 
under behavioral addictions reflects its increasing impact on mental health. Behavioral addictions 
may cause family and social conflicts, stress due to unmet responsibilities, anxiety, and irritability. 
Social media addiction is particularly prevalent among young adults. A 2025 meta-analysis 
reported a prevalence rate of 18.4% among university students and its negative effects on academic 
performance. Another study with 1,215 students found higher addiction levels associated with 
increased depression scores. Excessive use also affects body dissatisfaction and self-esteem. These 
findings show that social media addiction decreases self-esteem, disrupts emotional regulation, and 
impairs interpersonal functioning. Social comparison tendencies and idealized digital identities 
may worsen self-perceptions, contributing to low self-esteem and social anxiety. 
Multiple studies have shown significant negative relationships between social media addiction and 
self-esteem. Facebook addiction has been linked to low self-esteem. Similarly, low self-esteem was 
associated with higher social media addiction scores. Research from Ecuador reported moderate 
negative effects of social media addiction on self-esteem and well-being. A 2023 adolescent study 
found that addiction negatively predicted self-esteem and body image. Self-esteem is a 
fundamental construct related to life satisfaction, self-efficacy, psychological resilience, and 
interpersonal relationships. 
Interpersonal difficulties are defined as "interpersonal problems," while cognitive and behavioral 
processes intended to reduce tension in these areas are conceptualized as "interpersonal problem-
solving". Interpersonal problem-solving skills enable constructive conflict resolution and support 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
4 
 
social adaptation, relationship quality, and well-being. Social media influences how individuals 
generate and solve interpersonal problems, though evidence is limited. Excessive use leads to 
relationship deterioration, communication restrictions, and increased interpersonal conflicts. Social 
media addiction may impair interpersonal problem-solving due to its negative impact on overall 
functioning. Additionally, individuals with higher interpersonal problem-solving skills show lower 
addiction levels. Internet addiction has also been associated with avoidance-oriented coping. 
Acceptance and Commitment Therapy (ACT), a mindfulness-based intervention focusing on 
psychological flexibility, encourages individuals to accept internal experiences and act in 
accordance with personal values. ACT promotes awareness of thoughts and emotions and 
engagement in value-driven behaviors. Research demonstrates its effectiveness for anxiety, 
depression, addictive behaviors, and self-perception. ACT-based interventions have reduced social 
media use and decreased psychological distress in university students. ACT has also been found 
effective in reducing FOMO and increasing psychological flexibility. 
ACT has improved self-esteem and interpersonal problem-solving in diverse populations, such as 
individuals with schizophrenia, PCOS, body dysmorphic disorder, and obesity. ACT reduced 
internet addiction components and interpersonal difficulties among high school students. It also 
improved adolescents' interpersonal skills and was comparable to CBT in addressing interpersonal 
problems. 
Despite the correlational evidence linking social media addiction to self-esteem and interpersonal 
functioning, ACT-based interventions remain limited, especially for young adults. Thus, our study 
offers theoretical and practical innovation by applying a third-wave therapy model to digital-age 
psychosocial problems. The study aims not only to reduce addictive behaviors but also to improve 
psychological flexibility, self-esteem, and interpersonal problem-solving skills. Findings are 
expected to guide mental health professionals, psychiatric nurses, counselors, and university 
guidance services. 
The study also aligns with the 12th Development Plan (2024-2028), which emphasizes informing 
youth about digital risks, supporting evidence-based policy design, and promoting healthy 
technology use. 
 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
5 
 
Hypotheses  
H1a: ACT-based psychoeducation increases self-esteem.  
H1b: ACT-based psychoeducation reduces ineffective interpersonal problem-solving. 
H1c: ACT-based psychoeducation enhances effective interpersonal problem-solving. 
H1d: ACT-based psychoeducation reduces social media addiction. 
 
Study Design  
This randomized controlled trial (RCT) will be conducted at Kahramanmaraş Sütçü İmam 
University between November 1, 2025, and September 30, 2026. A 2×3 split-plot design 
(intervention/control × pretest/posttest/follow-up) will be used. Assessments will occur at baseline, 
post-intervention, and two-month follow-up. 
 
Study Population and Sample  
The study population includes students aged 18-30 enrolled between 01-May-2025 and 01-June-
2026. Based on G Power calculations (effect size d = 0.30; α = .05; power = .90), 31 participants 
per group were required. With 20% added for attrition, the total sample is 74 (37 per group). 
Intervention groups will consist of approximately 7-8 participants. 
Randomization Participants scoring ≥4 on the SMAS-AF will be randomized using simple 
randomization (Research Randomizer). A statistician not involved in the study will manage 
allocation. 
Participants will be randomly assigned to either the intervention group, which will receive an 8-
session ACT-based psychoeducational program, or the control group, which will not receive any 
intervention during the study period. Randomization will be performed using Research Randomizer 
by a statistician not involved in the study. The intervention and control groups will each consist of 
37 participants.  Both groups will complete assessments at baseline (pre-test), interim follow-up, 
and post-test using validated scales for self-esteem, interpersonal problem-solving skills, and social 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
6 
 
media addiction. The control group will receive a single psychoeducation session after the follow-
up assessment. 
Criteria 
 
Inclusion Criteria: 
Voluntary participation in the study. 
Age between 18 and 30 years. 
Social Media Addiction Scale - Adult Form (SMAS-AF) item average score of 4 or higher. 
Exclusion Criteria: 
Hearing or speech impairments that would prevent completing the surveys. 
Currently participating in a similar psychoeducational program. 
Receiving treatment for any psychiatric disorder at the time of the study. 
Withdrawal Criteria: 
Missing two consecutive sessions 
Disruptive behavior 
Non-compliance with group rules 
Failure to complete session assignments 
 
Variables 
Independent variable: ACT-based psychoeducation program 
Dependent variables: The score of Rosenberg Self-Esteem Scale (RSES), the score of Social Media 
Addiction Scale-Adult Form (SMAS-AF), the score of Interpersonal Problem-Solving Inventory 
 
Data Collection Tools  
Information Form; Rosenberg Self-Esteem Scale (RSES); Social Media Addiction Scale-Adult 
Form (SMAS-AF); Interpersonal Problem-Solving Inventory. 
 
Implementation 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
7 
 
Baseline assessments will be completed face-to-face. The intervention group will attend eight ACT-
based psychoeducation sessions administered by psychiatric nurse Zeynep Kekeç, certified in 
psychoeducation and ACT. Post-test assessments will be completed in the final session. The control 
group will not receive intervention during the study but will be offered a one-session program 
afterward. 
 
Data Analysis  
Data will be analyzed in SPSS. Normality will be assessed using the Shapiro-Wilk test. Descriptive 
statistics will be calculated. Parametric or non-parametric analyses will be selected based on 
distribution. Cronbach's alpha values will be computed. Significance level: p < .05. 
 
Ethical Considerations  
Ethical approval was obtained from the Kahramanmaraş Sütçü İmam University Medical Research 
Ethics Committee. Permissions for scales were secured. Participation is voluntary, and 
confidentiality and withdrawal rights will be ensured. 
 
References 
Masoumian, S., Ashouri, A., Ghomian, S., Keshtkar, M., Siahkamary, E., ve Vahed, N. 2021. 
"Efficacy of acceptance and commitment therapy compared to cognitive behavioral therapy on 
anger and interpersonal relationships of male students", Iranian Journal of Psychiatry, 16(1), 21-
29. https://doi.org/10.18502/ijps.v16i1.5374  
Bernal-Manrique, K. N., García-Martín, M. B., ve Ruiz, F. J. 2020. "Effect of acceptance and 
commitment therapy in improving interpersonal skills in adolescents: A randomized waitlist control 
trial", Journal of Contextual Behavioral Science, 17, 86-94. 
Firouzkouhi Berenjabadi, M., Pourhosein, M., ve Ghasemi Argene, M. 2021. "The effectiveness of 
acceptance and commitment therapy (ACT) on interpersonal difficulties and internet addiction 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
8 
 
among high school students", Journal of Applied Psychological Research, 12(2), 283-301. 
https://doi.org/10.22059/japr.2021.310151.643639  
Alavi Hajazi, F., ve Nezhadmohammad Nameghi, A. 2018. "The effect of group training based on 
acceptance and commitment on reducing anxiety and interpersonal problems in obese women", 
Journal of Research in Health, 8(6), 522-530. http://jrh.gmu.ac.ir/article-1-1481-en.html  
Dehbaneh, M. A. 2019. "Effectiveness of acceptance and commitment therapy in improving 
interpersonal problems, quality of life, and worry in patients with body dysmorphic disorder". 
Electronic Journal of General Medicine, 16(1). 
Shi, J.-Y., Cao, Y.-M., Luo, H.-Y., Liu, S., Yang, F.-M., Wang, Z.-H. 2023. "Effect of a group-based 
acceptance and commitment therapy (ACT) intervention on self-esteem and psychological 
flexibility in patients with schizophrenia in remission". Schizophrenia Research, 255, 213-221. 
https://doi.org/10.1016/j.schres.2023.03.042  
Moradi, F., Ghadiri-Anari, A., Dehghani, A., Reza Vaziri, S., Enjezab, B. 2020. "The effectiveness 
of counseling based on acceptance and commitment therapy on body image and self-esteem in 
polycystic ovary syndrome: An RCT". International Journal of Reproductive Biomedicine, 18(4), 
243-252. https://doi.org/10.18502/ijrm.v13i4.6887  
Bal, P. N., Kahraman, S., Hündür, U. 2025. "A correlational study of social media-related FoMO 
and psychological flexibility among adults: An acceptance and commitment therapy perspective". 
Asia Pacific Journal of Counselling and Psychotherapy. Advance online publication. 
https://doi.org/10.1080/21507686.2025.2495147  
Marmer, L. W., Nurwianti, F. 2020. "Group acceptance and commitment therapy to reduce 
psychological distress among college students with social media addiction". Proceedings of the 3rd 
International Conference on Intervention and Applied Psychology (ICIAP 2019) and the 4th 
Universitas Indonesia Psychology Symposium for Undergraduate Research (UIPSUR 2019), 132-
143. Atlantis Press. https://doi.org/10.2991/assehr.k.201125.011  
Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., Karekla, M. 2020. "The empirical status of 
acceptance and commitment therapy: A review of meta-analyses". Journal of Contextual 
Behavioral Science, 18, 181-192 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
9 
 
Twohig, M. P., Levin, M. E. 2017. "Acceptance and Commitment Therapy as a treatment for 
anxiety and depression: A review". Psychiatric Clinics of North America, 40(4), 751-770. 
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., Lillis, J. 2006. "Acceptance and commitment 
therapy: Model, processes and outcomes". Behaviour Research and Therapy, 44(1), 1-25 
Hayes, S. C., Strosahl, K. D., Wilson, K. G. 1999. Acceptance and commitment therapy: An 
experiential approach to behavior change. New York: Guilford Press. 
Ahmad, S., Nurwianti, F. 2020. "Using Acceptance and Commitment Therapy (ACT) in a group 
setting to increase quality of life in university students with social media addictions". Proceedings 
of the 2nd Tarumanagara International Conference on the Applications of Social Sciences and 
Humanities (TICASH 2020). Atlantis Press. https://doi.org/10.2991/assehr.k.201125.015  
Hasan, A. A.-H., Abu Jaber, A. 2019. "Prevalence of internet addiction, its association with 
psychological distress, and coping strategies among undergraduate students", Nurse Education 
Today, 81, 78-82. 
Berezovskaya, I. P., Shipunova, O. D., Kedich, S. I. 2019. "Internet addiction and youth coping 
strategies". Proceedings of the XI International Scientific Conference on Communicative Strategies 
of the Information Society, 1-6. Atlantis Press. 
Şahin, S., İbili, E., Uluyol, Ç. 2017. "Öğretmen adaylarında problem çözme eğilimi ve internet 
bağımlılığı ilişkisinin incelenmesi", Afyon Kocatepe University Journal of Social Sciences, 19(1), 
1-21. 
Mercan, N., Uysal, B. 2023. "The relationship of social media addiction with interpersonal 
problem-solving and personality traits in university students", Archives of Psychiatric Nursing, 43, 
50-56. https://doi.org/10.1016/j.apnu.2022.12.025  
İbili, E. 2017. "Internet addiction levels and problem-solving skills in the teaching profession: An 
investigation", Acta Didactica Napocensia, 10(4), 93-107. 
Yayman, E., Bilgin, O. 2020. "Relationship between social media addiction, game addiction and 
family functions", International Journal of Evaluation and Research in Education, 9(4), 979-986. 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
10 
 
Jiang, F., Lu, S., Zhu, X., Song, X. 2021. "Social media impacts the relation between interpersonal 
conflict and job performance", Asia Pacific Journal of Human Resources, 59(3), 420-441. 
Çam, S., Tümkaya, S. 2007. "Developing the interpersonal problem-solving inventory (IPSI): The 
validity and reliability process", Turkish Psychological Counseling and Guidance Journal, 3(28), 
95-111. 
Orth, U., Robins, R. W. 2014. "The development of self-esteem", Current Directions in 
Psychological Science, 23(5), 381-387. 
Rosenberg, M. 1965. Society and the adolescent self-image. Princeton: Princeton University Press. 
Çolak, M., Bingöl, O. S., ve Dayı, A. 2023. "Self-esteem and social media addiction level in 
adolescents: The mediating role of body image", Indian Journal of Psychiatry, 65(5), 595-600. 
https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_306_22  
Oleas Rodríguez, D., ve López-Barranco Pardo, G. 2024. "The impact of social media addiction 
on state self-esteem; a cross-sectional study in university students from Samborondón, Ecuador", 
European Public & Social Innovation Review, 9, 1-15. https://doi.org/10.31637/epsir-2024-1042  
Andreassen, C. S., Pallesen, S., ve Griffiths, M. D. 2017. "The relationship between addictive use 
of social media, narcissism, and self-esteem: Findings from a large national survey", Addictive 
Behaviors, 64, 287-293. https://doi.org/10.1016/j.addbeh.2016.03.006  
Vogel, E. A., Rose, J. P., Roberts, L. R., ve Eckles, K. 2014. "Social comparison, social media, and 
self-esteem", Psychology of Popular Media Culture, 3(4), 206-222. 
Hawi, N. S., ve Samaha, M. 2017. "The relations among social media addiction, self-esteem, and 
life satisfaction in university students", Social Science Computer Review, 35(5), 576-586 
Błachnio, A., Przepiorka, A., ve Pantic, I. 2016. "Association between Facebook addiction, self-
esteem and life satisfaction", Computers in Human Behavior, 55, 701-705. 
Khan, M. A., Alvi, S. M., Hafeez, S., Akhtar, S., ve Younis, K. 2025. "The impact of media exposure 
on self-esteem and body-satisfaction among youth: The moderating role of resilience", 
ACADEMIA International Journal for Social Sciences, 4(2), 2237-2252. 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
11 
 
Salari, N., Zarei, H., Rasoulpoor, S., Ghasemi, H., Hosseinian-Far, A., ve Mohammadi, M. 2025. 
"The impact of social networking addiction on the academic achievement of university students 
globally: A meta-analysis", Public Health in Practice, 100584. 
Woods, H. C., ve Scott, H. 2016. "#Sleepyteens: Social media use in adolescence is associated with 
poor sleep quality, anxiety, depression and low self-esteem", Journal of Adolescence, 51, 41-49. 
Doğan Keskin, A., ve Aral, N. 2021. "Game addiction: A current review", Journal of Dependence, 
22(3), 327-339. 
Nakayama, H., Ueno, F., Mihara, S., Kitayuguchi, T., ve Higuchi, S. 2020. "Relationship between 
problematic internet use and age at initial weekly internet use", Journal of Behavioral Addictions, 
9(1), 129-139. 
Cheng, C., Lau, Y. C., Chan, L., ve Luk, J. W. 2021. "Prevalence of social media addiction across 
32 nations: Meta-analysis with subgroup analysis of classification schemes and cultural values", 
Addictive Behaviors, 117, 106845. https://doi.org/10.1016/j.addbeh.2021.106845  
Çiftçi, H. 2018. "Social media addiction in university students", MANAS Journal of Social Studies, 
7(4), 417-434. 
Hruska, J., ve Maresova, P. 2020. "Use of social media platforms among adults in the United 
States—Behavior on social media", Societies, 10(1), 27. https://doi.org/10.3390/soc10010027  
Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., ve 
Bonner, R. L. Jr. 2015. "Exposure and use of mobile media devices by young children", Pediatrics, 
136(6), 1044-1050. https://doi.org/10.1542/peds.2015-2151  
Bülbül, H., ve Tunç, T. 2018. "Phone and game addiction: Scale analysis, the starting age and its 
relationship with academic success", Süleyman Demirel University Visionary Journal, 9(21), 1-13. 
https://doi.org/10.21076/vizyoner.431446   
Links  
Türkiye Cumhuriyeti Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı. 2023. "On İkinci Kalkınma 
Planı (2024-2028) 

NCT: Not yet assigned 
ACT-SM 
07-April-2025 
12 
 
URL: 
https://www.sbb.gov.tr/wp-content/uploads/2023/12/On-Ikinci-Kalkinma-Plani_2024-
2028_11122023.pd  
T.C. Sağlık Bakanlığı. 2018. Davranışsal Bağımlılıklarla Mücadele Ulusal Strateji Belgesi ve 
Eylem Planı (2019-2023). T.C. İletişim Başkanlığı. 
URL: 
https://imyo.deu.edu.tr/wp-content/uploads/2021/12/davranissal-bagimliliklar-ile-
mucadele-ulusal