Iranian Journal of War and Public Health

Aims: Post-traumatic stress disorder (PTSD) is a prevalent and disabling mental health condition among military personnel and veterans that also affects spouses and families. Acceptance and Commitment Therapy (ACT) has emerged as a promising intervention for improving psychological flexibility and reducing trauma-related distress. This systematic review evaluated the effectiveness of ACT for PTSD among military personnel, veterans, and their spouses.

Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, SID, and Magiran from database inception through May 25, 2026. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT 2018).

Findings: Fifteen studies were included. ACT was associated with reductions in PTSD symptoms, anxiety, depression, experiential avoidance, psychological distress, and alcohol-related problems, while improving psychological flexibility, resilience, quality of life, and social functioning. Evidence consistently supported the effectiveness of ACT among military personnel and veterans, whereas evidence for military spouses remained limited.

Conclusion: ACT appears to be a promising intervention for PTSD and related psychological difficulties in military personnel and veterans. However, additional large-scale randomized controlled trials with longer follow-up periods, particularly involving military spouses and families, are needed to strengthen the current evidence base.