the efficacy of acceptance and commitment therapy on internalized shame, fear of success, and anxiety sensitivity in nursing with imposter

Background: imposter phenomenon (ip), marked by self-doubt and fear of exposure, is common among high-achieving individuals, including nursing students facing academic and clinical pressures. these challenges heighten shame, fear of success, and anxiety sensitivity, harming mental health and performance. acceptance and commitment therapy (act), focusing on psychological flexibility, is a promising intervention. this study evaluated the act’s effectiveness in reducing these patterns in nursing students with ip.methods: this quasi-experimental study used a parallel-group design with pre-test and post-test measures. thirty-six nursing students with ip from tehran (districts 7 and 8) were purposively sampled and non-randomly assigned to the experimental (n=18) and control (n=18) groups. the experimental group attended eight 90-minute act sessions, while the control group received no intervention. data were collected using validated psychological scales and analyzed using mancova, adjusting for baseline scores. results: the findings revealed that act led to a significant reduction in internalized shame (f=39.86, p<0.001), fear of success (f=57.27, p<0.001), and anxiety sensitivity, including its physical (f=56.55, p<0.001), cognitive (f=45.58, p<0.001), and social (f=47.41, p<0.001) dimensions. the effect sizes were large, indicating substantial improvements in the mental health of the experimental group compared to the control group (p<0.001).conclusion: act effectively reduces internalized shame, fear of success, and anxiety sensitivity in nursing students with ip. by fostering psychological flexibility and value-driven behavior, act may enhance mental health, academic resilience, and professional confidence. integrating act into nursing education could support students’ psychological well-being and success.