The Effectiveness of Existential Therapy on Cognitive Flexibility, Experiential Avoidance, Internalized Shame, and Anxiety Sensitivity in Clients of Beauty Centers: A Systematic Meta-Analytic Review

Background: Psychological distress among clients of beauty centers is increasingly discussed within contemporary clinical and health psychology, particularly in relation to body image concerns, self-evaluative processes, experiential avoidance, and heightened sensitivity to anxiety-related sensations. Existential therapy, with its emphasis on meaning, freedom, responsibility, authenticity, mortality awareness, and self-confrontation, has been proposed as a potentially useful intervention for modifying maladaptive cognitive-emotional processes. The present systematic meta-analytic review examined the effectiveness of existential therapy on cognitive flexibility, experiential avoidance, internalized shame, and anxiety sensitivity in clients of beauty centers. Methods: A systematic search strategy was designed to identify empirical and review studies published between ۲۰۲۰ and ۲۰۲۵ in international and Persian-language databases and indexed sources. Search terms were constructed around existential therapy, cognitive flexibility, experiential avoidance, shame, internalized shame, anxiety sensitivity, body image, and beauty-related service populations. Studies were screened according to predefined inclusion and exclusion criteria. Effect sizes were synthesized using random-effects models. Heterogeneity was assessed using the \(Q\) statistic, \(I^۲\), and between-study variance \(\tau^۲\). Publication bias was examined using funnel plot inspection and Egger-type asymmetry logic. Moderator patterns were explored descriptively where study-level reporting allowed. Results: The synthesized evidence indicated that existential therapy was associated with beneficial changes in all four target outcomes. The largest effects were observed for experiential avoidance and internalized shame, followed by anxiety sensitivity and cognitive flexibility. Across studies, the direction of findings consistently favored existential-based interventions over comparison conditions or pretest baselines. Heterogeneity was moderate to high, reflecting variation in intervention dosage, population characteristics, and outcome measurement tools. The evidence base, although promising, remains limited in sample size and geographic diversity. Conclusion: Existential therapy appears to be a clinically meaningful intervention for reducing maladaptive avoidance-based and self-evaluative processes while strengthening cognitive flexibility among clients of beauty centers. However, stronger randomized trials, standardized measures, and cross-cultural replications are needed before firm generalized conclusions can be drawn.

کلیدواژه ها:

existential therapy ، cognitive flexibility ، experiential avoidance ، internalized shame ، anxiety sensitivity ، beauty centers ، meta-analysis