Study aim: Comparison of the effectiveness of expressive writing and music therapy on distress tolerance and maternal role adaptation in mothers of premature infants Design: Randomized clinical trial with control group, 2 intervention groups and 1 control, unblinded, on 90 patients. G*Power3 software was used for randomization. Settings and conduct: This randomized controlled clinical trial compares expressive writing and music therapy on distress tolerance and maternal role adaptation in 90 mothers of preterm infants in Namazi and Hafez Hospitals, Shiraz. Participants are assigned to three groups and receive interventions over six 15–20 minute sessions for two weeks. Data are collected using demographic questionnaires, the Simons and Gaher Distress Tolerance Scale, and the Heydarpour et al. Maternal Role Adaptation Instrument at three time points and analyzed. Participants/Inclusion and exclusion criteria: Inclusion criteria: -Maternal age above 18 years. -Preterm birth (less than 37 weeks of gestation). -Minimum level of maternal literacy sufficient for completing the questionnaires. -Absence of psychiatric disorders or use of related psychotropic medications (self-reported), and absence of chronic physical illnesses. -Singleton pregnancy. -No history of previous preterm delivery. -Hospital stay of at least 14 days. Exclusion criteria: -Mothers other than those in the neonatal ward -Mothers of infants admitted to other hospitals Intervention groups: Expressive writing group: Mothers in this group write down their thoughts and feelings using paper and pen. Music therapy group: Mothers in this group listen to 6 pieces of music selected by a music specialist using headphones. Control group: They receive routine ward care without any additional intervention. Main outcome variables: Peace of mind and life of mothers of preterm infants; maternal stress and anxiety; maternal care for their infant in the ward