New Study Compares Acceptance and Behavioral Therapy for Anxiety

Anxiety conditions range from mild to severe. They include generalized anxiety (GAD), phobia, social anxiety, obsessive compulsive behavior (OCD), and posttraumatic stress (PTSD). One of the most widely accepted methods of treatment for anxiety is cognitive behavioral therapy (CBT). However, many individuals who have anxiety do not respond well to this form of treatment. Some people are unable to make the cognitive changes necessary to achieve a positive outcome, while others cannot commit to the therapy and therefore never realize the benefits of treatment. Experts have explored other avenues of treatment for these individuals and have found that acceptance commitment therapy (ACT) is an effective alternative.

ACT is a mindfulness-based approach that encourages clients to accept their anxious feelings nonjudgmentally and to focus on the present moment and their physiological reactions while experiencing anxiety. ACT does not promote change in the beliefs about the anxious feeling, merely acceptance. CBT, on the other hand, teaches clients how to change the thoughts they associate with anxious feelings in order to elicit a different and more adaptive response. Some research has compared these two approaches, but no study has looked at specific measures of improvement in a clinical sample of anxious individuals. To address this gap, Joanna J. Arch of the Department of Psychology and Neuroscience at the University of Colorado recently examined several dimensions of outcome in participants being treated with CBT versus participants being treated with ACT.

For her study, Arch assessed 128 individuals after they completed an exposure therapy combined with either ACT or CBT. She evaluated their levels of clinical severity, quality of life, mood problems, and overall symptom severity at treatment conclusion and again 6 and 12 months posttreatment. Arch discovered that both ACT and CBT resulted in significant symptom reduction but in different ways. CBT provided a higher quality of life rating than ACT, whereas ACT resulted in lower clinical severity ratings at conclusion and follow-up. Arch concluded, “Overall, our findings suggest that ACT is a highly viable treatment alternative to CBT, the current gold-standard psychosocial treatment for anxiety disorders.”

Arch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., Craske, M. G. (2012). Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0028310

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  • Mbenitarlon


    June 22nd, 2012 at 11:17 AM

    While I am more of an advocate for CBT in that it helps you to change the way that you cognitively process those anxieties and fears, I do realize that one of the bigger drawbacks to this is that most people who need it are not willing to make the necessary commitment to the treatment that they need to make in order to fully see the changes that they could then discover in their own lives. As a result of that I think that ACT could help those who are a little more inclined to go for the change on their own time and in their own way. I know that they will still need some guidance and ACT still offers this to them but without the feeling of such a commitment that is needed for CBT to be the most beneficial. I think that just giving them something to work on and focus on could be good for many people who fight against anxiety and could be just enough of a tweak to give them a real sense that this does not have to always overtake them.

  • Reese


    June 23rd, 2012 at 6:09 AM

    I have no experience with this at all.
    Is there this feeling among those who have anxious feelings that this is somehow not accepted, that makes them feel less than others?
    That’s so odd to me that they would feel this sort of judgement and yet I know I have never thought less of someone just because this might be something that they deal with.
    It’s a part of who they are, and I kind of like this concept that ACT doesn’t encourage them to necessarily change, but to kind fo embrace the feelings and just come to learn how to live with those feelings of anxiety in a way that does not give them so much power.

  • billy r

    billy r

    June 24th, 2012 at 4:27 AM

    Not too sure that Acceptance therapy will be able to gain its legs because I think that most people looking for treatment wat more than making peace with their symptoms; they wish to not have them at all!

  • AW


    June 25th, 2012 at 12:39 AM

    Different individuals react differently and their definition of the perfect therapy may differ too.really helps to have alternatives to accommodate this variance in people.beneficial to all.

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