A Randomised Controlled Trial of Acceptance and Commitment Therapy and Cognitive-Behaviour Therapy for Generalised Anxiety Disorder

Abstract

The study examined the relative efficacy of group acceptance and commitment therapy (ACT) for generalised anxiety disorder (GAD) compared to group cognitive-behavioural therapy (CBT). Fifty-one individuals with GAD were randomly allocated to a 6-week intervention, either ACT or CBT. Participants were assessed at pre-treatment, post-treatment, and 3-month follow-up on symptom measures, quality of life, and process measures. Data from 38 participants (19 in each group) were available at post-assessment, indicating significant improvements on all measures for both treatment conditions. Treatment gains were maintained at follow-up, with significant further improvements in anxiety, depression and stress symptoms for both groups. While no between-group differences were found at treatment completion, a significant interaction indicating steeper reduction in worrying symptoms (d = .79) from pre- to post-assessment was found for the ACT group compared to the CBT group. Furthermore, in relation to worrying, at treatment completion 78.9% of participants in the ACT group achieved reliable change compared to 47.4% of participants in the CBT group. However, both groups showed equivalent reliable change rates of 60% at the follow-up assessment. The results suggest that group ACT was as efficacious as group CBT. While participants in the ACT group maintained treatment gains at follow-up, participants in the CBT group continued to improve between post-assessment and follow-up.

A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology

“…ACT also encourages individuals to clarify their personal values and engage in behaviors that are consistent with these values in order to help them regulate their emotions. Randomized controlled trials have found that in adults ACT decreases: depression (Öst, 2014), psychotic symptoms (Bach and Hayes, 2002;Bach, Hayes, and Gallop, 2012;Gaudiano and Herbert, 2006;White et al, 2011), panic disorder, generalized anxiety disorder, and social anxiety (Arch et al, 2012;Avdagic, Morrissey, and Boschen, 2014), obsessive-compulsive disorder (Twohig et al, 2010), drug and nicotine dependence (Hernández-López, Luciano, Bricker, Roales-Nieto, and Montesinos, 2009;Luoma, Kohlenberg, Hayes, and Fletcher, 2012), borderline personality disorder (Gratz and Gunderson, 2006;Morton, Snowdon, Gopold, and Guymer, 2012), chronic pain (Hann and McCracken, 2014;Veehof, Oskam, Schreurs, and Bohlmeijer, 2011;Weineland, Arvidsson, Kakoulidis, and Dahl, 2012;Wetherell et al, 2011), and improves weight control (Forman et al, 2007;Juarascio, Forman, and Herbert, 2010;Lillis, Hayes, Bunting, and Masuda, 2009). Research evidence for the application of ACT with adolescents is less extensive although four randomized controlled trials have found that it can reduce depressive symptoms, unsafe sexual behaviors, chronic pain, anxiety, and stress (Hayes, Boyd, and Sewell, 2011;Livheim et al, 2014;Metzler, Biglan, Noell, Ary, and Ochs, 2000;Wicksell, Melin, Lekander, and Olsson, 2009).…”

Psychotherapie der Angststörungen

“…Die Reduktion der Erlebensvermeidung scheint ein wichtiger Wirkmechanismus zu sein, weil damit eine erhöhte Bereitschaft, auch unangenehme Erfahrungen und Gefühle zu erleben, einhergeht [21]. In RCT-Studien konnten für ACT ähnlich hohe Effekte wie für klassische KVT gefunden werden [22,23]. Öst [24] hingegen kritisiert anhand seiner Metaanalyse die Qualität solcher Studien und sieht die Wirksamkeit bei Angststörungen als noch unzureichend nachgewiesen an.…”

Acceptance and Commitment Training in the workplace

“…ACTraining is founded on the principles of Acceptance and Commitment Therapy (ACT) [2], a cognitive-behavioral therapy shown to be efficacious for treating many clinical concerns [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The ACT model, whether applied in the clinic or the workplace, leads to measurable behavior change and focuses on improving psychological flexibility.…”