Treatment of Three Anxiety Disorder Cases With Acceptance and Commitment Therapy in a Private Practice

Abstract

Acceptance and commitment therapy (ACT) for anxiety disorders is a type of cognitive behavioral therapy that focuses on decreasing the behavior regulatory function of anxiety and related cognitions, and has a strong focus on behavior change that is consistent with client values. In this case series, 3 consecutive referrals seeking treatment for anxiety disorders at a private practice were treated with 9-13 sessions of ACT. In-session exposure therapy was not included to determine the effects of ACT without the compounding effects of already proven treatment procedures. The treatment procedure was identical across disorders to test the use of a unified treatment protocol for anxiety disorders: panic disorder with agoraphobia, comorbid social phobia and generalized anxiety disorder, and posttraumatic stress disorder. All participants showed clinical improvement in their specific anxiety disorders as rated on multiple standardized assessments after treatment, with gains maintained at follow-up (8 months or more). Time series assessments, taken throughout treatment, of anxiety and avoidance behaviors showed large decreases in avoidance but not in anxiety, suggesting ACT was effective by changing the way participants responded to anxiety rather than anxiety itself.

A Case Study: An ACT Stress Management Group in a University Counseling Center

“…Over the past several years, a growing body of research has demonstrated that ACT is effective in treating individuals with a wide range of behavioral and health issues, including depression, anxiety, substance use problems, smoking, diabetes, chronic pain, epilepsy, and work-related stress (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). Specifically, there has been a great deal of research demonstrating ACT's efficacy in treating anxiety (Arch & Craske, 2008;Codd, Twohig, Crosby, & Enno, 2011;Eifert et al, 2009;Roemer & Orsillo, 2007;Roemer, Orsillo, & Salters-Pedneault, 2008). The ACT model of anxiety disorders proposes that attempts at regulating anxiety are at the core of anxiety disorders rather than the presence of particular levels of anxiety (Codd et al, 2011).…”

“…Specifically, there has been a great deal of research demonstrating ACT's efficacy in treating anxiety (Arch & Craske, 2008;Codd, Twohig, Crosby, & Enno, 2011;Eifert et al, 2009;Roemer & Orsillo, 2007;Roemer, Orsillo, & Salters-Pedneault, 2008). The ACT model of anxiety disorders proposes that attempts at regulating anxiety are at the core of anxiety disorders rather than the presence of particular levels of anxiety (Codd et al, 2011). Thus, ACT aims to decrease avoidance of these inner experiences as the dominant response to anxiety (Codd et al, 2011).…”

“…The ACT model of anxiety disorders proposes that attempts at regulating anxiety are at the core of anxiety disorders rather than the presence of particular levels of anxiety (Codd et al, 2011). Thus, ACT aims to decrease avoidance of these inner experiences as the dominant response to anxiety (Codd et al, 2011). ACT proposes that trying to modify, change, or suppress anxious thoughts can be counterproductive and may intensify the struggle to rid oneself of anxious thinking (Arch & Craske, 2008).…”

Acceptance and Commitment Therapy for the Treatment of Posttraumatic Stress Among Adolescents

“…Four case studies have shown preliminary support for the use of ACT as a treatment of PTSD in adults (Codd, Twohig, Crosby, & Enno, 2011;Orsillo & Batten, 2005;Twohig, 2009) and late-adolescence/young-adulthood (Batten & Hayes, 2005). Further, given the central role of emotional avoidance in individuals with PTS and PTSD, ACT theoretically makes sense as a treatment for PTS (Walser & Hayes, 2006).…”

“…To date, no large studies have been conducted on ACT to treat PTSD, but four case studies have shown preliminary support for the use of ACT as a treatment for PTSD in adults (Codd et al, 2011;Orsillo & Batten, 2005;Twohig, 2009) and in late adolescence/early adulthood (Batten & Hayes, 2005). Further, a substantial amount of data supports the relationship between ACT processes and PTSD symptoms.…”