Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators.

Abstract

Objective Cognitive behavioral therapy (CBT) is an empirically supported treatment for social phobia. However, not all individuals respond to treatment and many who show improvement do not maintain their gains over the long-term. Thus, alternative treatments are needed. Method The current study (N=87) was a 3-arm randomized clinical trial comparing CBT, Acceptance and Commitment therapy (ACT), and a waitlist control group (WL) in participants with a DSM-IV diagnosis of social phobia. Participants completed 12 sessions of CBT or ACT or a 12-week waiting period. All participants completed assessments at baseline and post-treatment, and participants assigned to CBT and ACT also completed assessments at 6 and 12 months following baseline. Assessments consisted of self-report measures, a public speaking task, and clinician ratings. Results Multilevel modeling was used to examine between-group differences on outcomes measures. Both treatment groups outperformed WL, with no differences observed between CBT and ACT on self-report, independent clinician, or public speaking outcomes. Lower self-reported psychological flexibility at baseline was associated with greater improvement by the 12-mo follow-up in CBT compared to ACT. Self-reported fear of negative evaluation significantly moderated outcomes as well, with trends for both extremes to be associated with superior outcomes from CBT and inferior outcomes from ACT. Across treatment groups, higher perceived control, and extraversion were associated with greater improvement, whereas comorbid depression was associated with poorer outcomes. Conclusions Implications for clinical practice and future research are discussed.

Comparing the Effectiveness of Cognitive Behavioral Therapy with Acceptance and Commitment Therapy on Reduction of Social Anxiety Disorder Symptoms in University Students

“…Blanco et al [17] reported a lower response rate of CBT to social anxiety disorder compared to drug therapy and both treatments together. More over despite experiencing considerable Success [18] in a recent research [3], it has been reported that CBT had important shortcomings, such as not all individuals responded to this treatment, the long-term treatment outcomes were not stable, and, trying to control thoughts that accompany the unpleasant excitement, often increases them. Barlow et al [19] also reported that many recipients of CBT abandoned the treatment before it ends, and relapse following successful treatment, seeking additional treatment usually happened.…”

“…Barlow et al [19] also reported that many recipients of CBT abandoned the treatment before it ends, and relapse following successful treatment, seeking additional treatment usually happened. Crask et al [3] acknowledged that despite the successful treatment of people with anxiety disorders, they remain vulnerable to developing anxiety and mood disorders across the lifespan. Furthermore, there is growing interest in behavioral approaches that do not rely on cognitive restructuring, which is a substantial component of CBT, such as behavioral activation treatment for depression [20].…”

“…It's the second most commonly diagnosed anxiety disorder, and one of the three common psychiatric disorders in the United States [2,3]. The main feature of this disorder is a significant fear or anxiety, which is tolerated or avoided by great difficulty, about one or more social situations in which it is possible for the patient being judged, negatively evaluated, or rejected [4].…”

The Effect of Acceptance and Commitment Therapy (ACT) on Body Image in Women between the Ages of Thirty and Forty after Beauty Surgeries

“…ACT comprises six central processes which lead to psychological flexibility. These six processes include: 1) acceptance, 2) fusion, 3) self as a context, 4) relationship with the present, 5) values and 6) commitment (14). Acceptance and commitment are important substitutes which help to reach avoidance based on experiences.…”

“…ACT as a therapy which is based on acceptance and commitment, is a third-wave treatment behavior which clearly accepts changes in the mechanism of thoughts and feelings, instead of changing their shapes, contents, and frequencies (14). ACT is rooted in a philosophical theory called "functional contextualism", and it is based on a research plan connected to language and cognition, which is called "Intellectual Relationships Framework Theory".…”