Acceptance & Commitment Therapy for Anxiety

Anxiety disorders are characterized by a pattern of frequent, constant worry and anxiety over many different activities and events. They range from generalized anxiety to anxiety over specific situations, such as phobias or social anxiety. Though untreated anxiety disorders can cause significant impairment, there are many tools that can help minimize symptoms. One of these is acceptance and commitment therapy (ACT).

Beliefs and Goals of ACT

• ACT is considered a cognitive behavioral therapy (CBT) due to its focus on thoughts that cause distress. However, it is broader than traditional CBT therapies because it also includes a place for experience, feelings and context. ACT is based on the belief that the key to a better life is to overcome negative thoughts and feelings. The desired end result of ACT is for individuals to be able to perform effectively even in the presence of difficult or disruptive thoughts.

Primary Focus

• ACT therapists work to assist clients in changing internal self-talk and external talk. This therapy suggests that just by becoming aware of having certain feelings and beginning to accept that these feelings are natural based on circumstances seems to help alleviate anxiety. When people have feelings about their feelings, their symptoms become worse. ACT teaches clients to accept the feelings for the moment so that they will not continue to be stuck with them. ACT for Anxiety Disorders' website quotes Mattaini (1997) as saying that ACT does not ask clients to accept every situation (e.g. dangerous ones), but that some things should either be ultimately accepted, accepted for now, accepted with expectation of eventual change, or changed now.

The Groundwork of ACT

• ACT is comprised of six processes that need to take place for effective change to occur. The first is to evaluate how the client has avoided feelings surrounding a problem in the past. Then, the patient's avoidance tools are assessed for effectiveness. The individual usually becomes aware that these coping skills have not been effective and have made circumstances worse. The patient realizes that she has tried to eliminate unpleasant inner thoughts and feelings instead of accepting them as normal and transient.

Building on the Groundwork

• After vital groundwork has been established, therapists teach clients more effective strategies to accept thoughts and feelings. Part of this involves learning to be aware of the part of self that is observant and watchful. This part of self experiences, but does not judge thoughts and feelings. Once mastery of these two tasks is achieved, there are two more steps that need to be taken. The first is for the client to choose a direction and become willing to do the work of experiencing, accepting and facing negative emotional states. The last stage is entirely focused on commitment. Commitment is about giving up fighting or denying that life happens, and along with it, comes thoughts and feelings. The commitment is to live life without letting those thoughts and feelings define the patient or control behavior and choices.

Research

• Kristy L. Dalrymple, PhD, and James D. Herbert, PhD (Brown Medical School, 2007) completed a study on the efficacy of ACT in the treatment of social anxiety disorder. They found that there was significant increase in quality of life for those in the study who had received ACT in a 12-week program. SocialWorkToday.com reports that research has been shown to be useful in sexual abuse survivors, at-risk adolescents, and those with substance abuse or mood disorders (including anxiety).

Warning

• Acceptance and vommitment yherapy may be an effective intervention for anxiety. However, it will only work well if the therapist can utilize the tools with skill. You should only receive this therapy from someone trained in this technique. There are many practical and experiential exercises the trained therapist can use to address the processes listed above that may not be available to those not specifically educated on this therapy.