Acceptance and Commitment Therapy for Generalized Anxiety Disorder: A Narrative Review.

Background and Aim: Generalized Anxiety Disorder is one of the most common anxiety disorders. The purpose of this study was to investigate Effectiveness of Acceptance and Commitment Therapy (ACT) on Emotional Processing, Irrational Beliefs and Rumination in Patients with Generalized Anxiety Disorder. Methods: The research method was quasi-experimental pretest-posttest with a control group. 30 patients with generalized anxiety disorder referred to daily psychiatric treatment centers in Golpayegan in the first half of 2019 were selected and randomly assigned to experimental and control groups. The experimental group received Acceptance and Commitment Therapy program in 8 sessions of 90 minutes. However, the control group did not receive this intervention during the research process. The questionnaires used in this study included Spitzer Generalized Anxiety Disorder Scale (2006), Baker Emotional Processing Scale (2007), Jones Irrational Beliefs Questionnaire (1968), Nolen-Hoeksema and Morrow (1991) Rumination Questionnaire. The data were analyzed by analysis of covariance using SPSS 24 software. Results: The results of data analysis showed that Acceptance and Commitment Therapy has significantly influenced Emotional Processing (p<0.001), Irrational Beliefs (p<0.001) and Rumination (p<0.001). Conclusion: Considering the effectiveness of acceptance and commitment-based therapy on emotional processing, irrational beliefs and rumination in patients with generalized anxiety disorder, it is suggested that training workshops be held to become more familiar with the principles and techniques of this training for counselors and therapists active in the field of this disorder.

Objective: The purpose of this study was to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on cognitive fusion and social anxiety in women suffering from generalized anxiety disorder. Methods: This study was an applied, quasi-experimental design with pre-test, post-test, and follow-up, including a control group. The population consisted of all women with generalized anxiety disorder who attended counseling centers in Sari city. The sample included 30 women with generalized anxiety disorder, selected via convenience sampling and randomly assigned to two groups: the experimental group receiving ACT for social anxiety disorder (Hayes, 2012) and a wait-list control group. Data were collected using the Social Anxiety Questionnaire (Watson & Friend, 1969) and the Cognitive Fusion Questionnaire (Gillanders, 2014). Data were analyzed using repeated measures ANOVA with SPSS-26 software. Findings: The results showed significant differences between the ACT treatment group and the control group. ACT was effective in reducing cognitive fusion (F = 15.25, p < .001) and social anxiety (F = 38.86, p < .001) in women with generalized anxiety disorder (p < .001). Conclusion: Therefore, it can be concluded that Acceptance and Commitment Therapy may serve as an effective intervention method for improving cognitive fusion and social anxiety in women with generalized anxiety disorder.

Objective: This study aimed to compare the effectiveness of schema therapy with acceptance and commitment therapy (ACT) using exposure techniques on cognitive avoidance in female patients with generalized anxiety disorder. Methods: A total of 10 women with generalized anxiety disorder were selected through purposeful sampling with Structured Clinical Interview for DSM Disorders (SCID-5). To determine the absence of personality disorder, Millon’s clinical multiaxial inventory (MCMI-III) (Millon and Groosman, 2005) was used. Schema therapy was conducted for 20 weekly sessions and ACT with exposure techniques for 12 weeks and follow-up for 6 weeks. The cognitive avoidance questionnaire (CAQ) (Sexton and Douglas, 2004) was used as a pretest and posttest to follow up on the results. Analysis of variance with repeated measures was used to test the research hypotheses. Results: The results showed that schema therapy is more effective than ACT in the subscales of thought suppression (F=12.80, P=0.037) and avoidance of threatening (F=25.61, P=0.015), but they have no significant statistical difference in other subscales and total score. Both treatments significantly reduced the total score of cognitive avoidance, but they lacked a statistically significant difference. Conclusion: Schema therapy and ACT with exposure techniques are effective in reducing the severity of symptoms and improving cognitive avoidance in females with generalized anxiety disorder.

سالمندی فرایند زیستی است که تمام موجودات زنده از جمله انسان‌ها آن را تجربه می‌کنند، از این رو توجه خاص و پیشگیری از اختلالاتی نظیر باورهای غیرمنطقی و نگرش منفی به مرگ در سالمندی بسیار مهم است. بنابراین مطالعه حاضر با هدف تعیین اثربخشی درمان مبتنی بر تعهد و پذیرش بر باورهای غیرمنطقی و نگرش به مرگ سالمندان انجام شد. روش پژوهش نیمه آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل بود.جامعه آماری پژوهش کلیه سالمندان شهر خرم آباد در سال 1399 بودند. حجم نمونه پژوهش شامل 30 نفر سالمند (60 تا 70 سال) بود که با روش نمونه‌گیری در دسترس و با توجه به ملاک‌های ورود و خروج مطالعه انتخاب شدند. گروه آزمایش مداخله آموزشی را در قالب هشت جلسه 90 دقیقه‌ای هفتگی دریافت نمودند. پرسش‌نامه‌های مورد استفاده در این پژوهش شامل پرسش‌نامه باورهای غیرمنطقی اهواز و نیمرخ نگرش به مرگ وونگ بود. داده‌ها با تحلیل کوواریانس تک متغیره، با استفاده از نرم‌افزارSPSS نسخه 22 مورد تجزیه و تحلیل قرار گرفتند. یافته‌ها نشان داد که بین گروه‌های آزمایش و کنترل در پس­آزمون از نظر باورهای غیرمنطقی و نگرش به مرگ تفاوت معنی‌داری وجود داشت (001/0>P). به عبارت دیگر درمان مبتنی بر تعهد و پذیرش باعث کاهش باورهای غیرمنطقی و نگرش منفی به مرگ شد. منطبق با یافته‌های پژوهش حاضر می‌توان درمان مبتنی بر تعهد و پذیرش را به عنوان یک روش کارا جهت کاهش باورهای غیرمنطقی و نگرش منفی به مرگ سالمندان پیشنهاد داد.

An Open Trial of Group Acceptance and Commitment Therapy With an Adjunctive Mobile App for Generalized Anxiety Disorder

Objective: This study aims to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) on reducing health anxiety and enhancing emotional self-awareness among adult women with Generalized Anxiety Disorder (GAD). Methods and Materials: In this randomized controlled trial, 45 adult women diagnosed with GAD in Tehran were assigned to one of three groups: ACT (n = 15), CBT (n = 15), or a control group (n = 15). The ACT group participated in eight 90-minute sessions, while the CBT group underwent twelve 60-minute sessions. Both interventions spanned a 12-week period. Health anxiety was measured using the Health Anxiety Inventory (HAI), and emotional self-awareness was assessed with the Emotional Self-Awareness Scale (ESAS). Assessments were conducted at baseline, post-intervention, and at a four-month follow-up. Data analysis involved repeated measures ANOVA and Bonferroni post-hoc tests using SPSS-27 software. Findings: Both ACT and CBT groups showed significant reductions in health anxiety and significant increases in emotional self-awareness from baseline to post-test, which were maintained at the four-month follow-up (p < .001). No significant differences were found between the ACT and CBT groups regarding the effectiveness of the interventions (p > .05). The control group did not exhibit significant changes over time (p > .05). The Time × Group interaction was not statistically significant, indicating similar patterns of improvement in both intervention groups. Conclusion: ACT and CBT are equally effective in reducing health anxiety and enhancing emotional self-awareness among adult women with GAD. The findings suggest that both therapies can be viable options for treating health anxiety and improving emotional self-awareness.

La thérapie d’acceptation et d’engagement

This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales-21. Process outcomes included ACT- and RNT-related measures: general RNT, experiential avoidance, cognitive fusion, values, and generalized pliance. At the 1-month follow-up, linear mixed effects models showed that the intervention was efficacious in reducing emotional symptoms (d = 2.42, 95% confidence interval [1.64, 3.19]), with 94.12% of participants in the RNT-focused ACT condition showing clinically significant change in the Depression, Anxiety, and Stress Scales-21 total scores versus 9.09% in the WLC condition (70% vs. 8% in intention-to-treat analysis). The intervention effects were maintained at the 3-month follow-up. No adverse events were found. A very brief RNT-focused ACT intervention was highly effective in the treatment of depression and GAD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The prevalence of anxiety disorder in Indonesia increases significantly every year. It is worth special attention, especially in facing the uncertainty during pandemic. Acceptance and Commitment Therapy (ACT) is one of the third-wave cognitive behavior therapy (CBT), usually used for anxiety disorder treatment. In this research, I want to examine the effectiveness of Acceptance and Commitment Therapy (ACT) to decrease the level of Generalized Anxiety Disorder (GAD), taking General Anxiety Disorder-7 (GAD-7), Geriatic Anxiety Inventory (GAI), and Beck Anxiety Inventory (BAI), as the standard. It uses a meta-analysis techniques processed by statdirect trial version 2.0. It involves 17 experimental journals of ACT and GAD (n experiment group = 574; n control group = 513). The assessment of ACT and GAD bases itself on random effect size (I2 = 83.3%), without any publication bias (-3.88). The result shows that ACT is still effective to decrease the level of GAD (d= -.66; medium effect size). The result concludes that the ACT needs the assistance from other interventions. It also suggests research replication to multiply the references related to the effectiveness of ACT.

Acceptance and commitment therapy (ACT) gained support for treating transdiagnostic features of major depressive (MDD) and generalized anxiety disorders (GAD). However, ACT’s intrapersonal emphasis may be insufficient for targeting interpersonal treatment goals. Integrating ACT with functional analytic psychotherapy offers theory-based strategies for responding to ACT-specific processes through the contingent interpersonal relationship thereby targeting both intra- and interpersonal treatment goals. Yet, no research examined the efficacy of this integrative approach (i.e., functional-analytic acceptance and commitment therapy [FACT]) in treating comorbid MDD and GAD. In this case study, we conceptualized a man with comorbid MDD and GAD from a FACT perspective, described FACT treatment across 28 sessions, and presented pretreatment, termination, and 6-month posttreatment data on FACT-specific treatment targets. Depression symptoms, self-compassion, mindfulness, and interpersonal relationships improved despite unchanged physiological anxiety symptoms throughout treatment. These preliminary data provide clinicians with a conceptual framework for treating clients using FACT and may guide future research on integrative treatment approaches.

Background:Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.Materials and Methods:A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other's work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).Results:Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.Conclusion:ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.

Acceptance and Commitment Therapy (ACT) is gaining traction as an effective therapy for a wide range of presenting concerns. Limited research and discussion has been published focused on utilizing ACT with older adults. The ACT model is proposed to be a good fit for this population because many older adults may already be values orientated due to awareness that their lifetime is limited. A trans-diagnostic approach that normalizes experiences common to older age may be advantageous given older adults often present with heterogeneous issues and life experiences. A case study of an 89-year-old woman experiencing late-life clinical depression and generalized anxiety disorder is presented. A significant factor contributing to her distress was her struggle with the cognitive and physical changes associated with aging. Results suggest that a brief ACT course implemented by a relative novice ACT therapist was effective in reducing psychological inflexibility as well as reducing distress to non-clinical levels at 6 weeks post therapy. Potential implications for adapting ACT with older adults are discussed, as well as reflections on some of the potential challenges for clinicians who are ACT beginners.

Generalised anxiety disorder (GAD) is the most common anxiety disorder in older people and is characterised by excessive anxiety and worry that is experienced as being difficult to control. Current recommended first-line treatments for GAD include pharmacotherapy and psychological therapy, but some people experience GAD that does not respond to these treatments. Such treatment-resistant GAD (TR-GAD) is associated with numerous negative outcomes in older people. However, evidence-based guidance on how to manage TR-GAD in older people is lacking. Previous research suggests that Acceptance and Commitment Therapy (ACT), tailored to the needs and preferences of older people with TR-GAD, may help reduce anxiety in this population. To determine the clinical and cost-effectiveness of tailored ACT plus usual care (UC) in comparison to UC alone for reducing anxiety in older people with TR-GAD. The CONTACT-GAD trial is an international, multi-centre, parallel, two-arm RCT with a 9-month internal pilot phase. 296 individuals aged ≥ 60 years with TR-GAD will be recruited from primary and secondary care services (and their equivalent in Australia) and via self-referral at approximately 11 UK sites and 4 Australian sites. TR-GAD will be defined as GAD that has failed to respond adequately to pharmacotherapy and/or psychotherapy, as described in step 3 of the UK's stepped care model for GAD (and its equivalent in Australia). Participants will be randomly allocated to receive up to 14 one-to-one sessions of ACT with a booster session at approximately 3-months post-intervention plus UC or UC alone by an online randomisation system. Participants will complete outcome measures at baseline and 6- and 12-months post-randomisation. The primary outcome will be anxiety at six months. Secondary outcomes will include quality of life, depression, psychological flexibility, resource use, health-related quality of life, capability, adverse events, satisfaction with therapy, personally meaningful behaviour change and engagement in activities. Outcome assessors will be blind to treatment allocation. Primary analyses will be by intention-to-treat, with data being analysed using multi-level modelling. The CONTACT-GAD trial will provide much needed evidence on the management of TR-GAD in older people. ISRCTN Registry, https://www.isrctn.com/ISRCTN85462326, registered 04/01/2023. 3.0 (09/05/2025).

Adolescence increases vulnerability to mental ill-health, particularly anxiety disorders like Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD). Still, the understanding of Psychological Flexibility/Inflexibility (PF/PI) as a transdiagnostic framework relevant to explaining these difficulties and the efficacy of Acceptance and Commitment Therapy (ACT) in addressing adolescent SAD and GAD remains limited. Hence, this study has two aims: examining the role of PI/PF on adolescents’ mental health and assessing ACT’s efficacy for adolescent SAD and GAD. We will collect data from 400 community adolescents and employ network analysis to explore connections between PI/PF processes, anxiety, and flourishing. We will also investigate pathways linking PI/PF processes with flourishing and anxiety across samples (clinical SAD, clinical GAD, and mentally healthy groups), expecting to find similar patterns. Furthermore, a Randomized Controlled Trial with three groups (control, SAD experimental and GAD experimental), each comprising 29 participants, and four assessment moments (pre- and post-intervention and 3- and 6-months follow-up) will be conducted. Similar improvements are anticipated in both experimental groups, driven by changes in PI/PF processes. Findings from this work will provide valuable evidence to PI/PF as accurate conceptualizations of human suffering and expand the transdiagnostic application of ACT to adolescents with anxiety disorders.

Introduction and Aim: With the increase of the geriatric population, the need for effective care and treatment of many older adults with psychiatric disorders and behavioral problems has become more visible. Acceptance and Commitment Therapy (ACT) is one of the effective interventions used in Geropsychiatric care. In this review, it is aimed to draw attention to the fact that acceptance and determination therapy applied in geropsychiatric care is an effective method. Method: The literature review was carried out using the keywords "kabul ve kararlılık terapisi", "yaşlılarda kabul ve kararlılık terapisi", "acceptance and commitment therapy", "acceptance and commitment therapy on elderly" in current databases. Findings: Acceptance and Commitment Therapy aims to enable the individual to recognize the feelings, thoughts and behaviors of the moment they are in, accept them as they are, open a place in their mind and turn to behaviors that serve their values. Acceptance and Commitment Therapy is a treatment approach that encourages people to experience and manage negative emotions and thoughts, and its main purpose is to increase psychological flexibility. When the literature is reviewed, acceptance and determination therapy; It improves the quality of life in elderly people, has a positive effect on diabetes-related emotional discomfort, fear of death and obsession, reduces chronic pain severity, anxiety, depression, increases self-efficacy and social adaptation, improves quality of life in elderly women, and perceived negative stress in elderly men with cardiovascular disorders It appears to reduce. The mode of application of the intervention may differ. When the literature is examined, it is seen that the intervention is generally applied as a group session, but there are also studies performed individually. In addition, it has been observed that there is no standard for the number and duration of sessions, and it can be applied at different times and frequencies. Conclusion and Recommendations: The studies examined have shown that Acceptance and Commitment Therapy is an effective geropsychiatric care intervention that can be applied to individuals to adapt to physical, social and psychological changes due to the aging process. It is recommended to inform nurses about Acceptance and Commitment Therapy, to raise awareness about the usability and application of these approaches, to apply this intervention in geropsychiatric care and to share the results of the application.