Acceptance or Change: Treating Socially Anxious College Students with ACT or CBGT

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APA Citation: 

Block, J. A., & Wulfert, E. (2000). Acceptance or change: Treating socially anxious college students with ACT or CBGT. The Behavior Analyst Today, 1(2), 1-55.

Publication Topic: 
ACT: Empirical
Publication Type: 
acceptance, social anxiety

Traditionally, cognitive-behavioral therapy has worked from the assumption that anxiety, depression and other forms of emotional discomfort are caused by maladaptive or irrational patterns of thinking. Cognitive-behavioral therapists have developed an informationprocessing model, whereby hypothesized cognitive structures, or schemas, are causally involved in the development of psychopathology. Early maladaptive schemas predispose clients to distort events in a characteristic fashion (Young, Beck, & Weinberger, 1993). Treatment is aimed at identifying and modifying maladaptive beliefs and the underlying schemas from which they arise. Numerous interventions have been developed to accomplish these goals and many of these treatment procedures have received strong empirical support (Chambless & Hollon, 1998).

Acceptance-based therapeutic procedures stand in contrast to treatments that emphasize the modification of private events (thoughts and feelings). Rather than viewing psychological difficulties as the result of faulty thought processes that need to be changed, therapies that emphasize acceptance consider the struggle to change or avoid private events as problematic itself. Avoiding private experiences that are not under voluntary control requires the individual to avoid situations that elicit these experiences. This solves one problem but creates another one as a result of constricting activities and not taking part in life’s events (Hayes & Wilson, 1994). To illustrate, the speech anxious student never speaks up in class and avoids unpleasant feelings; but there are costly long-term effects of her behavior. She has systematically passed off occasions that would have prepared her for future professional and personal opportunities. Hayes, Wilson, Gifford, Follette, & Strosahl (1996) have conceptualized a number of different topographically-defined behavioral disorders along the functional dimension of experiential avoidance. Acceptancebased methods encourage clients to let go of the struggle and come to accept the inevitable internal and external events of their lives (Wulfert, 1994).

The concept of acceptance is not new in the field of psychology. It serves as a key component in numerous psychological traditions...

Small RCT on the treatment of social anxiety. Compared ACT to Cognitive Behavioral Group Therapy and to a no treatment control. Results indicated that ACT participants evidenced a significant increase in reported willingness to experience anxiety, a significant decrease in behavioral avoidance during public speaking, and a marginally decrease in anxiety during the exposure exercises as compared with the control group. Similar results were found for CBGT, but ACT found greater changes in behavioral avoidance.
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