Block, 2002

Traditional cognitive-behavioral therapy, grounded in social learning theory, has worked from the assumption that anxiety and other forms of emotional discomfort are caused by maladaptive, irrational thinking. Subsequently, treatments based on such conceptualizations are aimed at identifying and modifying these faulty thought processes. Acceptance-based methods, or those that encourage clients to end the struggle and come to terms with the inevitable events in one's life (Wulfert, 1994), stand in contrast to these traditional cognitive-behavioral interventions. While acceptance-based conceptualizations and treatment strategies are not new within the field of psychology, until recently such approaches have been scarce within the behavioral literature. Recent work by Hayes and colleagues (e.g., Hayes & Wilson, 1994) presents a comprehensive conceptualization of human suffering with a foundation in contextual behavior analysis, as well as a resulting treatment package that emphasizes the importance of emotional acceptance and behavioral action, Acceptance and Commitment Therapy. Although both cognitive-behavioral therapy and ACT have been tested and have received empirical support with a variety of problems to date, no well-controlled comparison of these two approaches has been conducted in a clinical population. This study sought to investigate the relative efficacy, as well as mechanisms of action, of brief public speaking workshops based on ACT and Cognitive-Behavioral Group Therapy (CBGT; Heimberg, 1991), in college students with a fear of public speaking. Results offer support for the efficacy of both treatment approaches in reducing anxiety and avoidance and increasing willingness to engage in previously feared activities. Findings related to mechanisms of action are less conclusive and warrant further investigation.