Anxiety Disorders: Acceptance Commitment Therapy

The current essay focuses on two different therapeutic techniques, Acceptance and Commitment Therapy and Solution Focused Brief Therapy. The initial component of the essay outlines the therapeutic orientations of both approaches; then, the different approaches are related to a case study of a young lady called Linda who is seeking counseling due to feelings of hopelessness. The essay is then finished with some of the author’s personal opinions on the two therapeutic approaches.

Acceptance and Commitment Therapy (ACT) is one of the recent contemporary psychological interventions used today. Researched over the past 40 years, and more effectively utilized in the past decade for a diverse range of clinical conditions. The initial industry reaction to (ACT) was free- flowing, both positive and negative. Nevertheless, Hayes (2008) suggested that the negative reactions mainly stemmed from just the misunderstandings of ACT. Hofmann & Asmundson (2008) had much to say about the technical level (ACT), and made comment that it was too similar to cognitive behavioural therapy (CBT).

Acceptance and commitment therapy (ACT) is a relatively new form of therapy derived from a combination of cognitive and behaviour interventions, which are constructed on empirical evaluation of communication and cognitions (Hayes, 2004).

Cognitive behavioral therapy (CBT) is a derivative of behavioral therapy, where changing one’s behavior to modify problems is the core of treatment. With CBT the therapist takes on a teacher approach, demystifying patient’s belief and irrational behaviors with rational beliefs and behaviors (Corey, 2008). Cognitive restructuring is the basic technique with this form of therapy that involves changing how you think about negative beliefs by restructuring them into positive ones. With CBT the hypothesis is that our emotions stem mainly from our beliefs, which influence the evaluations and interpretations we make of the reactions we have to life situations (Corey, 2008). For example, if a client (Tony Soprano) believes in order to be a man, he has to treat others as if he is more dominant, this very belief may be the reason for his ‘antisocial behavior.’ Furthermore, the therapist tries to restructure a client’s negative beliefs so the patient identifies and dispute these irrational beliefs constructing rational ones.

Researchers such as Hayes and Strosahl (2005) defines acceptance and commitment therapy (ACT) as an empirically based intervention technique from the cognitive behavior model of psychotherapy that employs mindfulness and acceptance methods mixed in various ways. Grounded within the practical concept of functional contextualism and based on the comprehensive idea of language and cognition, ACT is different from the normal or traditional cognitive behavioral therapy. The differences are manifested in the paradigm of instead of teaching people to control their emotions, ACT teaches them to acknowledge, accept and embrace the emotions and or feelings (Hayes, Louma, Bond, Masuda, & Lillis, 2006). Primarily, western traditions

Cognitive-behavioral therapy (CBT) is a short-term, empirically valid amalgamation of facets from cognitive and behavior therapies. Cognitive-behaviorists believe that psychological problems stem from maladaptivity in both thought and behavior patterns, whether self-taught or learned from others. Therefore, changes have to take place in both thoughts and actions. Cognitive-behavioral therapy is structured as collaboration between client and therapist, focusing on the present. A prominent aspect of CBT is the client’s duty to be an active participant in the therapeutic process (Corey, 2013).

Over the course of my career I have been trained in interventions from various theoretical orientations, with particular emphasis on Cognitive Behavioral Therapy (CBT). I always find myself gravitating to the structure of CBT, which in order to be effective, requires collaboration between the provider and patient to identify maladaptive patterns of thoughts, emotions, and behaviors within the context of the individual’s environment. The CBT approach has a wide array of carefully constructed exercises, in addition to various protocols, to help clients evaluate and change their thoughts and behaviors.

Social anxiety is a prevalent and common disorder amongst society. Social anxiety disorder is expressed as a fear in public and social situations for an individual (Kashdan, Farmer, Adams, Mcknight, Ferssizidis, Nezelf 2013). A person with social anxiety fears that a social appearance, outcome, or situation will lead a to negative response to their surrounding audience (Kashdan, Farmer, Adams, Mcknight, Ferssizidis, Nezelf 2013). However there are numerous treatments for social anxiety. Cognitive behavioral therapy is one of the most efficacious treatments that a patient may receive (Hambrick, Weeks, Harb, & Heimberg, 2003. Cognitive behavioral therapy has numerous techniques that can be used on patients. The result of using cognitive

Cognitive Behavioral Therapy (CBT) is a collaborative practice model in which the practitioner and the patient focus on improving mental health by addressing the patient’s feelings, thoughts, and behaviors (T. Eick, J. Matuszak, & A. Stacey, personal communication, November 19th, 2015). This model is beneficial as it addresses challenging behavior by looking into the thoughts and feelings behind the behavior, instead of only trying to change the outward appearance. In the first sessions of this therapy, the client is told what CBT is, the client describes what they believe are the problems that need to be addressed, and goals are set to solve these problems (T. Eick, J. Matuszak, & A. Stacey, personal communication, November 19th, 2015). This is helpful because if the client has a say in setting their own goals they are more motivated to follow through with them. During the intervention sessions of this model the worker discusses dysfunctional thoughts with the client and how these appear in different situations. Goals are also reassessed in a collaborative approach to determine if they are working and are appropriate. When treatment is coming to an end, it is collaboratively discussed if the client and those important to them believe they are ready to end treatment. It is important that there is a summary of what skills the client has learned and for relapse prevention, identify possible future triggers and how the client will address these. This model is very

The third wave of behavioral therapy includes acceptance and commitment therapy, dialectical behavior therapy, and mindfulness-based cognitive therapy. These types of therapies are designed to help people accept difficult life experiences and to persuade individuals to act on their core values. An evolution of cognitive-behavioral therapy, ACT, MBCT, and DBT not only include the thought process within the behavioral network, but mindfulness and acceptance as well. Instead of teaching people to control their thoughts and feelings in the case of CBT, ACT & DBT draws from far eastern philosophies of noticing and accepting the things in life that you cannot change.

A couple of researchers at the Anxiety Disorders Research Center in the Department of Psychology at the University of California, Los Angeles (UCLA) examined weaknesses of CBT (Craske et al., 2014). Although CBT has been known for the most effective treatment for social phobia, not all patients show improvements after the treatment. Patients easily drop out during, or at the early stage of the treatment. Even patients who successfully finished the entire session tend to have a hard time continuing to use methods they learned and to maintain low level of anxiety, so the likelihood of reoccurrence exists. Therefore, alternative ways to solve these weaknesses are needed in order to develop the treatment itself and to provide the most matchable treatment method for each patient, according to the article by Craske et al. (2014).

Fear, an intensive form of anxiety, can be crippling in nature to some people. It is important that we overcome our fears to be able to grow and mature. There are three main ways in which we can manage or resolve fear: behavioral therapy, systematic desensitization, and exposure desensitization. Behavioral therapy was introduced by John B. Watson, a behavioral psychologist, and involved an individual alternating engagements in coping and relaxation techniques to help desensitize that person to the stressors (Seaward, 2015). Systematic desensitization involves the anxious person learning to de-stress from the fear in small, piecemeal increments through which they always feel in control. Exposure desensitization, on the other hand, occurs when the individual is introduced to the real stressor is brief and save encounters with the stressor. Through combinations of the three different ways to

Many people experience butterflies in their stomach, sweaty palms, pounding of the heart or a combination of all three in intimidating social situations. But for many, over 15 million American adults, “this anxiety causes extreme self-consciousness in everyday social or performance situations” (SAD Brochure, pg. 2). For these individuals, their anxiety occurs during simple tasks like ordering food or making a phone call. This brochure attempts to inform their audience about what Social Anxiety Disorder is, how this disorder affects these individuals, and how to get treatment for it. The ADAA has created this Social Anxiety Disorder brochure, that incorporates many “adapting strategies” (Penrose and Katz 2010, pg. 205), appeals

Exposure therapy is an effective treatment for specific phobias, Social Anxiety Disorder, Generalized Anxiety Disorder, Panic Disorder, Posttraumatic Stress Disorder, and Obsessive-Compulsive Disorder. Exposure therapy may be used as a stand-alone treatment or it may be used as a component of the therapeutic package. For example, if a client seeks treatment for a fear of spiders, he may receive exposure therapy. However, if a client has PTSD and is struggling with his marriage, he may be treated with Cognitive Behavior Therapy and receive exposure therapy as a treatment component.

There are two main theories applied to relationships, Social Exchange Theory and Equity Theory underpin commonly used behavioural therapies such as Cognitive Behavioural Therapy, Enhanced Cognitive Behavioural Therapy and Integrative Cognitive Behavioural Therapy. More recent studies in neuroscience and behaviour and the importance of language have led to the development of Relational Frame Theory and Acceptance and Commitment Therapy as an alternative approach. In this essay I will outline the relationship models comparing and contrasting them. I will also introduce and briefly touch on Relational Frame Theory and Acceptance and Commitment Therapy as an additional approach to couples counselling and offer considerations which an