ACT for anxiety and obsessive-compulsive and related disorders: A research review

In a research review of ACT for anxiety, Twohig, Capel and Levin (2024) summarise the literature exploring the efficacy of ACT with anxiety problems. The paper explores how ACT, as a transdiagnostic intervention, has been applied in the treatment of anxiety disorders, OCD, and related disorders. It emphasises the importance of psychological flexibility, which refers to the ability to engage in meaningful activities while being mindful and accepting of internal experiences. The paper presents several key findings:

First, ACT, as a transdiagnostic intervention, has been applied successfully across various anxiety disorders, OCD, and related conditions. It has shown effectiveness in treating anxiety disorders, OCD, and trichotillomania.

Second, psychological inflexibility is positively related to worse outcomes in anxiety, OCD, and related disorders. Psychological flexibility, which is a core component of ACT, is identified as the strongest process of change in therapy. It refers to the capacity to engage in meaningful activities while accepting and being mindful of internal experiences.

Preliminary research also suggests that ACT may be efficacious in treating excoriation disorder, hoarding, and body dysmorphic disorder.

Furthermore, psychological flexibility is not only important in ACT but also predicts outcomes in other interventions. This implies that enhancing psychological flexibility can be beneficial for clients across different treatment approaches.

Overall, the findings highlight the effectiveness of ACT in treating anxiety and OCD, and the significant role of psychological flexibility as a process of change. These insights can guide practitioners in implementing ACT as a transdiagnostic treatment and focusing on fostering psychological flexibility to improve outcomes for individuals with anxiety and obsessive-compulsive and related disorders.

Implications for practitioners

1. Consider ACT as a transdiagnostic treatment: ACT can be applied across different anxiety disorders, OCD, and related conditions, making it a versatile approach for practitioners.
2. Focus on psychological flexibility: Help clients develop psychological flexibility by encouraging them to engage in meaningful activities while accepting and being mindful of their internal experiences.
3. Use disorder-specific measures: While general measures of psychological flexibility, such as the Acceptance and Action Questionnaire-II (AAQ-II), can be useful, utilising disorder-specific measures can provide a more accurate assessment of changes in psychological flexibility and symptomatology.
4. Collaborate with clients: Involve clients in the treatment process and encourage them to explore what works for them in terms of their goals and values.
5. Consider complementary interventions: ACT can be integrated with other evidence-based treatments to enhance outcomes for clients with anxiety and OCD.

 

Reference

Twohig, M. P., Capel, L. K., & Levin, M. E. (2024). A review of research on acceptance and commitment therapy for anxiety and obsessive-compulsive and related disorders. Psychiatric Clinics of North America, 1-15. doi: https://doi.org/10.1016/j.psc.2024.04.013

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