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Behavior Modification
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A Randomized Controlled Effectiveness Trial of Acceptance and Commitment Therapy and Cognitive Therapy for Anxiety and Depression

Evan M. Forman

Department of Psychology, Drexel University, evan.forman{at}drexel.edu

James D. Herbert

Department of Psychology, Drexel University

Ethan Moitra

Department of Psychology, Drexel University

Peter D. Yeomans

Department of Psychology, Drexel University

Pamela A. Geller

Department of Psychology, Drexel University

Acceptance and commitment therapy (ACT) has a small but growing database of support. One hundred and one heterogeneous outpatients reporting moderate to severe levels of anxiety or depression were randomly assigned to traditional cognitive therapy (CT) or to ACT. To maximize external validity, the authors utilized very minimal exclusion criteria. Participants receiving CT and ACT evidenced large, equivalent improvements in depression, anxiety, functioning difficulties, quality of life, life satisfaction, and clinician-rated functioning. Whereas improvements were equivalent across the two groups, the mechanisms of action appeared to differ. Changes in "observing" and "describing" one's experiences appeared to mediate outcomes for the CT group relative to the ACT group, whereas "experiential avoidance," "acting with awareness," and "acceptance" mediated outcomes for the ACT group. Overall, the results suggest that ACT is a viable and disseminable treatment, the effectiveness of which appears equivalent to that of CT, even as its mechanisms appear to be distinct.

Key Words: acceptance and commitment therapy • cognitive therapy • cognitive-behavior therapy • psychotherapy outcome • mechanisms of action

Behavior Modification, Vol. 31, No. 6, 772-799 (2007)
DOI: 10.1177/0145445507302202
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Home page
 Clinical Case StudiesHome page
D. E. Baruch, J. W. Kanter, A. M. Busch, and K. L. Juskiewicz
Enhancing the Therapy Relationship in Acceptance and Commitment Therapy for Psychotic Symptoms
Clinical Case Studies, June 1, 2009; 8(3): 241 - 257.
[Abstract] [PDF]