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Cited by 63Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMindfulness and Compassion InterventionsPsychological Treatments and Assessments

Acceptance or change: Treating socially anxious college students with ACT or CBGT.

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Block, Jennifer A., Wulfert, Edelgard·2000·The Behavior Analyst Today
DOI 10.1037/h0099879
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Abstract

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 information-processing model, whereby hypothesized 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. Acceptance-based 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 and clearly plays some role in almost all psychological interventions. As Hayes (1994) conveys, acts of psychological acceptance can occur on a continuum and may be differentially valued across psychotherapeutic approaches. Acceptance of one's own private experience lies at the heart of the theories and therapies of the humanistic tradition, such as Rogers' (1951) client-centered therapy. Acceptance was strongly encouraged in client-centered therapy through the use of empathic listening and a shared understanding of feelings. Gestalt therapy also stresses the immediacy of experiencing, and holds the assumption that much of the dysfunction in our modern society is the result of people becoming experience-phobic and avoiding their own feelings (Greenberg, 1994). However, solid evidence to empirically support these acceptance-based interventions is largely absent from the scientific literature as humanistic and experiential types of therapies have historically been much less subjected to empirical evaluation. If the humanistic traditions represent one end of the acceptance spectrum, behavioral and cognitive-behavioral approaches have fallen on the other end of the continuum. Until recently, the explicit incorporation of acceptance has been scarce in these approaches as they traditionally have emphasized change. A glance at some of the techniques used in contemporary behavioral interventions evidences this fact. Clients judged to exhibit maladaptive thinking are instructed to examine the evidence for their beliefs. They are taught to identify their automatic thoughts, label them according to established categories of cognitive distortions and replace them with more adaptive rational responses (Young et al. …

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  • A small social anxiety study (N=11) without randomization showed equivalent results for group ACT and group CBT.

    “A study so small (N=11) that randomization could not be used showed equivalent results for group ACT and group CBT.36”

    From Acceptance and Commitment Therapy as a Treatment for Anxiety and Depression (2017) · cites this paper as [36]

    The Procedure reports 11 participants across the three conditions and says assignment was semi-random because of scheduling constraints, not because the study was too small. The Results and Discussion report improvement in both active-treatment groups, but say it was premature to judge their differential effectiveness; they do not establish equivalent results. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • ACT has proven useful in ameliorating social experiences in SAD by decreasing main symptoms of social anxiety and increasing willingness to engage in social and/or performance situations.

    “Specifically for SAD, ACT has proven to be useful in ameliorating social experiences by decreasing the main symptoms of social anxiety and by increasing the willingness to engage in social and/or performance situations (Block and Wulfert, 2000; Kocovski et al., 2009; Ossman et al., 2006).”

    From The role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review. (2022) · cites this paper as Block and Wulfert, 2000

    The Results and Discussion report that social-anxiety scores generally decreased and willingness to enter feared situations increased among ACT participants. But the authors call these preliminary, self-reported findings from a small pilot study and say the treatments may be effective; they do not establish that ACT has 'proven' useful for SAD broadly. The willingness measure was limited to academic public-speaking situations (Measures). (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • Block and Wulfert (2000) found a slight difference that favored CBT for anxiety reduction, through changing of beliefs, and ACT for increased willingness to engage in feared situations, regardless of changes in anxiety.

    “Block and Wulfert (2000) found a slight difference that favored CBT for anxiety reduction, through changing of beliefs, and the ACT for increased willingness to engage in feared situations, regardless of changes in anxiety.”

    From The role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review. (2022) · cites this paper as Block and Wulfert, 2000

    The Results and Discussion section says anxiety measures slightly favored CBGT and willingness ratings slightly favored ACT. It presents belief change as a possible explanation for reduced anxiety and willingness regardless of anxiety change as an expectation for ACT, not as mechanisms the study established. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Findings indicated a decrease in symptoms of social phobia and fear among both intervention groups, whereas the wait-list group exhibited no change or increased anxiety.

    “Findings indicated a decrease in symptoms of social phobia and fear among both intervention groups, whereas the wait-list group exhibited no change or increased anxiety.”

    From Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review (2013) · cites this paper as Block & Wulfert, 2000

  • In Block and Wulfert (2000), both ACT and CBGT conditions reported clinical improvement on social anxiety in SAD students.

    “Both participants in the ACT and CBGT conditions reported clinical improvement on social anxiety”

    From The role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review. (2022) · cites this paper as Block and Wulfert, 2000

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Cites

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2 of the 17 references couldn’t be matched to a known paper.

Research works printed but not linked: 7

  1. Biglan, A. (1989). A contextual approach to treating family distress. In G. Singer and L. Irvin (Eds.), Supporting the family: Enabling a positive adjustment to children with disabilities. Baltimore, MD: Paul H. Brookes. Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7-18.
  2. Greenberg, L. (1994). Acceptance in experiential therapy. In S. C. Hayes, N. S. Jacobson, V. M. Follette, & M. J. Dougher (Eds.), Acceptance and change: Content and context in psychotherapy. Reno, NV: Context Press.
  3. Hayes, S. C. (1994). Content, context, and types of psychological acceptance. In S. C. Hayes, N. S. Jacobson, V. M. Follette, & M. J. Dougher (Eds.), Acceptance and change: Content and context in psychotherapy. Reno, NV: Context Press.
  4. Khorakiwala, D. (1991). An analysis of the process of client change in a contextual approach to therapy. Unpublished doctoral dissertation, University of Nevada, Reno.
  5. McCurry, S. M. (1991). Client metaphor use in a contextual form of therapy. Unpublished doctoral dissertation, University of Nevada, Reno.
  6. Wulfert, E. (1994). Acceptance in the treatment of alcoholism: A comparison of Alcoholics Anonymous and social learning theory. In S. C. Hayes, N. S. Jacobson, V. M. Follette, & M. J. Dougher (Eds.), Acceptance and change: Content and context in psychotherapy. Reno, NV: Context Press.
  7. Young, J. E., Beck, A. T., & Weinberger, A. (1993). Depression. In D. H. Barlow (Ed.), Clinical Handbook of Psychological Disorders (2 nd ed.). NY: Guilford Press.

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Authors
Block, J. A., & Wulfert, E.
ORCID
Wulfert, Edelgard
Venue
The Behavior Analyst Today
Publisher
American Psychological Association (APA)
Published
2000
Volume
1
Issue
2
Pages
3-10
ISSN
1539-4352 (ISSN-L)
DOI
10.1037/h0099879
OpenAlex
W1976895412
Cited by
63
References
17
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 8 · 2013: 8 · 2012: 6
FWCI
0.00
Type
journal article
Language
en
Open access
Licence
Locations
The Behavior Analyst Today (publishedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
social anxiety, acceptance and commitment therapy, ACT, cognitive behavioral therapy, experiential avoidance, early maladaptive schemas, university students, acceptance-based therapy, schema therapy, treatment comparison, avoidance behavior, client-centered therapy, Gestalt therapy

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