In a recent article entitled Randomized Controlled Trial of Cognitive Behavoral Therapy and Acceptance and Commitment Therapy for Social Phobia: Outcomes and Moderators Posted on Journal of Consulting and Clinical Psychologythe authors wanted to test the effectiveness of the CBT and Act in the treatment of social phobia (http://dx.doi.org/10.1037/a0037212)
Although several studies are found in the literature that attest to the effectiveness of the CBT for the social phobia treatmentno less there are several reasons to investigate other forms of treatment, since not all subjects respond adequately to the CBT, both because several studies demonstrate how cognitive renovation is not only effective, and because they are taking hold protocols of treatment in which different types of intervention are privileged, such as behavioral activation or acceptance, such as the Acceptance and Commitment Therapy (ACT).
The first objective of this study is in fact to compare the effectiveness of Act and CBT In treating social phobia, chosen by the authors for the lower heterogeneity of the disorder, as well as for the high Lifetime incidence.
The second purpose was to evaluate the various mediators in the outcome of the treatment, to understand its mechanisms of action. The authors have chosen the mood as mediators (defined as a mediator not referring to any theory) and two mediators defined by the models themselves of treatment: experiential avoidance for the act and fear of the negative judgment for the CBT.
The authors hypothesize that the Act is superior to the CBT when patients also present depressive aspects, while the opposite happens if patients have moderate levels of Anxiety Sensitità.
The sample is composed of 100 subjects recruited via the Internetwith announcements in local newspapers or through public posters; The subjects satisfied the criteria of the DSM IV for the generalized social phobia And they were randomly divided into the three categories of the study: 29 Act, 33 CBT and 25 waiting list (10 patients abandoned the study before starting therapy and 3 were excluded due to lack of other criteria).
The assessments were made at the beginning and at the end of the treatment (12 sessions) and 3 and 9 months from the conclusion.
The evaluation concerned the quality of life (as an index of the psychological flexibility produced by the Act) and the symptomatological level (object of the CBT intervention). The tools used were the Anxiety Disorders Interview Schedule –iv (Adis IV); A staircase created specifically by combining the Liebowitz Social Anxiety Scale-Ceelf-Report (LSPS-SR), the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS); the Quality of Life Inventory (Qoli); In addition, the subjects have self -evaluated their discomfort through the Subjective Units of Desease (Suds) in an exposure task (public speaking).
The competence of the therapists involved was tested through independent evaluators: 45 audio seats recorded casually were evaluated by blind evaluators to whom it was asked to use for the evaluation of adherence to ACT and CBT protocols the Drexel University Act/Ct Therapist Adherence and Competence Rating Scale.
17 patients abandoned during treatment (11 for the CBT and 5 for the Act, 1 for the LDA).
The results showed that patients who had received a treatment (Act or CBT) improved more than those who had been on the waiting list only; Both ACT and CBT have proven to be effective in the treatment of social anxietyalthough the CBT is demonstrated higher in reducing the symptoms (measured with self report) linked to the fear of negative judgment and, surprisingly, it was equally superior with patients showing a lower psychological flexibility. These results seem to confirm themselves also to the follow up.
In conclusion, this article seems to confirm that the ACT is a further treatment protocol that can be effective for the treatment of this disorder.
