Category: Treatment - ACT
Social anxiety disorder is one of the most prevalent psychological disorders in our society (Herbert & Cardaciotto, 2005). Cognitive Behavioral Therapy (CBT) is considered a gold standard for the treatment of anxiety disorders (Craske, 2014); however, some individuals do not respond to CBT, and other approaches to treatment continue to be investigated. One alternative approach is Acceptance and Commitment Therapy (ACT). ACT theorizes that accepting, rather than attempting to control, maladaptive thoughts and emotions will result in greater life satisfaction (Hayes et al., 1999). Acceptance-based approaches have been used for treatment of social anxiety (Eifert & Forsyth, 2006), and have also been tentatively shown to be effective for increasing speech performance in socially-anxious individuals (Glassman, 2016). However, more research is needed to determine if acceptance-based approaches can reliably improve public speaking performance in socially-anxious individuals. The current study compared the effects of brief acceptance-based and cognitive-control-based intervention protocols (Goldfarb, 2009). It was hypothesized that participants receiving the ACT protocol would display higher levels of speech performance as well as exhibit more anxiety and greater levels of acceptance at post-speech evaluation. Undergraduate students from a Midwestern university participated in this study. Requirements for inclusion were based on participant endorsement of a requisite level of social anxiety on a prescreening survey (Social Phobia Scale; Mattick & Clark, 1998). Eligible participants were randomly assigned to one of the two protocols, and then prepared and delivered a 5-minute speech in front of an audience of two confederates. Speech performance was evaluated using the Perception of Speech Performance Scale (Rapee & Lim, 1992). Additional pre/post measures included the Speilberger State Anxiety Inventory (SSAI; Speilberger, 1983), the Acceptance and Action Questionnaire (AAQ; Hayes et al., 2003), and Subjective Units of Discomfort (SUDS; Wolpe & Lazarus, 1966). Although data collection is currently ongoing, 16 individuals have participated and another 14 are expected to complete the study. The public speaking task used sufficiently induced anxiety, as shown by the significantly higher participant SUDS ratings given during the speech, compared to baseline, F(1.43, 20.02)=5.65, p=.02. The CBT and ACT groups did not significantly differ in terms of speech performance, F(1,14)=.65, p=.44. Although no group X time interactions were found, all participants showed reductions in anxiety on the SSAI following the speech F(1,14)=8.28, p=.01, as well as increases in acceptance on the AAQ, F(1,14)=4.34, p=.05. Although analyses have not yet revealed significant differences in speech performance, the preliminary data indicated the public speaking task was reliable and valid, and the interventions were rated by participants as “somewhat” useful, on average. By exploring the relationship between intervention and public speaking performance, this research may be able to identify an effective strategy to not only alleviate public speaking anxiety, but also to improve speech performance.
Clinical Psychology Master's Student
Minnesota State University, Mankato