Acceptance And Commitment Therapy in Reducing Experiential Avoidance and Increasing Awareness In 20–40-Year-Old Women with Social Phobia

Zahra Masihi, Maryam Soleymanfarokh, Maryam Nasri, Mehdi Rezaei, Seyed Abdolmajid Bahrainian

Abstract


Examined acceptance and commitment therapy (ACT) for reducing experiential avoidance and increasing awareness in women with social phobia disorder. Social phobia can impact negatively on quality of life of individuals. Participants were assessed at baseline and three-months post-baseline. Clinically significant changes were observed in the group that received ACT. This study examined the outcome acceptance and commitment therapy in women with social phobia disorders treated in community mental health clinics. A total of participants (range of 20-40 years) with a principal diagnosis of social phobia disorders were evaluated on average, 3-month post-treatment. Outcomes included reducing of experiential avoidance, increasing and changes in social phobia symptoms. A significant difference between the mean post-test scores of the study group and the control group. In other words, acceptance and commitment therapy resulted in a significant decrease in avoidance scores and a significant increase in awareness scores in 20–40-year-old women. (p<0/05). The outcomes of this trial will inform clinicians whether ACT to reduce in experiential avoidance and increase in awareness for women with social phobia is likely to improve outcomes.


Keywords


Acceptance and Commitment Based Therapy; Experiential Avoidance; Consciousness; Social Phobia Disorder

Full Text:

PDF

References


Amini, F., Zare, H., Agha Yosefi, A. R., & Hashemi, S. E. (2020). the Effect of Mindfulness on Styles of Decision-Making among Employees of Parsian Gas Refining Company: Mediating Role of Self-Reflection. Knowledge & Research in Applied Psychology, 21(2), 75-83.

Arch, J. J., Fishbein, J. N., Ferris, M. C., Mitchell, J. L., Levin, M. E., Slivjak, E. T., . . . Kutner, J. S. (2020). Acceptability, feasibility, and efficacy potential of a multimodal acceptance and commitment therapy intervention to address psychosocial and advance care planning needs among anxious and depressed adults with metastatic cancer. Journal of Palliative Medicine, 23(10), 1380-1385.

Arch, J. J., Landy, L. N., & Brown, K. W. (2016). Predictors and moderators of biopsychological social stress responses following brief self-compassion meditation training. Psychoneuroendocrinology, 69, 35-40.

Asher, M., Asnaani, A., & Aderka, I. M. (2017). Gender differences in social anxiety disorder: A review. Clinical psychology review, 56, 1-12.

Asnaani, A., Aderka, I. M., Marques, L., Simon, N., Robinaugh, D. J., & Hofmann, S. G. (2015). The structure of feared social situations among race-ethnic minorities and Whites with social anxiety disorder in the United States. Transcultural psychiatry, 52(6), 791-807.

Ataie, S., Fata, L., & Abhari, A. A. (2014). Rumination and Cognitive Behavioral Avoidance in Unipolar Mood Disorder and Social Anxiety Disorder: Comparison between Dimensional and Categorical Approaches. Iranian Journal of Psychiatry & Clinical Psychology, 19(4).

Block, J. A., & Wulfert, E. (2000). Acceptance or change: Treating socially anxious college students with ACT or CBGT. The Behavior Analyst Today, 1(2), 3.

Boland, R., Verdiun, M., & Ruiz, P. (2021). Kaplan & Sadock’s synopsis of psychiatry: Lippincott Williams & Wilkins.

Brown, K., Creswell, J., & Ryan, R. (2015). Handbook of mindfulness: Theory, research, and practice. New York, NY, US: The Guilford Press.

Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of personality and social psychology, 84(4), 822.

Clifton, B. (2023). Anxiety, Experiential Avoidance, and Physical Health: A Research Portfolio. University of Leicester,

Dalrymple, K. L., & Herbert, J. D. (2007). Acceptance and commitment therapy for generalized social anxiety disorder: A pilot study. Behavior modification, 31(5), 543-568.

Dindo, L., Van Liew, J. R., & Arch, J. J. (2017). Acceptance and commitment therapy: a transdiagnostic behavioral intervention for mental health and medical conditions. Neurotherapeutics, 14, 546-553.

Emanuel, A. S., Updegraff, J. A., Kalmbach, D. A., & Ciesla, J. A. (2010). The role of mindfulness facets in affective forecasting. Personality and Individual differences, 49(7), 815-818.

Eqharari, L. H., Asadi, F., Javazi, S., & Vahid, T. A. (2019). Effectiveness of Acceptance and Commitment (ACT) Therapy on Behavioral Inhibition and Cognitive-behavioral Avoidance of Women with Generalized Anxiety Disorder. Iranian Journal of Nursing Research, 13(6), 31-38 [In Persian].

Fanaee, S., & Sajjadian, I. (2016). The effectiveness of acceptance and commitment therapy on experiential avoidance in overweight individuals. Journal of Research in Behavioural Sciences, 14(2), 146-153.

Firouzbakht, M., Riahi, M.-E., & Tirgar, A. (2017). A Survey on Factors Affecting on Iranian Women’s Social Health: A Review Study in Persian Database. SAL?MAT-I IJTIM?? (Community Health), 4(3), 186-196 [In Persian]. doi:10.22037/ch.v4i3.16613

Fleming, J. E., & Kocovski, N. L. (2014). Mindfulness and Acceptance-based Group Therapy for Social Anxiety Disorder: A Treatment Manual Second Edition. Unpublished manuscript.

Folke, F., Parling, T., & Melin, L. (2012). Acceptance and commitment therapy for depression: A preliminary randomized clinical trial for unemployed on long-term sick leave. Cognitive and Behavioral Practice, 19(4), 583-594.

Forman, E. M., Shaw, J. A., Goetter, E. M., Herbert, J. D., Park, J. A., & Yuen, E. K. (2012). Long-term follow-up of a randomized controlled trial comparing acceptance and commitment therapy and standard cognitive behavior therapy for anxiety and depression. Behavior therapy, 43(4), 801-811.

Gloster, A. T., Meyer, A. H., & Lieb, R. (2017). Psychological flexibility as a malleable public health target: Evidence from a representative sample. Journal of Contextual Behavioral Science, 6(2), 166-171.

Hayes-Skelton, S. A., & Eustis, E. H. (2020). Experiential avoidance. In Clinical handbook of fear and anxiety: Maintenance processes and treatment mechanisms. (pp. 115-131). Washington, DC, US: American Psychological Association.

Hinds, E., Jones, L. B., Gau, J. M., Forrester, K. K., & Biglan, A. (2015). Teacher distress and the role of experiential avoidance. Psychology in the Schools, 52(3), 284-297.

Hollis-Walker, L., & Colosimo, K. (2011). Mindfulness, self-compassion, and happiness in non-meditators: A theoretical and empirical examination. Personality and Individual differences, 50(2), 222-227.

Hülsheger, U. R., Alberts, H. J., Feinholdt, A., & Lang, J. W. (2013). Benefits of mindfulness at work: the role of mindfulness in emotion regulation, emotional exhaustion, and job satisfaction. Journal of applied psychology, 98(2), 310.

Iturbe, I., Pereda-Pereda, E., Echeburúa, E., & Maiz, E. (2021). The effectiveness of an acceptance and commitment therapy and mindfulness group intervention for enhancing the psychological and physical well-being of adults with overweight or obesity seeking treatment: The Mind&Life randomized control trial study protocol. International journal of environmental research and public health, 18(9), 4396.

Joulaei, H., Maharlouei, N., lankarani, K. B., Razzaghi, A., & Akbari, M. (2016). Narrative review of women’s health in Iran: challenges and successes. International Journal for Equity in Health, 15(1), 25 doi:10.1186/s12939-016-0316-x

kamran, a., Rostamifar, R., & moghtadaei, k. (2022). The Effectiveness of Acceptance and Commitment Therapy on Experiential Avoidance and Emotional Processing in Patients with Irritable Bowel Syndrome. Health Psychology, 11(41), 155-170. doi:10.30473/hpj.2022.59386.5250

karimiazar, f., Saken Azari, R., Abdoltajedini, P., & Azmoudeh, M. (2022). The effect of acceptance and commitment based therapy on the symptoms of social anxiety in shy girls adolescents. Journal of Nursing Education, 10(1), 46-54. doi:10.22034/ijpn.10.1.46

Kocovski, N. L., Fleming, J. E., & Rector, N. A. (2009). Mindfulness and acceptance-based group therapy for social anxiety disorder: An open trial. Cognitive and Behavioral Practice, 16(3), 276-289.

Koohikamali, S., Poursharifi, H., Sodagar, S., & Ashayeri, H. (2021). The Effectiveness of Acceptance and Commitment Therapy (ACT) on Health-Related Quality of Life in Infertile Women. Community Health Journal, 15(4), 46-57 [In Persian]. doi:10.22123/chj.2022.265268.1645

Koohpaei, A. R., Khandan, M., Arab, Z., Mobinizadeh, V., & Moamenian, S. (2015). Survey of Mental Health Status Among Female Workers in Qom Province in 2014: Opportunities and Challenges. Journal of Rafsanjan University of Medical Sciences, 14(8), 691-700. Retrieved from http://journal.rums.ac.ir/article-1-2622-fa.html

Lorian, C. N., & Grisham, J. R. (2011). Clinical implications of risk aversion: An online study of risk-avoidance and treatment utilization in pathological anxiety. Journal of anxiety disorders, 25(6), 840-848.

Lundgren, T., Reinebo, G., Fröjmark, M. J., Jäder, E., Näslund, M., Svartvadet, P., . . . Parling, T. (2021). Acceptance and commitment training for ice hockey players: a randomized controlled trial. Frontiers in Psychology, 12, 685260.

Lundgren, T., Reinebo, G., Näslund, M., & Parling, T. (2020). Acceptance and commitment training to promote psychological flexibility in ice hockey performance: A controlled group feasibility study. Journal of Clinical Sport Psychology, 14(2), 170-181.

MacDonald, H. Z., & Price, J. L. (2017). Emotional understanding: examining alexithymia as a mediator of the relationship between mindfulness and empathy. Mindfulness, 8, 1644-1652.

Masoumi, S., & Ebrahimi, L. (2020). The Role of Cognitive Avoidance and Cognitive Emotion Regulation in the Prediction of Suicidal Ideas in Students. Thoughts and Behavior in Clinical Psychology, 15(56), 27-35.

Mehboodi, K., Mohammadi, N., Rahimi, C., & Sarafraz, M. R. (2022). The efficacy of intensive short-term dynamic psychotherapy (ISTDP) on self-esteem, emotion regulation, and defense mechanisms in men with social anxiety disorder. Journal of Psychological Science, 21(111), 461-474. doi:10.52547/jps.21.111.461

Molavi, P., Mikaeili, N., Rahimi, N., & Mehri, S. (2014). The Effectiveness of Acceptance and Commitment Therapy Based on Reducing Anxiety and Depression in Students with Social Phobia. Journal of Ardabil University of Medical Sciences, 14(4), 412-423.

Moridi, A. A., & Nourimoghadam, S. Comparison of cognitive emotion regulation strategies, mindfulness and cognitive flexibility in gifted and normal students. Psychology, 19(45), 87-104.

Nourimoghadam, S., & Zare, B. (2019). self-control. Mindfulness. Emotion- regulation. Journal of Applied Psychological Research, 9(4), 141-153 [In Persian] doi:10.22059/japr.2019.71007

Ossman, W. A., Wilson, K. G., Storaasli, R. D., & McNeill, J. W. (2006). A preliminary investigation of the use of acceptance and commitment therapy in group treatment for social phobia. International Journal of Psychology and Psychological Therapy, 6(3), 397-416.

Pourfaraj Omran, M. (2011). The Effectiveness of Acceptance and Commitment Group Therapy in Social Phobia of Students. Knowledge and Health in Basic Medical Sciences, 6(2), 1-5 [In Persian]. doi:10.22100/jkh.v6i2.100

Roohi, R., Soltani, A. A., Zinedine Meimand, Z., & Razavi Nematollahi, V. (2019). The effect of acceptance and commitment therapy (act) on increasing the self-compassion, distress tolerance, and emotion regulation in students with social anxiety disorder. Quarterly Journal of Child Mental Health, 6(3), 173-187.

Salmanpour, F. A., & Pasha, G. (2023). The effect of acceptance and acceptance therapy (ACT) on happiness, mental health and quality of life of mothers with autistic children. Psychology of Woman Journal, 4(1), 81-89.

Schneier, F., & Goldmark, J. (2015). Social Anxiety Disorder. In D. J. Stein & B. Vythilingum (Eds.), Anxiety disorders and gender (pp. 49-67). Cham: Springer International Publishing.

Sexston, K., & Dugas, M. (2004). An investigation of the factors leading to cognitive avoidance in worry. Paper presented at the Poster presented at the annual convention of the association for advancement of behavior therapy, New Orleans, LA.

Shinde, M. A. S. (2019). Mental Health among Working and Non-Working Women in Aurangabad City. Think India Journal, 22(13), 1137-1143.

Solimanpour, M., Pirkhaefi, A., & Zahrakar, K. (2022). Comparison of the efficacy of acceptance and commitment therapy (ACT) and compassion-focused therapy (CFT) on quality of life in patients with vitiligo. Journal of Psychological Science, 21(113), 987-1004. doi:10.52547/jps.21.113.987

Talebi, M. (2021). The effectiveness of mindfulness-based cognitive therapy on anxiety, happiness and mindfulness in nurses. Avicenna Journal of Nursing and Midwifery Care, 29(2), 126-136.

Twohig, M. P., Ong, C. W., Krafft, J., Barney, J. L., & Levin, M. E. (2019). Starting off on the right foot in acceptance and commitment therapy. Psychotherapy, 56(1), 16.

Yarollahi, N. A., & Shairi, M. R. (2018). Investigation the role of experiential avoidance on anticipation general health in non-clinical samples. Shenakht Journal of Psychology and Psychiatry, 5(3), 1-11. doi:10.29252/shenakht.5.3.1

Yazdi, S. M., Darvizeh, Z., & Sheikhi, Z. (2015). A comparative study on cognitive failures and coping strategies in people with major depression disorder (MDD), generalized anxiety disorder (GAD), and comorbidity. Journal of psychological studies, 11(3), 7-28.

Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z., & Goolkasian, P. (2010). Mindfulness meditation improves cognition: Evidence of brief mental training. Consciousness and cognition, 19(2), 597-605.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

World of Researches Publication