Topic: Anxiety
Target Population: Adults
Sector: Community-Based
This program is for adults who have a primary diagnosis of generalized anxiety disorder (GAD).
Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder (ABBT for GAD), a community-based mental health program, is designed to help clients reduce GAD symptomatology to non-clinical levels and enhance their quality of life by promoting awareness of the present moment, acceptance of internal states, and involvement in significant activities.
One internal randomized controlled trial (RCT) with a wait-list condition has been conducted. From pretest to posttest, participants in the treatment group, compared to those in the wait-list group, experienced improvements in GAD symptoms and perceived control over anxiety, depressive symptoms, psychological flexibility, mindfulness, emotional regulation, and uncertainty tolerance. At posttest, over three-fourths (76.92%) of the treatment group no longer met criteria for GAD compared to one-sixth (16.67%) of the wait-list group. Follow-up analyses involving all of the participants who received treatment, including those from the wait-list condition, indicated gains made during treatment were maintained over a 9-month period. An additional internal RCT has been conducted in which a group format of ABBT for GAD was compared to a standard nondirective supportive group therapy, and improvements in outcomes of anxiety and stress were seen at posttest and at a 3-month follow-up for both groups.
ABBT for GAD is comprised of two treatment phases:
Phase 1 (Sessions 1 to 7) - Clients learn about how anxiety, emotions, and experiential avoidance contribute to impairment; understand the advantages of accepting internal experiences and making value-consistent decisions; and learn about mindfulness. Clients develop mindfulness-based skills, identify what they find meaningful about different aspects of their lives (e.g., relationships, work, community involvement) through writing assignments, and make commitments to use mindfulness strategies in the areas of their lives that they value.
Phase 2 (Sessions 8 to 16) - Clients focus on using the skills they have learned to help them perform actions they value each week. If setbacks occur, therapists and clients review content from earlier sessions.
A typical session format involves starting with a mindfulness-skill practice, reviewing the prior session's assignment, introducing the current session's content, and concluding with a new assignment. The final three sessions also include reviewing the client's progress, identifying the most helpful strategies, and developing a maintenance plan.
Since its development in 2002, ABBT for GAD has been used with more than 5,000 individuals in 30 U.S. states and territories and in Australia, Brazil, Canada, Denmark, Iran, Israel, New Zealand, Singapore, Spain, Sweden, Switzerland, and the United Kingdom.
Facilitators are generally mental health providers and are required to read "Mindfulness- and Acceptance-Based Behavioral Therapies in Practice." Please visit mindfulwaythroughanxiety.com/books/ for more information on this book. In addition, a variety of workshops are available. Please visit http://mindfulwaythroughanxiety.com/workshops-training-and-consultation-services/ or email abbttraining@gmail.com to learn more.
Considerations for implementing this program include recruiting providers with a suitable background and professional experience, ensuring providers read the required training text, gaining client buy-in, and finding a suitable location to conduct sessions.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
If you are interested in implementing ABBT for GAD, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
ABBT for GAD consists of 16 sessions. Sessions one through four are delivered weekly for 90 minutes each; sessions five through 13 are delivered weekly for 60 minutes each; sessions 14 through 16 are delivered every other week for 60 minutes each.
Implementation materials include the book mentioned in the Training section; please refer to the website listed in the Training section for more information. Optional program materials are free and include an ABBT for GAD manual, treatment handouts, weekly competence forms, and an adherence checklist. Please use details in the Contact section for additional information.
To move ABBT for GAD to the Effective category on the Clearinghouse Continuum of Evidence, at least two evaluations must be conducted that demonstrate sustained, positive outcomes lasting at least one year from program completion or at least two years from the beginning of the program. At least one of these studies must be conducted independently of the program developer.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu
You may also contact Dr. Lizabeth Roemer by email lizabeth.roemer@umb.edu or visit https://mindfulwaythroughanxiety.com or https://roemerlab-umb.com
http://roemerlab-umb.com/, http://mindfulwaythroughanxiety.com/, Roemer and Orsillo (2007); Hayes-Skelton, Roemer, and Orsillo (2013); and nrepp.samhsa.gov/ViewIntervention.aspx?id=366 (This website no longer contains program information)
de Almeida Sampaio, T. P., Jorge, R. C., Martins, D. S., Gandarela, L. M., Hayes‐Skelton, S., Bernik, M. A., & Lotufo‐Neto, F. (2020). Efficacy of an acceptance‐based group behavioral therapy for generalized anxiety disorder. Depression and Anxiety, 37(12), 1179-1193.
Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: Evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology, 76(6), 1083-1089. https://doi.org/10.1037/a0012720
Treanor, M., Erisman, S. M., Salters-Pedneault, K., Roemer, L., & Orsillo, S. M. (2011). Acceptance-based behavioral therapy for GAD: Effects on outcomes from three theoretical models. Depression and Anxiety, 28(2), 127-136. https://doi.org/10.1002/da.20766
Roemer, L., Williston, S. K., Eustis, E. H., & Orsillo, S. M. (2013). Mindfulness and acceptance-based behavioral therapies for anxiety disorders. Current Psychiatry Reports, 15(11), 1-10. https://doi.org/10.1007/s11920-013-0410-3
Hayes, S. A., Orsillo, S. M., & Roemer, L. (2010). Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behaviour Research and Therapy, 48(3), 238-245. https://doi.org/10.1016/j.brat.2009.11.006
Michelson, S. E., Lee, J. K., Orsillo, S. M., & Roemer, L. (2011). The role of values-consistent behavior in generalized anxiety disorder. Depression and Anxiety, 28(5), 358-366. https://doi.org/10.1002/da.20793
Millstein, D. J., Orsillo, S. M., Hayes-Skelton, S., & Roemer, L. (2015). Interpersonal problems, mindfulness, and therapy outcome in an acceptance-based behavior therapy for generalized anxiety disorder. Cognitive Behaviour Therapy, 44(6), 491-501. https://doi.org/10.1080/16506073.2015.1060255
Morgan, L. P. K., Graham, J. R., Hayes-Skelton, S., Orsillo, S. M., & Roemer, L. (2014). Relationships between amount of post-intervention mindfulness practice and follow-up outcome variables in an acceptance-based behavior therapy for generalized anxiety disorder: The importance of informal practice. Journal of Contextual Behavioral Science, 3(3), 173-178. https://doi.org/10.1016/j.jcbs.2014.05.001
Dahlin, M., Ryberg, M., Vernmark, K., Annas, N., Carlbring, P., & Andersson, G. (2016). Internet-delivered acceptance-based behavior therapy for generalized anxiety disorder: A pilot study. Internet Interventions: The Application of Information Technology in Mental and Behavioural Health, 6, 16-21. https://doi.org/10.1016/j.invent.2016.08.004
Fuchs, C. H., West, L. M., Graham, J. R., Kalill, K. S., Morgan, L. P. K., Hayes-Skelton, S., . . . Roemer, L. (2016). Reactions to an acceptance-based behavior therapy for GAD: Giving voice to the experiences of clients from marginalized backgrounds. Cognitive and Behavioral Practice, 23(4), 473-484. https://doi.org/10.1016/j.cbpra.2015.09.004
Hayes-Skelton, S., Roemer, L., & Orsillo, S. M. (2013). A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 81(5), 761-773. https://doi.org/10.1037/a0032871
Zargar, F., Farid, A. A. A., Atef-Vahid, M., Afshar, H., & Omidi, A. (2013). Comparing the effectiveness of acceptance-based behavior therapy and applied relaxation on acceptance of internal experiences, engagement in valued actions and quality of life in generalized anxiety disorder. Journal of Research in Medical Sciences, 18(2), 118-122.
