title: An Experimental Comparison of Techniques: Cognitive Defusion, Cognitive Restructuring, and in-vivo Exposure for Social Anxiety.
abstract: BACKGROUND
  One of the primary differences between Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for anxiety is the approach to managing negative thoughts. CBT focuses on challenging the accuracy of dysfunctional thoughts through cognitive restructuring exercises, whereas ACT attempts to foster acceptance of such thoughts through cognitive defusion exercises. Previous research suggests that both techniques reduce the distress associated with negative thoughts, though questions remain regarding the benefit of these techniques above and beyond exposure to feared stimuli.
  
  
  OBJECTIVE
  In the present study, we conducted a brief experimental intervention to examine the utility of cognitive defusion + in-vivo exposure, cognitive restructuring + in-vivo exposure, and in-vivo exposure alone in reducing the impact of negative thoughts in patients with social anxiety disorder.
  
  
  METHODS
  All participants completed a brief public speaking exposure and those in the cognitive conditions received training in the assigned cognitive technique. Participants returned a week later to complete a second exposure task and self-report measures.
  
  
  RESULTS
  All three conditions resulted in similar decreases in discomfort related to negative thoughts. ANOVA models failed to find an interaction between change in accuracy or importance and assignment to condition in predicting decreased distress of negative thoughts.
  
  
  CONCLUSIONS
  These preliminary results suggest that changes in perceived importance and accuracy of negative thoughts may not be the mechanisms by which cognitive defusion and cognitive restructuring affect distress in the short-term.
authors: Michael E. DeBakey VA Medical Center,Houston,Baylor College of Medicine,Houston, andSouth Central Mental Illness Research,Education and Clinical Center,Houston,USA.
authors: Terri L
authors: TL
authors: Barrera
authors: Ralph H. Johnson VA Medical Center,Charleston,USA.
authors: Derek D
authors: DD
authors: Szafranski
authors: University of Houston,USA.
authors: Chelsea G
authors: CG
authors: Ratcliff
authors: Warren Alpert Medical School of Brown University,Providence,USA.
authors: Sarah L
authors: SL
authors: Garnaat
authors: Monash University,Australia.
authors: Peter J
authors: PJ
authors: Norton
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000328:Adult; D001007:Anxiety / Q000523:psychology; D001008:Anxiety Disorders / Q000628:therapy*; D003071:Cognition; D003072:Cognition Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000523:psychology; D012920:Social Behavior Disorders / Q000523:psychology / Q000628:therapy*; D013060:Speech
keywords: Cognitive defusion; cognitive restructuring; exposure; social anxiety disorder