title: Evaluating the Effectiveness of ACT for Anxiety Disorders in a Self-Help Context: Outcomes From a Randomized Wait-List Controlled Trial.
abstract: Rigorous evaluations of cognitive behavioral self-help books for anxiety in pure self-help contexts are lacking. The present study evaluated the effectiveness of an Acceptance and Commitment Therapy (ACT) self-help workbook for anxiety-related concerns, with no therapist contact, in an international sample. Participants (N=503; 94% mental health diagnosis) were randomized to an immediate workbook (n=256) or wait-list condition (n=247). Assessments at pretreatment, 12weeks, 6months, and 9months evaluated anxiety and related symptoms, quality of life, and ACT treatment processes (e.g., psychological flexibility). Participants in the wait-list arm crossed over to the workbook following the 12-week assessment. The workbook condition yielded significant improvements on all assessments from pre- to posttreatment relative to wait-list, and these gains were maintained at follow-ups. The pattern observed in the wait-list condition was virtually identical to the active treatment arm after receiving the workbook, but not before. Attrition was notable, but supplemental analyses suggested dropout did not influence treatment effects for all but one measure. Overall, findings provide preliminary support for the effectiveness of this self-help workbook and suggest ACT-based self-help bibliotherapy might be a promising low-cost intervention for people experiencing significant anxiety-related concerns.
authors.affiliation: University at Albany, State University of New York. Electronic address: tritzert@albany.edu.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Ritzert
authors.affiliation: University at Albany, State University of New York.
authors.forename: John P
authors.initials: JP
authors.lastname: Forsyth
authors.affiliation: University at Albany, State University of New York.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Sheppard
authors.affiliation: University at Albany, State University of New York.
authors.forename: James F
authors.initials: JF
authors.lastname: Boswell
authors.affiliation: University at Albany, State University of New York.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Berghoff
authors.affiliation: Chapman University.
authors.forename: Georg H
authors.initials: GH
authors.lastname: Eifert
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy*; D001638:Bibliotherapy / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult
keywords: acceptance and commitment therapy; anxiety disorders; bibliotherapy; self-help