Acceptance and Commitment Therapy (ACT) for Comorbid Generalized Anxiety Disorder and Premenstrual Dysphoric Disorder: A Transdiagnostic Approach

Abstract

The present case details the use of Acceptance and Commitment Therapy (ACT) with “June,” a 26-year-old biracial woman presenting with generalized anxiety disorder (GAD) and premenstrual dysphoric disorder (PMDD). Across 37 sessions in a community-based training clinic, treatment focused on reducing psychological inflexibility and strengthening flexibility processes, including acceptance, defusion, present-moment awareness, values clarity, and committed action. June entered treatment with severe anxiety, marked mood lability during her luteal phase, and significant relationship and occupational stress. The therapist tracked progress with standardized measures and qualitative reports. June showed clinically meaningful improvements in anxiety, psychological flexibility, wellbeing, and valued living. Though some of her premenstrual symptoms persisted, she no longer met criteria for PMDD at termination. This case highlights ACT’s relevance as a transdiagnostic approach for clients managing both GAD and cyclical mood disturbances. It also underscores ACT’s emphasis on relating flexibility to overarching values to help clients maintain motivation and consistent application of skills.