Acceptance-Based Behavioral Therapies for Anxiety

Abstract

11 reactions to these experiences that are characteristic of individuals with anxiety and other disorders) while developing behavioral repertoires that are broad, flexible, effective, and values driven (to counteract the rigid, restricted, and avoidant behavioral patterns that are typical of individuals with anxiety disorders). Within this broader category, we include our own integration of many of the underlying principles and techniques derived from these third wave therapies into traditional cognitive-behavioral therapy for anxiety (Orsillo et al., 2003; Roemer & Orsillo, 2005; Roemer, Salters-Pedneault, & Orsillo, in press). Although we have been testing the efficacy of our approach with individuals with GAD (see Roemer & Orsillo, 2005), we use a similar approach with clients with diverse clinical presentations. CONCEPTUALIZING PSYCHOPATHOLOGY AS EXPERIENTIAL AVOIDANCE Although mounting evidence suggests that therapies teaching skills of acceptance and mindfulness are effective in reducing psychopathology (e.g., Baer, 2003; Hayes et al., 2004), a careful formulation as to how these approaches specifically address psychopathology is critical (Teasdale, Segal, & Williams, 2003). Although theorists from other traditions have certainly emphasized the importance of acceptance in psychotherapy (e.g., Greenberg & Safran, 1987; Rogers, 1961), we will focus here on behav-ioral and cognitive-behavioral models. A particularly useful and well-elaborated account comes from Steve Hayes and his colleagues. Hayes, Wilson, Gifford, Follette, and Stosahl (1996) convincingly argued that ex-periential avoidance, defined as mental and behavioral strategies aimed at changing the form or frequency of one's current internal experience (e.g., thoughts, emotions, images, physiological sensations), contributes to the development and maintenance of many forms of psychopathology. From this perspective, anxiety disorders develop when individuals engage in cognitive and behavioral strategies aimed at reducing or eliminating anxiety-related internal experiences. Most obviously, individuals may severely restrict their behavior with the goal of avoiding certain anxiety-related stimuli and/or environments that are likely to elicit anxiety. As this avoidance or escape behavior increases and generalizes, increasingly more subtle behavioral changes will likely occur that further diminish quality of life. Cognitive strategies, such as efforts to suppress certain internal experiences , distract attention away from them, or actively change their content, are also viewed as methods of experiential avoidance that may contribute to the development and maintenance of anxiety disorders. Acceptance-and Mindfulness-Based Approaches to Anxiety : Conceptualization and Treatment, edited by Lizabeth Roemer, and Susan M. Orsillo, Springer, 2005. ProQuest Ebook Central,