Practitioner Development

Acceptance and commitment therapy for generalized social anxiety disorder: a pilot study.

Dalrymple et al. (2007) · Behavior modification 2007
★ The Verdict

ACT plus exposure gave large, quick relief to adults with social anxiety in a small pilot.

✓ Read this if BCBAs running exposure therapy for anxious adults.
✗ Skip if Clinicians who only treat young children or non-anxiety cases.

01Research in Context

01

What this study did

Kleinert et al. (2007) ran a small pilot with 19 adults who had social anxiety disorder.

For 12 weeks the adults got acceptance and commitment therapy plus exposure.

The team checked scores before and after, with no control group.

02

What they found

Social anxiety dropped a lot and quality of life went up.

Nothing changed during the short baseline, so gains looked linked to treatment.

03

How this fits with other research

Sasson et al. (2022) tried a similar idea: exposure plus brief mindful emotion awareness for adults with social anxiety.

Some clients did better, some did not, showing the mix-and-match approach can work but needs close tracking.

Lanfranchi et al. (2022) moved the idea down to kids, using video feedback plus cognitive prep and also saw quick social gains, proving the anxiety target travels across ages.

van der Miesen et al. (2024) reviewed ACT for parents of autistic children and found early signs it helps caregiver stress, hinting that ACT’s core skills may ease anxiety in many roles.

04

Why it matters

You already use exposure for social anxiety.

This pilot says weaving in ACT can boost impact.

Try adding one ACT move—like having clients note scary thoughts without pushing them away—during your next exposure task and watch if avoidance drops faster.

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Add a two-minute values clarification before the first exposure trial and track client willingness each session.

02At a glance

Intervention
other
Design
pre post no control
Sample size
19
Population
anxiety disorder
Finding
positive
Magnitude
large

03Original abstract

Despite the demonstrated efficacy of cognitive-behavior therapy (CBT) for social anxiety disorder (SAD), many individuals do not respond to treatment or demonstrate residual symptoms and impairment posttreatment. Preliminary evidence indicates that acceptance-based approaches (e.g., acceptance and commitment therapy; ACT) can be helpful for a variety of disorders and emphasize exposure-based strategies and processes. Nineteen individuals diagnosed with SAD participated in a 12-week program integrating exposure therapy and ACT. Results revealed no changes across a 4-week baseline control period. From pretreatment to follow-up, significant improvements occurred in social anxiety symptoms and quality of life, yielding large effect size gains. Significant changes also were found in ACT-consistent process measures, and earlier changes in experiential avoidance predicted later changes in symptom severity. Results suggest the acceptability and potential efficacy of ACT for SAD and highlight the need for future research examining both the efficacy and mechanisms of change of acceptance-based programs for SAD.

Behavior modification, 2007 · doi:10.1177/0145445507302037