The Effects of a Brief Acceptance-Based Behavioral Treatment Versus Traditional Cognitive-Behavioral Treatment for Public Speaking Anxiety: An Exploratory Trial Examining Differential Effects on Performance and Neurophysiology.
A single 90-minute acceptance session improved speech performance more than traditional CBT, even though CBT cut self-reported nerves more.
01Research in Context
What this study did
Schertz et al. (2016) ran a small randomized trial with adults who feared public speaking. One group got a 90-minute acceptance-based behavior treatment. The other got the same length of traditional CBT.
Both groups gave a speech before and after the session. Trained observers scored how well each person performed. The team also tracked heart rate and asked each speaker how nervous they felt.
What they found
The acceptance group looked better to observers. Their speeches sounded smoother and more confident. The traditional CBT group said they felt less anxious, but their speeches did not look better.
Heart-rate data slightly favored the acceptance group, but the difference was small. In short, acceptance training helped performance more; traditional CBT helped self-reported worry more.
How this fits with other research
Plant et al. (2007) found ACT and CBT both cut general anxiety the same amount. The new study shows that when the goal is better performance, acceptance work can pull ahead.
Kaufman et al. (2010) saw ACT beat CBT for college students with eating issues. The pattern is similar here: acceptance tools outshine classic CBT when behavior change matters more than feeling better.
Rieth et al. (2022) later showed that a 10-minute online ACT-style module pushed socially anxious adults to seek help. Together these studies say brief acceptance tools work, even at a distance.
Why it matters
If your client must perform—present a book report, lead a job interview, or give a wedding toast—90 minutes of acceptance skills can lift observer ratings fast. You can weave simple acceptance drills (noticing nerves without fighting them, stating values aloud) into one session. Do not drop traditional CBT; it still lowers subjective fear. Pick the tool that matches the goal: acceptance for visible performance, CBT for internal comfort.
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02At a glance
03Original abstract
Individuals with public speaking anxiety (PSA) experience fear and avoidance that can cause extreme distress, impaired speaking performance, and associated problems in psychosocial functioning. Most extant interventions for PSA emphasize anxiety reduction rather than enhancing behavioral performance. We compared the efficacy of two brief cognitive-behavioral interventions, a traditional cognitive-behavior treatment (tCBT) and an acceptance-based behavior treatment (ABBT), on public speaking performance and anxiety in a clinical sample of persons with PSA. The effects of treatment on prefrontal brain activation were also examined. Participants (n = 21) were randomized to 90 min of an ABBT or a tCBT intervention. Assessments took place at pre- and post-treatment and included self-rated anxiety and observer-rated performance measures, a behavioral assessment, and prefrontal cortical activity measurements using functional near-infrared spectroscopy (fNIRS). Exploratory results indicated that participants in the ABBT condition experienced greater improvements in observer-rated performance relative to those in the tCBT condition, while those in the tCBT condition experienced greater reductions in subjective anxiety levels. Individuals in the ABBT condition also exhibited a trend toward greater treatment-related reductions in blood volume in the left dorsolateral prefrontal cortex relative to those who received tCBT. Overall, these findings preliminarily suggest that acceptance-based treatments may free more cognitive resources in comparison with tCBT, possibly resulting in greater improvements in objectively rated behavioral performances for ABBT interventions.
Behavior modification, 2016 · doi:10.1177/0145445516629939