Acceptance and Commitment Therapy for Social Anxiety Disorder

Understanding Acceptance and Commitment Therapy for SAD

Therapist's office.
ACT teaches you how to stop struggling against your anxiety.. Pixabay / Oliver Kepken

Acceptance and Commitment Therapy (ACT) was developed in 1986 by psychology professor Steven Hayes. ACT is part of the third wave of behavioral therapies, following on the heels of second-wave therapies such as cognitive-behavioral therapy (CBT).

ACT was developed along with a research program known as Relational Frame Theory. ACT also shares many of the values of Buddhist philosophy.

Although CBT is an effective form of therapy for social anxiety disorder (SAD), not everyone responds to CBT.

ACT shows promise for use with SAD, and can be used in brief or long-term individual, couples or group therapy.

If you are going to be receiving ACT for SAD, it is important to understand how this type of therapy is different from more traditional behavioral treatments. Knowing what to expect will make it easier for you to get the most out of ACT.

Basic Premises of ACT

ACT is different from traditional western therapy treatments in that there is no assumption that being "healthy" is normal.

Instead, ACT theorists argue that your normal everyday thoughts and beliefs can become destructive.

In addition, according to ACT, language is at the root of human suffering. This is because it is the basis for negative thoughts and emotions such as deception, prejudice, obsession, fear, and self-criticism.

Goal of ACT

The goal of ACT is not to totally get rid of your social anxiety symptoms. In fact, according to ACT, trying to directly control or lessen your symptoms will actually make them worse.

While receiving ACT, you will be encouraged to enjoy a meaningful life, accept that there will always be pain and suffering, and that you should detach from it and take action based on your values. It is expected that your symptoms will become less as a by-product of ACT therapy.

ACT Tools

Your ACT therapist will use metaphors to convey messages to you during therapy.

Therapy usually involves experiential exercises (in which you will take an active part), values-guided behavioral interventions (learning about what you value in life), and mindfulness skills training (becoming aware of the present moment).

How ACT is Different From CBT

Both ACT and CBT involve awareness of your thoughts. However, the goal of ACT is the acceptance of negative thoughts while the goal of CBT is the reduction or elimination of negative thoughts.

For example, while a CBT therapist will argue that negative thoughts cause your social anxiety, an ACT therapist will argue that it is your struggle against negative thoughts which creates your social anxiety.

Research Support for SAD

Although there is a large amount of empirical data to support ACT for various disorders, research into the use of ACT for SAD is in its infancy.

In a 2002 study of public speaking anxiety in college students, participants displayed improvement in social anxiety symptoms and a reduction in avoidance after receiving ACT.

In a 2005 pilot study of ACT treatment with individuals diagnosed with generalized SAD, study participants showed improvement in social anxiety symptoms, social skills, and quality of life, and decreased avoidance.

In a 2013 study of mindfulness and acceptance-based group therapy compared with traditional cognitive-behavioral group therapy, it was shown that mindfulness may be the most important aspect of ACT therapy in terms of changing your SAD symptoms, whereas with CBT, changing your thought processes may be most important.

Finally, another 2013 study confirmed that having a commitment to a purpose in life helped to relieve social anxiety. As this is one of the basic tenants of ACT, this lends support for this type of therapy.

Overall, if you are the type of person who prefers meditative practice to examining and changing your thought processes, ACT may be suited to you.


Block JA. Acceptance or change of private experiences: A comparative analysis in college students with public speaking anxiety. Doctoral dissertation: University at Albany, State University of New York. 2002.

Dalrymple KL, Herbert JD. Acceptance and commitment therapy for generalized social anxiety disorder: a pilot study. Behavior Modification. 2007;31(5):543-68.

Harris R. Embracing Your Demons: An Overview of Acceptance and Commitment Therapy. Psychotherapy in Australia. 2006;12(4):2-7.

Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: Guilford; 1999.

Kashdan TB, McKnight PE. Commitment to a purpose in life: An antidote to the suffering by individuals with social anxiety disorder. Emotion (Washington, DC). 2013;13(6):1150-1159. doi:10.1037/a0033278.

Kocovski, Nancy L et al. “Mindfulness and acceptance-based group therapy versus traditional cognitive behavioral group therapy for social anxiety disorder: a randomized controlled trial.” Behaviour research and therapy 51.12 (2013) : 889-98.

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