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Acceptance and Commitment Therapy for Social Anxiety Disorder

Understanding Acceptance and Commitment Therapy for SAD


Updated July 07, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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 in conjunction 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 differs from more traditional behavioral methods. Knowing what to expect will make it easier for you to get the most out of ACT.

Basic Premises of ACT

ACT differs from traditional western psychological methods in that there is no assumption of "healthy normality". Instead, ACT theorists argue that normal psychological processes of your mind can become destructive. In addition, language is believed to be at the root of human suffering, in that 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 the reduction of your social anxiety symptoms. In fact, ACT asserts that trying to directly control or reduce 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 be reduced as a by-product of ACT therapy.

ACT Tools

Your ACT therapist will rely on the use of metaphors to convey messages to you during therapy. Therapy typically consists of experiential exercises, values-guided behavioral interventions, and mindfulness skills training.

How ACT Differs 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, whereas 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 problematic social anxiety.

Research Support for SAD

Although there is a large amount of empirical data to support ACT for use with 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.

ACT shows promise as a new therapy for SAD, however more research is needed to confirm the effectiveness of this approach for use in treating SAD.


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.

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