Acceptance and Commitment Therapy: A Randomized Technique Evaluation Trial

Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Scott T. Gaynor

Second Advisor

Dr. Amy Naugle

Third Advisor

Dr. C. Richard Spates

Fourth Advisor

Dr. Roberto Flachier


Acceptance and commitment therapy, cognitive behavior therapy


The necessary and sufficient treatment strategies involved in Acceptance and Commitment Therapy's (ACT) multi-component treatment package have only begun to be dismantled via component analog studies. There is empirical evidence supporting cognitive defusion and valued action, specific components of ACT's total treatment package. Together, these processes directly attempt to increase awareness of thoughts as ideas (rather than concrete facts), thereby allowing for increased psychological and behavioral flexibility to move toward valued goals. Fifty-two university students reporting significant distress, low self-esteem, and depressive symptoms were randomized to six weekly therapy sessions of cognitive defusion (3 sessions) plus values-based activity scheduling (3 sessions) versus six weeks of supportive therapy. During the cognitive defusion sessions, two main strategies were utilized: vocalizing techniques (e.g., Titchener's repetition) and Contents on Cards. Values-based activity scheduling focused on values clarification and activity scheduling. Intent-to-treat analyses exploring reductions in depressive symptoms and distress taken at pre-, mid-, and post-treatment found significant time by treatment interactions for participants meting criteria for depression (n = 34) suggesting that ACT techniques produced greater change over supportive therapy. These findings contribute to the literature in determining the specific, active agents of ACT and the theoretically specified technique-to-process-to-outcome relations.


Though this dissertation is available electronically only on the WMU campus, a print copy can be found in Waldo Library at call number RC 9999.2.H578 and can be requested through Interlibrary Loan.

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