Exposure with acceptance-based versus habituation-based rationale for public speaking anxiety

Social Anxiety Disorder (SAD) is a potentially debilitating condition affecting approximately 12% of the population at some point in their life (Ruscio et al., 2008). SAD is divided into two subtypes: generalized and nongeneralized. Nongeneralized SAD refers to individuals whose fears are limited to one or two social situations, most commonly public speaking. Empirically supported treatments for public speaking anxiety generally include an exposure component (usually in vivo/simulated exposure). Exposure is often presented within the context of a habituation rationale, but cognitively- based therapies utilize a rationale for exposure based on cognitive restructuring and belief modification. Research investigating the incremental benefit of adding other treatment components to exposure has yielded mixed results; however, there is preliminary evidence that the context in which exposure is presented can have an impact on treatment outcome. Recently, acceptance-based therapies have begun to frame exposure as an opportunity to increase one’s willingness to experience anxiety while engaging in valued behaviors, rather than as a vehicle for modifying maladaptive cognitions and reducing anxiety. However, little research has been conducted on the efficacy of acceptance-based therapies for public speaking anxiety, and no component control studies have examined the utility of an acceptance/cognitive defusion rationale and context for exposure. The present study compared exposure within an acceptance/defusion context to exposure with a habituation-based rationale in the treatment of public speaking anxiety. Treatment was x delivered in a group format over 6 weekly sessions. The hypothesis of superior outcomes for the acceptance-based group was not supported by the data; no significant differences were found between the two treatment conditions. All participants improved on outcome measures of social/public speaking anxiety and speech quality (social skills).