Monday, June 28, 2010

Mindfulness and Acceptance Workbook for Anxiety

Last week I attended the Association for Contextual Behavioral Science (ACBS) World Conference in Reno, NV. During the lunch hour for a pre-conference weekend training with Dr. John Forsyth from the University at Albany, SUNY , we had the option of sitting in on a presentation of some unpublished research John and his lab had collected about his recent self-help book, The Mindfulness and Acceptance Workbook for Anxiety, which he co-authored with Dr. Georg Eifert. I have an interest in the effectiveness of self-help books, so I was eager to see what he found.

John presented data from two studies. In the first study, he gave out free copies of his book through a website to participants who agreed to be randomly assigned to either receive his book immediately, or to receive it after being part of a 12-week waitlist condition. Participants were assessed before receiving the book, after 12-weeks, and at 3 and 6-month follow-ups. At the end of 12-weeks, compared to the waitlist, participants who used the book showed dramatic improvements in anxiety, depression, worry, social anxiety, and even PTSD. What’s especially interesting about this is that anxiety decreased even though the book’s emphasis is on improving one’s life through cultivation of mindfulness, acceptance, and compassion rather than on getting rid of anxiety (and depression is not really addressed to my recollection). Readers of the book had significant increases in mindfulness, self-compassion, and quality of life that were maintained over the 3 and 6-month follow-ups. The same pattern happened for people who used the book after getting off the waitlist. Another remarkable thing about this study is that about half the participants were currently in psychotherapy and/or taking meds, suggesting that the book contributed to improvements above and beyond individual treatment. Nearly everyone (91%) had been in therapy before.

In a second study that is still underway, John used a similar design to compare his book to The Cognitive Behavioral Workbook for Anxiety, a respected workbook by William J. Knaus. John’s lab is still collecting follow-up data, but results are showing that, although both books appear effective, people using the Mindfulness workbook are showing greater outcomes on virtually all measures.

I think these studies are great for several reasons. For one, the market is filled with self-help books but rarely are they evaluated to determine if people actually find them helpful
. Two, this is the most naturalistic study I’ve seen, as participants have no additional interaction with John’s lab except to complete the online outcome assessments. Some other studies I’ve seen involve occasional interaction with someone from the lab to help people with a book, but in these studies, people are largely left to their own devices. Lastly, this study is very brave in that John risked finding: 1.) that his book was not helpful after all; 2.) that his book was helpful, but not as helpful as the Cognitive Behavioral workbook. Instead, his commitment to science has paid off for him in a big way. This book is a great illustration of how cultivation of mindfulness, acceptance, and compassion can really improve our lives.

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