EFFECTIVENESS OF ACCEPTANCE AND COMMITMENT THERAPY IN THE TREATMENT OF GENERALIZED ANXIETY DISORDER: A NON-RANDOMIZED CONTROLLED TRIAL IN PESHAWAR

Abstract

Objective: This study aimed to examine the effectiveness of Acceptance and Commitment Therapy (ACT) in reducing anxiety symptoms and improving mindfulness and psychological flexibility among patients with GAD in Peshawar.

Methods: A non-randomized controlled trial was conducted among patients aged 19-50 years who had Generalized Anxiety Disorder, as defined by the DSM-5. People in the study were split into two groups: one received Acceptance and Commitment Therapy (eight one-on-one sessions during eight weeks), and the other received psychoeducation. We had all participants complete standard questionnaires about how they felt at the beginning and at the end of their treatment. These questionnaires were the GAD-7 (for Generalized Anxiety Disorder), the PSWQ (Penn State Worry Questionnaire), the CFQ (Cognitive Fusion Questionnaire), and the FFMQ (Five-Facet Mindfulness Questionnaire). We used paired and independent t-tests to analyze the results, and calculated the 'effect size' (using Cohen's d) to show the strength of any changes.

Results: Participants receiving ACT demonstrated significant reductions in GAD-7 and PSWQ scores (p < 0.001) and increased mindfulness and psychological flexibility (p < 0.001) compared with the control group. Between-group effect sizes ranged from large to very large (Cohen's d = 0.85–1.20). No adverse effects were reported.

Conclusion: Acceptance and Commitment Therapy is an effective intervention for treating GAD, producing meaningful improvements in anxiety reduction and mindfulness enhancement among Pakistani patients. Integrating ACT into routine psychological services may improve treatment outcomes and reduce chronic worry patterns prevalent in this population.