A Randomized Controlled Trial of Acceptance-Based Behavior Therapy and Cognitive Therapy for Test Anxiety

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    • 00:08

      LILY BROWN: Hello, my name is Lily Brown.And I'm a clinical psychology resident at the Warren AlpertMedical School of Brown Universityand a graduate student at the University of California, LosAngeles.The work that I'm going to describe briefly in this videocan be found in full detail in a 2011 article published

    • 00:29

      LILY BROWN [continued]: in Behavior Modification entitled "A RandomizedControlled Trial of Acceptance-Based BehaviorTherapy and Cognitive Therapy for Test Anxiety, a PilotStudy."This work was performed in collaborationwith Doctors Evan Forman and JamesHerbert at Drexel University.As a brief background for this research,

    • 00:50

      LILY BROWN [continued]: it's important to understand that most people reportsome degree of test anxiety, or fears and worriesabout academic performance or evaluationsat some point throughout their education.However, most people do not experiencefunctional impairment as a result of this anxiety.A certain subset, estimated at around 20% to 35%

    • 01:13

      LILY BROWN [continued]: of college students experience functional impairmentas a result of their anxiety.This functional impairment can manifestas failing examinations, failing coursework altogether,procrastination, or premature termination of coursesas of maladaptive way to cope with the anxiety tied

    • 01:37

      LILY BROWN [continued]: into education.Cognitive therapy developed by Aaron Beckfocuses on challenging irrational thoughts and beliefsthrough cognitive reappraisal, whichhas been explored previously as a treatment option for testanxiety.While some studies have shown a benefit of this procedure,

    • 01:57

      LILY BROWN [continued]: others have found that cognitive therapy performs comparablyor slightly worse than behavioral approaches thatemphasize approach toward feared situations,or in this case, tests.This really puts clinicians in a bind.Particularly those who are workingin a school or university-based setting

    • 02:20

      LILY BROWN [continued]: and who are seeking to treat patients presentingwith functional impairment as a result of test anxiety.For this reason, we developed a protocolfor treating testing anxiety using principles developedfrom acceptance and commitment therapyby Steve Hayes, Kirk Strosahl and Kelly Wilson.

    • 02:42

      LILY BROWN [continued]: This acceptance-based behavioral therapyfocuses on increasing approach toward feared situations,gaining distance or cognitive diffusion from thoughts,and increasing mindfulness of internal sensations, emotions,and thoughts.So to compare and contrast these strategies,

    • 03:04

      LILY BROWN [continued]: cognitive therapy might focus on training patientsto challenge thoughts like, "I'm going to fail"using counter thoughts like, "I really studied a lot.And I know this material."Or, "I haven't failed a course in the past.So it's not likely that I'm going to fail this one."

    • 03:25

      LILY BROWN [continued]: In contrast, acceptance-based approachesmight encourage increased awarenessof distressing thoughts without attempting to changeor suppress the thoughts.Labeling thoughts as just that, thoughts,can increase cognitive diffusion from themand allow for redirection of attentionback to the content of the examination.

    • 03:48

      LILY BROWN [continued]: So, we therefore decided to complete a studywhere we directly compared acceptance-based approachesto cognitive approaches in a one session, two hour group-basedtreatment for test anxiety.For this study we recruited 16 college studentswho scored in an elevated range on a measure of test anxiety.

    • 04:11

      LILY BROWN [continued]: They were randomized to either a cognitive therapy groupor an acceptance-based group.These groups were led by graduate students.And these groups focused equally on experiential exercisesand cognitive strategies.In the cognitive therapy group, the contentempathized cognitive restructuring and relaxation

    • 04:34

      LILY BROWN [continued]: techniques.In the acceptance-based group, the focuswas on cognitive diffusion and mindfulnessor attention training.In terms of the results, both groupsreported a significant reduction in pre-to post-intervention self report ratings of test anxiety.

    • 04:56

      LILY BROWN [continued]: There were not any differences in self report ratingsof test anxiety by condition.In terms of performance, we collected scoreson mid-term evaluations that werecollected throughout the quarter at pre- and post-group.We found that whereas those in the acceptance-base group

    • 05:19

      LILY BROWN [continued]: experienced an improvement in performance from pre-to post-intervention, those in the cognitive therapy groupexperienced deterioration in their performance.And there was a significant time-by-condition effect here.This is particularly important, giventhat the emphasis in acceptance-based approaches

    • 05:41

      LILY BROWN [continued]: is not on symptom reduction.Instead, it's on increasing awareness and actiontoward values.Of course there are a number of important limitationsof this study.The first being, this is a very small sample size.And naturally these results have to be replicated

    • 06:03

      LILY BROWN [continued]: before any strong conclusions are drawn from these findings.However, these results demonstrate, at leastpreliminarily, that incorporating techniquesof mindfulness and diffusion mightbe particularly helpful in terms of improving performanceon examinations.

    • 06:23

      LILY BROWN [continued]: If you have any questions about this study, or aboutour protocol, or any comments in general about the studyplease send me an email.I'd love to be in touch.My email address is lily_brown@brown.edu.

    • 06:45

      LILY BROWN [continued]: I thank you very much for watching this video.And I really look forward to hearing from you.

A Randomized Controlled Trial of Acceptance-Based Behavior Therapy and Cognitive Therapy for Test Anxiety

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Abstract

Clinical psychology student Lily Brown presents a pilot study that compared acceptance-based behavior therapy and cognitive therapy as treatments for test anxiety. Both approaches reduced anxiety in students, but the cognitive therapy seemed to negatively affect test performance. The acceptance therapy improved test performance and lowered anxiety.

A Randomized Controlled Trial of Acceptance-Based Behavior Therapy and Cognitive Therapy for Test Anxiety

Clinical psychology student Lily Brown presents a pilot study that compared acceptance-based behavior therapy and cognitive therapy as treatments for test anxiety. Both approaches reduced anxiety in students, but the cognitive therapy seemed to negatively affect test performance. The acceptance therapy improved test performance and lowered anxiety.

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