Comparing the Effectiveness of Schema Therapy With Acceptance and Commitment Therapy on Cognitive Avoidance in Patients With Generalized Anxiety Disorder

Objective: This study aimed to compare the effectiveness of schema therapy with acceptance and commitment therapy (ACT) using exposure techniques on cognitive avoidance in female patients with generalized anxiety disorder. Methods: A total of 10 women with generalized anxiety disorder were selected through purposeful sampling with Structured Clinical Interview for DSM Disorders (SCID-5). To determine the absence of personality disorder, Millon’s clinical multiaxial inventory (MCMI-III) (Millon and Groosman, 2005) was used. Schema therapy was conducted for 20 weekly sessions and ACT with exposure techniques for 12 weeks and follow-up for 6 weeks. The cognitive avoidance questionnaire (CAQ) (Sexton and Douglas, 2004) was used as a pretest and posttest to follow up on the results. Analysis of variance with repeated measures was used to test the research hypotheses. Results: The results showed that schema therapy is more effective than ACT in the subscales of thought suppression (F=12.80, P=0.037) and avoidance of threatening (F=25.61, P=0.015), but they have no significant statistical difference in other subscales and total score. Both treatments significantly reduced the total score of cognitive avoidance, but they lacked a statistically significant difference. Conclusion: Schema therapy and ACT with exposure techniques are effective in reducing the severity of symptoms and improving cognitive avoidance in females with generalized anxiety disorder.