Psychological mechanism of acceptance and commitment therapy and rational emotive behavior therapy for treating
Shuanghu Fang1, Dongyan Ding1, Ru Zhang1
1School of Educational Science, Anhui Normal University, Wuhu, China.
Insights
Acceptance and Commitment Therapy (ACT) and Rational Emotive Behavior Therapy (REBT) effectively reduce hoarding symptoms and improve psychological flexibility. ACT showed greater efficacy than REBT in several areas, with psychological flexibility mediating outcomes.
Area of Science:
- Psychology
- Clinical Psychology
- Behavioral Science
Background:
- Hoarding is a prevalent global issue impacting mental and physical health.
- Current cognitive-behavioral therapies (CBTs) for hoarding have questionable long-term efficacy.
- Existing research on hoarding interventions is limited, primarily focusing on Western populations and lacking examination of mediating variables.
Purpose of the Study:
- To investigate the efficacy of Acceptance and Commitment Therapy (ACT) and Rational Emotive Behavior Therapy (REBT) on hoarding behaviors and related psychological outcomes.
- To explore mediating variables, such as psychological flexibility, in different cultural contexts.
- To address the gap in research on non-Western hoarding intervention efficacy.
Main Methods:
- A randomized controlled trial involving 139 college students with hoarding behaviors.
- Three groups: ACT (n=45), REBT (n=47), and a control group (n=47).
- Pre- and post-intervention assessments using validated scales for hoarding, OCD symptoms, emotion regulation, attachment anxiety, negative affect, psychological flexibility, and cognitive fusion.
Main Results:
- Both ACT and REBT significantly improved psychological flexibility, reduced cognitive fusion, hoarding symptoms (acquisition-difficulty discarding, clutter), negative affect, attachment anxiety, obsessive-compulsive symptoms, and emotion regulation difficulties compared to the control group.
- ACT demonstrated superior effectiveness over REBT in enhancing psychological flexibility and reducing hoarding, cognitive fusion, depression, stress, and obsessive-compulsive disorder.
- Psychological flexibility was identified as a mediator for the effects of ACT and REBT on hoarding, negative affect, and attachment anxiety.
Conclusions:
- ACT and REBT are effective interventions for hoarding behaviors, improving psychological flexibility and reducing various negative psychological outcomes.
- ACT may offer greater benefits than REBT for specific hoarding-related issues and psychological flexibility.
- Psychological flexibility plays a crucial role in mediating the therapeutic effects of these interventions on hoarding and associated psychological distress.
Abstract:
Hoarding is a common problem behavior worldwide and is detrimental to the physical and mental health of individuals and groups. Currently, effective interventions for hoarding are cognitive-behavioral therapies, but their post-intervention efficacy is questionable, and the available research does not examine the mediating variables of the effects of interventions on clinical outcomes. Moreover, current research on hoarding has focused on Western countries. Therefore, there is a need to investigate the efficacy of other forms of cognitive behavioral therapy on hoarding as well as other psychological outcomes related to hoarding and mediating variables that contribute to its effectiveness in different cultural contexts. One hundred thirty-nine college students with higher hoarding behaviors were randomly divided into three groups: 45 in the Acceptance and Commitment Therapy (ACT) group, 47 in the Rational Emotive Behavior Therapy (REBT) group, and 47 in the control group. They completed the Saving Inventory-Revised (SI-R), Obsessive-Compulsive Symptom Scale (OCSS), Difficulties in Emotion Regulation Scale (DERS), Experiences in Close Relationships Inventory-Attachment Anxiety Subscale (ECR), Depression Anxiety Stress Scales (DASS-21), Acceptance and Action Questionnaire II (AAQ-II), and Cognitive Fusion Questionnaire (CFQ) before and immediately after the intervention. The results showed that ACT and REBT improved individuals' psychological flexibility, cognitive fusion, acquisition-difficulty discarding, clutter, negative affect (anxiety, depression, stress), attachment anxiety, obsessive-compulsive disorder, and difficulty in emotion regulation compared to the control group. In addition, ACT was more effective than REBT in improving psychological flexibility and reducing hoarding, cognitive fusion, depression, stress, and obsessive-compulsive disorder; there were no significant differences between the two in anxiety and emotion regulation difficulties. Furthermore, psychological flexibility is a mediator of the effect of ACT and REBT on some behavioral and psychological outcomes (hoarding, negative affect, attachment anxiety). Limitations were discussed.
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