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Health psychology (option) contemporary study: Avdagic et al. (2014)

Edexcel IAL Psychology · WPS03 Applications of Psychology

One of two optional contemporary studies (choose this or Russell et al., 2015): 'A randomised controlled trial of acceptance and commitment therapy and cognitive-behaviour therapy for generalised anxiety disorder' (spec 7.2.3).

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Aim and sample

Aim: to compare the effectiveness of group acceptance and commitment therapy (ACT) and group CBT for generalised anxiety disorder (GAD).

ACT teaches people to accept anxious thoughts and feelings rather than fight them, and to act in line with their values; CBT challenges and changes the thoughts.

Sample: recruited through newspaper adverts, flyers and email; GAD confirmed by a telephone diagnostic interview (ADIS-IV, DSM-IV criteria). People with psychotic symptoms, major cognitive deficits, substance abuse or current suicidal intent were excluded. 51 participants (34 female, 17 male), aged 19 to 69, randomly allocated to ACT (25) or CBT (26).

Procedure and measures

Each therapy: 2-hour group sessions over 6 weeks; 12 groups in total (6 ACT, 6 CBT).
Questionnaires before treatment, after treatment and at 3-month follow-up (mailed to participants).
Measures: Penn State Worry Questionnaire (worry); DASS-21 (depression, anxiety, stress); Quality of Life Inventory; ratings of distress and interference during treatment; and process measures of acceptance, intolerance of uncertainty, cognitive avoidance and beliefs about worry.
Drop-out: 3 from ACT (12%) and 6 from CBT (23%); complete post-treatment data for 38 (19 per group).

Results, conclusions and evaluation

Both groups showed significant reductions in worry, depression, anxiety and stress, and improved quality of life.
At the end of treatment ACT participants reported significantly lower distress and interference than CBT participants, and greater change in acceptance.
At 3-month follow-up, gains were maintained or improved, with no significant differences between ACT and CBT.
Conclusion: ACT is as useful as CBT for GAD; short group therapy is cost-effective. CBT participants may need more time to practise their skills.

Evaluation: randomised allocation, standardised measures and follow-up are strengths (cause and effect, reliability); but the sample was small and self-selected through adverts, drop-out was uneven, all measures were self-report (social desirability), there was no waiting-list or placebo group (so natural improvement cannot be ruled out), and follow-up was only 3 months.

Worked example

What percentage of the 51 participants provided complete post-treatment data?

38 / 51 x 100 = 74.5%.
So about 26% of the sample did not, which may bias the results if those who left differed from those who stayed.

Answer: 74.5%.

Key idea: Avdagic et al. (2014): RCT; 51 adults with GAD randomly allocated to group ACT (25) or group CBT (26); 2-hour sessions for 6 weeks; measured before, after and at 3 months. Both reduced worry, anxiety, stress and depression; ACT had lower distress and interference at the end; no difference at follow-up. Small, self-report, no control group.

Check yourself

What design did Avdagic et al. (2014) use?
- A case study of one client
- An ethnography
- A correlational survey
- A randomised controlled trial comparing two therapies
Show answer
A randomised controlled trial comparing two therapies. Random allocation to ACT or CBT.
How many participants were randomly allocated in Avdagic et al. (2014)?
Show answer
51. 25 ACT plus 26 CBT.
Three of the 25 ACT participants dropped out. What percentage is that?
Show answer
12 %. 3 / 25 x 100 = 12%.
How long did each therapy programme last?
- 2-hour group sessions over 6 weeks
- One 30-minute session
- Weekly individual sessions for a year
- Daily sessions for 3 months
Show answer
2-hour group sessions over 6 weeks. Six weeks of 2-hour group sessions.
What was found at the 3-month follow-up?
- Only the CBT group still improved
- All participants relapsed
- Gains were maintained and there was no significant difference between ACT and CBT
- ACT was far better on every measure
Show answer
Gains were maintained and there was no significant difference between ACT and CBT. Both therapies worked equally well by follow-up.
How does ACT differ from CBT?
- ACT teaches acceptance of anxious thoughts rather than challenging them
- ACT uses medication
- ACT is a type of SSRI
- ACT avoids any discussion of thoughts
Show answer
ACT teaches acceptance of anxious thoughts rather than challenging them. Acceptance versus challenge.
Explain one weakness of Avdagic et al. (2014).
Show answer
There was no waiting-list or placebo control group, so improvements could be due to time or expectations rather than the therapies themselves.. Name the weakness and its effect.

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Last updated 8 November 2026. Spotted a mistake? Tell us.