Single-case Experimental Design Evaluation of Repetitive Negative Thinking-Focused Acceptance and Commitment Therapy in Generalized Anxiety Disorder with Couple-related Worry

Young adults suffering from generalized anxiety disorder (GAD) show high levels of worry about different domains, with couple relationships being the most frequent one. Excessive worry in this domain might lead to couple dysfunction, which is associated with lower outcomes of cognitive behavioral therapy. The current study analyzes the effect of an individual, 3-session, acceptance and commitment therapy (ACT) protocol focused on repetitive negative thinking (RNT) in the treatment of GAD with couple relationship as the main worry domain. Three young adults with GAD participated in this study. A delayed multiple-baseline design was implemented. All participants completed a 5 to 7-week baseline without showing improvement trends in couple-related worry (Experiences in Close Relationships -Anxiety; ECR-A) and general pathological worry (Penn State Worry Questionnaire; PSWQ). Afterwards, they received the ACT protocol, and a 3-month follow-up was conducted. All 3 participants showed evidence of intervention effects on the ECR-A and PSWQ. The standardized mean difference effect sizes for single-case experimental design were very large for the ECR-A (g=5.93) and PSWQ (g=3.19). No adverse events were found. Brief, RNT-focused ACT protocols for treating GAD with couple relationship as the main worry domain deserve further empirical tests.