Date
5-20-2026
Department
School of Behavioral Sciences
Degree
Doctor of Psychology in Clinical Psychology (Psy.D.)
Chair
Christine Hutchison
Keywords
obsessive-compulsive disorder (OCD), acceptance and commitment therapy (ACT), exposure and response prevention (ERP), evidence-based treatment, therapy
Disciplines
Psychology
Recommended Citation
Page, Caroline A., "Acceptance and Commitment Therapy for the Treatment of Obsessive-Compulsive Disorder: A Critical Review of Evidence-Based Treatment Methods" (2026). Doctoral Dissertations and Projects. 8542.
https://digitalcommons.liberty.edu/doctoral/8542
Abstract
Obsessive-compulsive disorder (OCD) is a chronic and debilitating condition affecting approximately 3% of the U.S. population. Exposure and Response Prevention (ERP) is the current psychotherapeutic gold standard for treating OCD. Although highly effective, ERP can elicit much distress, has a limited focus on comorbidities, and has notable drop-out and refusal rates. Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy that may address some of these limitations as it (a) fosters a more accepting stance towards feared stimuli (obsessions) and (b) targets core mechanisms of OCD as well as transdiagnostic mechanisms seen in many other mental health disorders, such as experiential avoidance, cognitive fusion, and low distress tolerance. Instead of aiming to reduce fear and avoidance, ACT focuses on acceptance and the pursuit of value-based living despite obsessions. To identify ACT as an alternative/adjunctive to ERP, this review examines the (1) clinical presentation of OCD, (2) current evidence-based treatments for OCD, (3) theoretical processes of ACT, and (4) the experimental validity of ACT. RCTs, case studies, and case series indicate that ACT has effects comparable to ERP, with potential added benefits in addressing transdiagnostic mechanisms. Overall, ACT may be a promising alternative or adjunctive to ERP. Notable limitations of the available research include small sample sizes and restrictive exclusion criteria, limited head-to-head studies of ERP and ACT, and inconsistent definitions for what constitutes a response, remission, and clinically meaningful change. Recommendations for future research include larger sample sizes, dismantling studies, and standardized outcome definitions.
