Treatment Protocols

ACT for OCD (Adults): This is an eight-session weekly ACT manual for OCD. Exposures are not included in this protocol.

For more information please see: Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78(5), 705-716. doi:10.1037/a0020508
ACT for OCD (Adolescents): This protocol has been designed for youth 12 to 17 and is administered in eight to ten weekly sessions lasting one hour.

For more information please see: Armstrong, A. B., Morrison, K. L., & Twohig, M. P. (2013). Acceptance and commitment therapy for adolescent obsessive compulsive disorder. Journal of Cognitive Psychotherapy, 27, 175-190.
Parent Facilitated ACT for Pediatric OCD: This is a 9-session protocol for children with OCD.

For more information please see: Barney, J. Y., Field, C. E., Morrison, K. L., & Twohig, M. P. (2017). Treatment of pediatric obsessive compulsive disorder utilizing parent-facilitated acceptance and commitment therapy (ACT). Psychology in the Schools, 54, 88-100.
ACT+ERP for OCD: This is a 16-session twice-weekly therapist manual for OCD describing ERP conducted from an ACT framework.

For more information please see: Twohig, M. P., Abramowitz, J. S., Smith, B. M., Fabricant, L. E., Jacoby, R. J., Morrison, K. L., . . . Lederman, T. (2018). Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial. Behaviour Research and Therapy, 108, 1-9. doi:10.1016/j.brat.2018.06.005
ACT for Adolescent Anxiety: This is a twice-weekly group session protocol for adolescents with anxiety that was adapted using the DNA-V model.

For more information please see: Petersen, J.M., Davis, C.H., Renshaw, T.L., Levin, M.E. & Twohig, M.P. (In Press). School-based acceptance and commitment therapy for adolescents with anxiety: A pilot trial. Cognitive and Behavioral Practice. Download.
ACT for Compulsive Pornography Use: This is a 12-session weekly ACT manual for compulsive or problematic pornography use.

For more information please see: Crosby, J. M., & Twohig, M. P. (2016). Acceptance and Commitment Therapy for Problematic Internet Pornography Use: A Randomized Trial. Behavior Therapy, 47, 355-366. doi:10.1016/j.beth.2016.02.001
ACT for Impulsive Decision Making: This is an eight-session ACT manual for impulsive decision making. Problematic behaviors associated with impulsive decision making include substance use, procrastination, and overeating.

For more information please see: Morrison, K. L., Smith, B. M., Ong, C. W., Lee, E. B., Friedel, J. E., Odum, A., Madden, G. J., Ledermann, T., Rung, J., & Twohig, M. P. (2020). Effects of acceptance and commitment therapy on impulsive decision making. Behavior Modification, 44, 600-623
ACT for Clinical Perfectionism: This is an addendum for clinical perfectionism to be used with the ACT for OCD protocol. Diagnoses associated with clinical perfectionism include GAD, OCD, and OCPD.

For more information please see: Ong, C. W., Lee, E. B., Krafft, J., Terry, C. L., Barrett, T. S., Levin, M. E., & Twohig, M. P. (2019). A randomized controlled trial of acceptance and commitment therapy for clinical perfectionism. Journal of Obsessive-Compulsive and Related Disorders, 22.
ACT for Hoarding Disorder: This is a 10-session protocol for individual ACT for hoarding disorder.

For more information please see: Ong, C. W., Krafft, J., Panoussi, F., Petersen, J. M., Levin, M. E., & Twohig, M. P. (2021). In-person and online-delivered acceptance and commitment therapy for hoarding disorder: A multiple baseline study. Journal of Contextual Behavioral Science, 20, 108-117.
ACT Groups with an Adjunctive Mobile App for GAD: This is a protocol for a 6-session group ACT intervention utilizing an adjunctive mobile app for GAD. 

For more information please see: Krafft, J., Ong, C.W., Davis, C.H., Petersen, J.M., Levin, M.E. & Twohig M.P. (in press). An open trial of group acceptance and commitment therapy (ACT) with an adjunctive mobile app for generalized anxiety disorder (GAD). Cognitive and Behavioral Practice.
ACT for Trichotillomania: A therapist manual and workbook on ACT for trichotillomania are available for purchase online (see links below).

Therapist manual: https://global.oup.com/academic/product/trichotillomania-9780195336030?cc=us&lang=en&
Workbook: https://global.oup.com/academic/product/trichotillomania-9780195336054?lang=en&cc=us
 
For more information see: Woods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006). A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania. Behaviour research and therapy, 44(5), 639-656.
 
Lee, E. B., Homan, K. J., Morrison, K. L., Ong, C. W., Levin, M. E., & Twohig, M. P. (2020). Acceptance and commitment therapy for trichotillomania: A randomized controlled trial of adults and adolescents. Behavior modification, 44(1), 70-91.
 
Lee, E. B., Haeger, J. A., Levin, M. E., Ong, C. W., & Twohig, M. P. (2018). Telepsychotherapy for trichotillomania: A randomized controlled trial of ACT enhanced behavior therapy. Journal of Obsessive-Compulsive and Related Disorders, 18, 106-115.

ACT for Adolescents with Trichotillomania: This protocol was also adapted to youth ages 12 to 17 with trichotillomania using the book by Woods and Twohig (2008). The adapted protocol includes caretaker handouts, which you can download here.

For more information about this adapted youth protocol see: Twohig, M. P., Petersen, J. M., Fruge, J., Ong, C. W., Barney, J. L., Krafft, J., ... & Levin, M. E. (2021). A Pilot Randomized Controlled Trial of Online-Delivered ACT-Enhanced Behavior Therapy for Trichotillomania in Adolescents. Cognitive and Behavioral Practice.
ACT-Based Peer Coaching to Increase College Students' Adherence to Online Self-Help: This protocol was created for trained undergraduate college students to provide coaching to their peers using a combination of ACT and strategies from the supportive accountability model (Mohr et al., 2011). Coaching focused on helping college students adhere to a self-guided online ACT program (ACT Guide).

This protocol, particularly the phone delivered format, was found to increase adherence to and mental health improvements from online self-help: Klimczak, K.S., Twohig, M.P., Peacock, G.G. & Levin, M.E. (2022). Using peer-support coaching to improve adherence to online acceptance and commitment therapy self-help for college mental health: A randomized controlled trial. Behaviour Research and Therapy, 160, 104228.

Additional materials are available on OSF including training materials we used with the coaches: https://osf.io/bk8r9/