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Kabul ve Kararlılık Terapisi Perspektifinden Obsesif Kompulsif Bozuklukta Yaşantısal Kaçınma

Year 2026, Volume: 18 Issue: 1, 319 - 331, 31.03.2026
https://doi.org/10.18863/pgy.1659447

Abstract

Obsesif kompulsif bozukluk (OKB), obsesyon ve kompulsiyonlarla süregiden ve işlevselliği olumsuz yönde etkileyen, tedavi edilmediğinde kronikleşebilen psikiyatrik bir rahatsızlıktır. OKB’de ilaç tedavisi ve maruz bırakma-tepki önleme tekniklerini içeren Bilişsel Davranışçı Terapinin etkililiği kanıtlanmış görünse de tedavi bırakma oranları ve takip sonrası kalıntı belirtilerin görülmesi, araştırmacıları farklı tedavi yaklaşımlarına yöneltmiştir. Bu bağlamda ortaya çıkan üçüncü kuşak terapi yaklaşımlarından biri olan Kabul ve Kararlılık Terapisi (KKT), OKB tedavisinde yenilikçi ve etkili bir yaklaşım olarak giderek daha fazla ilgi görmektedir. KKT, temelde hayatın doğal akışı içerisinde var olan acılardan kaçınmak yerine onları kabul ederek kişinin yaşamını kendi seçtiği değerler doğrultusunda yönlendirmesini amaçlamaktadır. KKT yaklaşımı ile OKB tedavisinde, bireylerin psikolojik esneklik seviyelerini artırmaya yönelik müdahalelerle hastalığın prognozuna olumlu katkı sağlanabildiği görülmektedir. OKB hastalarında obsesyonların yarattığı kaygıdan kaçınmak için kompulsiyonlara girişmenin yanı sıra çok çeşitli yaşantısal kaçınma stratejileri izlenebilmektedir. KKT yaklaşımı ile, bu stratejilerinin azaltılarak olumsuz içsel yaşantıların kabulü yoluyla obsesyonların yarattığı kaygının giderilmesi ve kompulsiyonların ortadan kaldırılması sağlanabilmektedir. Bu derleme makalesi, OKB’de yaşantısal kaçınmayı KKT çerçevesinde ele almaktadır. Son yıllarda yayımlanan güncel çalışmalar ekseninde, KKT’nin OKB tedavisinde yaşantısal kaçınmayı nasıl hedef aldığı ve yapılan müdahalelerin OKB semptom şiddeti ve psikolojik esneklik arasındaki ilişkiye etkileri tartışılmaktadır.

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Experiential Avoidance in Obsessive-Compulsive Disorder from the Perspective of Acceptance and Commitment Therapy

Year 2026, Volume: 18 Issue: 1, 319 - 331, 31.03.2026
https://doi.org/10.18863/pgy.1659447

Abstract

Obsessive compulsive disorder (OCD) is a psychiatric disorder characterized by the persistence of obsessions and compulsions, which negatively impact functionality and may become chronic if left untreated. Although the efficacy of pharmacological treatment and Cognitive Behavioral Therapy (CBT) involving exposure and response prevention techniques has been proven in OCD, treatment discontinuation rates and residual symptoms following treatment have led researchers to explore different therapeutic approaches. One such approach gaining increasing interest is Acceptance and Commitment Therapy (ACT), a third-generation therapeutic model, which is proving to be an innovative and effective treatment for OCD. ACT primarily aims to guide individuals toward leading a life aligned with their chosen values, by accepting the pains that exist in the natural flow of life instead of avoiding them. In the treatment of OCD, with the ACT approach, interventions aimed at enhancing psychological flexibility have been shown to positively impact the prognosis of the disorder. In addition to engaging in compulsions to avoid the anxiety caused by obsessions, OCD patients may follow a wide variety of experiential avoidance strategies. With the ACT approach, these strategies can be reduced and the anxiety caused by obsessions and compulsions can be eliminated through the acceptance of negative internal experiences. This review article addresses experiential avoidance in OCD within the framework of ACT. Based on recent publications, the article discusses how ACT targets experiential avoidance in OCD treatment and the effects of interventions on the relationship between OCD symptom severity and psychological flexibility.

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  • Armstrong AB, Morrison KL, Twohig MP (2013) A preliminary investigation of acceptance and commitment therapy for adolescent obsessive–compulsive disorder. J Cogn Psychother, 27:175-190.
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  • Blackledge JT, Hayes SC (2001). Emotion regulation in acceptance and commitment therapy. J Clin Psychol, 57:243-255.
  • Blakey SM, Reuman L, Buchholz JL, Abramowitz JS (2017) Experiential avoidance and dysfunctional beliefs in the prediction of body image disturbance in a nonclinical sample of women. Body Image, 22:72-77.
  • Bluett EJ, Homan KJ, Morrison KL, Levin ME, Twohig MP (2014) Acceptance and commitment therapy for anxiety and OCD spectrum disorders: an empirical review. J Anxiety Disord, 28:612-624.
  • Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK et al. (2011) Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther, 42:676-688.
  • Chacin M, Chacin J, Suarez-Roca H (2019) Addicted to compulsions: a complex case study of obsessive and compulsive disorder treated with acceptance and commitment therapy (ACT) and exposure therapy (ERP). Drug Dependence and Addiction, 1:1–7.
  • Chawla N, Ostafin B (2007) Experiential avoidance as a functional dimensional approach to psychopathology: an empirical review. J Clin Psychol, 63:871-890.
  • Clark DA (2004) Cognitive-Behavioral Therapy for OCD. New York, Guilford Press.
  • Davazdahemami MH, Bayrami A, Petersen JM, Twohig MP, Bakhtiyari M, Noori M et al. (2020) Preliminary evidence of the effectiveness of acceptance and commitment therapy for death anxiety in Iranian clients diagnosed with obsessive-compulsive disorder. Bull Menninger Clin, 84(Suppl A):1-11.
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  • Didonna F, Lanfredi M, Xodo E, Ferrari C, Rossi R, Pedrini L (2019) Mindfulness-based cognitive therapy for obsessive-compulsive disorder: a pilot study. J Psychiatr Pract, 25:156-170.
  • Dougherty DD, Rauch SL, Jenike MA (2004) Pharmacotherapy for obsessive-compulsive disorder. J Clin Psychol, 60:1195-1202.
  • Eifert G, Forsyth J (2005) Acceptance & Commitment Therapy for Anxiety Disorders: A Practitioner’s Treatment Guide to Using Mindfulness, Acceptance, and Values-Based Behavior Change Strategies. Oakland, CA, New Harbinger.
  • Eisen JL, Sibrava NJ, Boisseau CL, Mancebo MC, Stout RL, Pinto A et al. (2013) Five-year course of obsessive-compulsive disorder: predictors of remission and relapse. J Clin Psychiatry, 74:233-239.
  • Evey KJ, Steinman SA (2023) A systematic review of the use of acceptance and commitment therapy to treat adult obsessive-compulsive disorder. Behav Ther, 54:1006-1019.
  • Fineberg NA, Baldwin DS, Drummond LM, Wyatt S, Hanson J, Gopi S et al. (2018) Optimal treatment for obsessive compulsive disorder: a randomized controlled feasibility study of the clinical-effectiveness and cost-effectiveness of cognitive-behavioural therapy, selective serotonin reuptake inhibitors and their combination in the management of obsessive compulsive disorder. Int Clin Psychopharmacol, 33:334-348.
  • Fisher PL, Wells A (2005) How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis. Behav Res Ther, 43:1543-1558.
  • Fletcher L, Hayes SC (2006) Relational frame theory, acceptance and commitment therapy, and a functional analytic definition of mindfulness. J Ration Emot Cogn Behav Ther, 23:315–336.
  • Freud S (1926) Ketlemeler, semptomlar ve kaygı. In Psikopatoloji Üzerine (Çeviri Ed. S Budak):229-329. Ankara, Öteki yayınları.
  • Gaudiano BA, Herbert JD (2006) Acute treatment of inpatients with psychotic symptoms using acceptance and commitment therapy: pilot results. Behav Res Ther, 44:415-437.
  • Gururaj GP, Math SB, Reddy JY, Chandrashekar CR (2008) Family burden, quality of life and disability in obsessive compulsive disorder: an Indian perspective. J Postgrad Med, 54:91-97.
  • Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K (1996) Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol, 64:1152–1168.
  • Hayes SC (2004) Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther, 35:639– 665.
  • Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J (2006) Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther, 44:1-25.
  • Hayes SC, Pistorello J, Levin M (2012) Acceptance and commitment therapy as a unified model of behavior change. Couns Psychol, 40:976-1002.
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There are 88 citations in total.

Details

Primary Language English
Subjects Clinical Psychology
Journal Section Review
Authors

Esra Arı Deniz 0009-0008-8230-8442

Salih Saygın Eker 0000-0003-4629-8669

Submission Date March 17, 2025
Acceptance Date June 1, 2025
Early Pub Date November 27, 2025
Publication Date March 31, 2026
Published in Issue Year 2026 Volume: 18 Issue: 1

Cite

JAMA Arı Deniz E, Eker SS. Experiential Avoidance in Obsessive-Compulsive Disorder from the Perspective of Acceptance and Commitment Therapy. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. 2026;18:319–331.

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