Document Type


Journal/Book Title/Conference

Clinical Case Studies

Author ORCID Identifier

Caleb D. Farley


Sage Publications, Inc.

Publication Date


First Page


Last Page



Social anxiety disorder (SAD) often develops during teenager years, and it is important to conceptualize developmentally appropriate interventions. Exposure therapy framed from a perspective of acceptance and commitment therapy (ACT) shows promise for decreasing pathology and increasing wellbeing. This case illustrates the process through which exposure therapy was integrated with ACT to elicit meaningful outcomes in a case of SAD with a 16-year-old female. Treatment outcomes assessed included engagement in values-based activities as well as assessments of depression, social anxiety, separation anxiety, generalized anxiety, experiential avoidance, and contextually targeted school-based wellbeing. Intervention centered on learning ACT principles through relatable metaphors and experiential exercises and practicing them with values-guided social exposures. This integration resulted in increased engagement in socially meaningful experiences over time as well as associated changes in treatment outcomes. Treatment implications, guidelines, and recommendations are presented, including the need for skill-focused treatments, identifying deficits in psychological flexibility, and maintaining a compassionate yet growth-oriented course of treatment.


Farley, C. D., & Twohig, M. P., Merging Acceptance and Commitment Therapy with Exposure Exercises to Treat Social Anxiety in a Teen, Clinical Case Studies 0(0) pp. 1-32. Copyright © 2023 The Author(s). DOI: 10.1177/15346501231217745.