Background & Objectives: Stuttering adults are more anxious than ordinary people in social situations. Therefore, researchers need to use appropriate treatment methods to reduce the anxiety of these clients. One of the treatment methods that seems to have a significant effect in reducing the symptoms of anxiety is tunified transdiagnostic treatment of emotional disorders. This method is based on cognitive–behavioral theories and is obtained by combining and consolidating of the common principles of support–based psychotherapies. Another transdiagnostic treatment that seems effective in reducing anxiety symptoms is the emotion efficacy therapy (EET), which is an integrative treatment. It draws its components from acceptance and commitment therapy and dialectical behavior therapy to create a sort of exposure–based protocol. The main aim of the present study was to compare the effectiveness of unified transdiagnostic treatment of emotional disorders and emotion efficacy therapy in reducing the symptoms of anxiety among adults with stuttering.
Methods: The research method was quasi–experimental with a pretest–posttest and a follow–up design with a control group. The statistical population included all stuttering adults who went to speech therapy clinics in Tehran City, Iran and the Iranian Stuttering Association for receiving speech therapy during the 2018–2019 years. Of whom, 36 stuttering adults were selected by available sampling and based on the inclusion and exclusion criteria. Then they were randomly assigned to the group of unified transdiagnostic treatment, the group of emotion efficacy therapy, and control group. The inclusion criteria were as follows: adults with developmental stuttering over 18 years old, presence of anxiety disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) and diagnostic interview, and having at least third–grade guidance school literacy. The exclusion criteria were as follows: having mental retardation and chronic physical diseases, or receiving psychotherapy, medication, or speech therapy during the treatment period. For the treatment groups, each intervention was performed based on two–hour sessions and no intervention was performed for the control group. This group was placed on the waiting list for treatment upon request. The tools used in the present study included the Beck Anxiety Inventory (Beck et al., 1988) which was used in three stages: pretest, posttest, and follow–up for three groups. To analyze the data, the repeated measures analysis of variance, Bonferroni post hoc test, 1–way analysis of variance, and the Chi–square test were used using SPSS software. P values less than 0.050 were considered significant.
Results: Results showed that the effect of the within–subjects factor, i.e., time (p<0.001), the between–subjects factor, i.e., the effectiveness of unified transdiagnostic treatment of emotional disorders and emotion efficacy therapy (p=0.001) as well as the interaction of these two factors (p=0.024) were significant on the anxiety variable. The difference between the average scores of the subjects of the two groups of emotion efficacy therapy and the unified transdiagnostic treatment of emotional disorders with the control group was significant in the anxiety variable (p=0.001, p=0.023, respectively). However, the difference in the average scores of the subjects of the two treatment groups in the anxiety variable was not significant (p=0.590). Also, there was a significant difference between the mean scores of the anxiety variable in the pretest and the posttest (p<0.001) and between the pretest and the follow–up (p=0.001) scores. However, the average anxiety scores in the posttest did not have a significant difference from the follow–up scores, which showed the persistence of the effectiveness of the two treatment methods in the follow–up phase (p=0.650).
Conclusion: In general, due to the significant effect of both treatment methods, i.e., the unified transdiagnostic treatment of emotional disorders and emotion efficacy therapy, stuttering therapists can use these two methods to reduce the anxiety of stuttering adults.