Exploring the Effectiveness and Acceptability of a Self-Help Acceptance-Based Behavior Intervention for Anxiety in Black Adults: An Uncontrolled Pilot Study

An estimated one in five Black Americans meet criteria for an anxiety disorder in their lifetimes (Alvarez et al., 2019), but only about 20% of these receive mental health services. Self-help materials that have been shown to be effective in reducing anxiety and worry could be one method of increasing access to evidence-informed treatments for Black Americans. The current study explored the acceptability and effectiveness of the Worry Less, Live More: The Mindful Way Through Anxiety Workbook (WLLM), a self-help workbook based on acceptance-based behavioral therapy, for reducing anxiety in a sample of Black individuals. Sixty-five Black individuals residing in the United States received the WLLM workbook and were asked to read it over 16 weeks at their own pace without intervention from researchers: 40 of those participants completed the follow-up survey. A majority of the participants agreed that the approach was a good match for them (70%) that it aligned with their personal and cultural views (60%), and that the strategies from the workbook were helpful for them when dealing with the stress related to encountering racial stressors (71%). There were significant improvements over time on self-reported general anxiety (d = .50, anxious arousal (d = .41), cognitive fusion (d = .45), and acceptance (d = .76), but no significant changes in engagement in values-based action over time. This study provided preliminary support for the acceptability of WLLM’s acceptance-based approach for Black adults.