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Qualitative interviews with 26 participants reveal a five-stage dynamic model of accepting anxiety.

Qualitative interviews with 26 participants reveal a five-stage dynamic model of accepting anxiety.
Photo by Vitaly Gariev / Unsplash
Key Takeaway
Consider using this five-stage model to investigate individual variability in anxiety acceptance processes.

This qualitative study involved 26 participants from a non-clinical sample who had prior experience with mindfulness-based anxiety interventions. Researchers conducted semi-structured interviews to explore the experience of accepting anxiety. The primary outcome was the development of a comprehensive model describing the acceptance process.

The analysis identified a five-stage dynamic model of acceptance. Stage 1 involves observing through the body with attentional focus on interoceptive experience. Stage 2 consists of identifying and acknowledging anxiety. Stage 3 includes validating and normalizing the experience through validation and self-compassion. Stage 4 is characterized by not reacting, utilizing decentering and nonreactivity. Stage 5 involves staying with the experience via exposure.

Facilitating factors that support engagement in the acceptance process were also identified, though specific details were not reported. No adverse events, serious adverse events, discontinuations, or tolerability data were reported as this was a qualitative study. The study has no reported limitations or funding conflicts.

The practice relevance of this work is that it provides a framework for developing more targeted clinical interventions and for investigating individual and contextual variability in these subprocesses. Clinicians should interpret these findings as descriptive insights rather than evidence of efficacy.

Study Details

EvidenceLevel 5
PublishedApr 2026
View Original Abstract ↓
Introduction Experiential acceptance refers to the capacity to be open to internal experiences without attempting to change or avoid them. Although acceptance is a core emotion regulation strategy within mindfulness- and acceptance-based interventions (MABIs) and a protective factor for mental health, its conceptualization and implementation remain unclear and ambiguous. The aim of this study was to clarify and develop a comprehensive model of accepting anxiety. Method Twenty-six participants from a non-clinical sample with prior experience in MABIs took part in semi-structured interviews exploring their experience of accepting anxiety. Data collection and analysis followed the principles of Grounded Theory to generate a data-driven model of the acceptance process. Results We identified a five-stage dynamic model involving distinct processes: (Stage 1) observing through the body with attentional focus on interoceptive experience; (Stage 2) identifying and acknowledging anxiety; (Stage 3) validating and normalizing the experience through validation and self-compassion; (Stage 4) not reacting characterized by decentering and nonreactivity; and (Stage 5) staying with the experience via exposure. We also identified facilitating factors that support engagement in the acceptance process. Conclusion These findings refine the understanding of acceptance as a multidimensional emotion regulation process by highlighting an active dynamic involving multiple mechanisms underlying the acceptance of anxiety. This model provides a framework for developing more targeted clinical interventions and for investigating individual and contextual variability in these subprocesses.
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