One of the most popular therapies among the emerging “third wave” treatments is acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999). In most trials, ACT is reported to be superior or equally effective as cognitive behavioral therapy (CBT; Hofmann & Amundson, 2008). For biofeedback practitioners, ACT may be more compatible with heart rate variability biofeedback (HRVB). In this article, I describe methods that can be used to combine the two interventions. Although much more work is needed, early studies report promising results using this combination. Here, I will focus on anxiety disorders, but the reader should be able to generalize the methods presented to other disorders.

HRVB is a type of biofeedback that relies on slow breathing techniques to alter heart rate patterns so as to create smooth sinewave patterns in beat-to-beat heart rate that match the respiration wave. With daily practice, it has been shown to...

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