Acceptance and Commitment Therapy (ACT)

What Is Acceptance and Commitment Therapy?

Acceptance and commitment therapy (ACT) is a type of psychotherapy that emphasizes acceptance to deal with negative thoughts, feelings, symptoms, or circumstances. It also encourages increased commitment to healthy, constructive activities that uphold your values or goals.

ACT therapists operate under a theory that suggests that increasing acceptance can lead to increased psychological flexibility. This approach carries a host of benefits, and it may help people stop habitually avoiding certain thoughts or emotional experiences, which can lead to further problems.

How does ACT work?

Unlike cognitive behavioral therapy (CBT), the goal of ACT is not to reduce the frequency or severity of unpleasant internal experiences like upsetting cognitive distortions, emotions, or urges. Rather, the goal is to reduce your struggle to control or eliminate these experiences while simultaneously increasing your involvement in meaningful life activities (i.e., those activities that are consistent with your personal values).

This process involves six components:

• Acceptance: This means allowing your inner thoughts and feelings to occur without trying to change them or ignore them. Acceptance is an active process.
• Cognitive defusion: Cognitive defusion is the process of separating yourself from your inner experiences. This allows you to see thoughts simply as thoughts, stripped of the importance that your mind adds to them.
• Self as context: This involves learning to see your thoughts about yourself as separate from your actions.
• Being present: ACT encourages you to stay mindful of your surroundings and learn to shift your attention away from internal thoughts and feelings.
• Values: These are the areas of your life that are important enough to you to motivate action.
• Commitment: This process involves changing your behavior based on principles covered in therapy.

During ACT, your therapist will help you learn how to apply these concepts to your life. They may teach you how to practice acceptance and cognitive defusion, or they may help you develop a different sense of yourself that’s distinct from your thoughts and feelings.

Sessions can also include mindfulness exercises designed to foster nonjudgmental, healthy awareness of thoughts, feelings, sensations, and memories that you have otherwise avoided. Your therapist may also help highlight moments when your actions didn't fit your values while helping you understand which behaviors would fit.

Your therapist may assign homework to practice between sessions, such as mindfulness, cognitive, or values clarification exercises. The homework is agreed upon between you and your therapist and can be modified to make it as personal and useful as possible.

What Can ACT Help With?

ACT has shown promise for a wide range of physical and psychological conditions. It is often applied in situations involving: 

• Depression
• Adjustment to Chronic Illness
• Anxiety
• Chronic Pain
• Eating Disorders
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD) 
• Stress Regulation
• Substance Abuse
• Work-place stress

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