Acceptance and Commitment Therapy (ACT)

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT) is an action-oriented approach to psychotherapy that stems from traditional behavior therapy and cognitive behavioral therapy. Clients learn to stop avoiding, denying, and struggling with their inner emotions and, instead, accept that these deeper feelings are appropriate responses to certain situations that should not prevent them from moving forward in their lives. With this understanding, clients begin to accept their hardships and commit to making changes in their behavior, regardless of what is going on in their lives and how they feel about it.

The theory behind ACT is that it is counterproductive to try to control painful emotions or psychological experiences; suppression of these feelings ultimately leads to more distress. ACT adopts the view that there are valid alternatives to trying to change the way you think, and these include mindful behavior, attention to personal values, and commitment to action.

ACT was developed in the 1980s by Dr. Steven C. Hayes, a psychologist who was quoted saying, “We as a culture seem to be dedicated to the idea that ‘negative’ human emotions need to be fixed, managed, or changed—not experienced as part of a whole life. We are treating our own lives as problems to be solved as if we can sort through our experiences for the ones we like and throw out the rest. Acceptance, mindfulness, and values are key psychological tools needed for that transformative shift”, which further outlines the foundations of this modality. 

ACT has been effective in treating:

  • Anxiety
  • Depression
  • Eating disorders
  • Obsessive-compulsive disorder (OCD)
  • Stress
  • Substance use
  • Psychosis

ACT aims to increase psychological flexibility through the development of six core processes:

1. Acceptance

Acceptance involves acknowledging and embracing the full range of your thoughts and emotions rather than trying to avoid, deny, or alter them.

2. Cognitive Defusion

Cognitive defusion involves distancing yourself from and changing the way you react to distressing thoughts and feelings, which will decrease their harmful effects. Techniques for cognitive defusion include observing a thought without judgment and labeling the automatic response.

3. Being Present

Being present involves being mindful in the present moment and observing your thoughts and feelings without judgment or trying to change them; experiencing events clearly and directly can help promote behavior change.

4. Self as Context

Self as context is an idea that expands the notion of self and identity; it highlights that people are more than their thoughts, feelings, and experiences.

5. Values

Values encompass choosing personal values in different domains and striving to live according to those principles. This stands in contrast to actions driven to avoid distress or adhere to other people’s expectations, for example.

6. Committed Action

Committed action involves taking concrete steps to incorporate changes that will align with your values and lead to positive change. This may involve goal setting, exposure to difficult thoughts or experiences, and skill development.

The belief in this modality is that if clients take steps to change their behavior while, at the same time, learning to accept their psychological experiences, clients can eventually change their attitudes and emotional states, leading to long-term recovery and sustainable growth.