What is Acceptance and Commitment Therapy (ACT)?

Acceptance and commitment therapy (ACT) is a type of talking therapy that encourages individuals to embrace and accept their thoughts and feelings instead of battling against them. ACT doesn’t eliminate the problem but equips a person with the tools to manage the problem and live a more fulfilling life. 

ACT is based on a few core principles and uses specific techniques to help individuals with a wide range of mental health challenges and emotional issues. This guide explains what to expect from acceptance and commitment therapy, so you can determine whether it’s the right fit for you. 

Introduction to Acceptance and Commitment Therapy

There are several types of therapy, like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). 

CBT focuses on helping individuals to become aware of the relationship between their thoughts, feelings, and actions. Acceptance and commitment therapy pulls in some principles from CBT but also includes other approaches and concepts, like acceptance. 

ACT is its own distinct approach with its own theories, techniques, and goals. Acceptance and commitment therapy focuses on the overarching goal of building something called “psychological flexibility,” combining acceptance and mindfulness with strategies to bring about behavioral change. Psychological flexibility is the ability to adapt to changing situations, accept difficult emotions, and take action that aligns with your values, even in the face of adversity. 

Psychological flexibility is essential for mental well-being because it reduces human suffering, increases resilience, and enhances well-being. 

The Core Principles of ACT

ACT uses a framework that revolves around six core principles that promote psychological flexibility. 

1. Acceptance: This principle is about becoming aware and accepting of sensations, thoughts, and feelings you might otherwise struggle against. It’s a very active process of embracing and living with difficult emotions, thoughts, or sensations rather than trying to eliminate them. 
2. Cognitive Defusion: Defusion techniques help you to create distance from your thoughts and not get caught up in the literal meaning. This area focuses on helping individuals learn that thoughts are just thoughts, not commands or reflective of reality. 
3. Present Moment: This involves bringing your attention to the present moment and fully engaging with what is currently happening rather than dwelling on the past or worrying about the future.  
4. Self as Context: Recognizing your observing self can help you to experience difficult emotions without judgment and being defined by them. 
5. Values: Your values are the core principles that guide your life. They give direction rather than actual goals. Examples of values include personal growth, family, creativity, and connectedness. 
6. Committed Action: This is the action that you take, guided by your values, to create a meaningful life. It can include making a plan and engaging in behaviors aligned with your values, even in the face of challenges. 

How ACT Helps You Embrace Acceptance

The concept of acceptance can be a bit tricky to grasp, especially when you’re used to pushing away or fighting against difficult emotions and thoughts. 

Here’s how ACT helps you to embrace acceptance: 

• It shifts your perspective from fighting to allowing difficult emotions without them completely taking hold of you. 
• It helps you recognize that emotions like sadness, stress, or fear are part of the human experience and not a sign of weakness. 
• It teaches you skills you can use in real life outside of your therapy session to embrace acceptance, like mindfulness, defusion, and willingness. 
• It helps you to identify your core values and take action that aligns with those values to live a more meaningful life. 

Acceptance is a skill that takes time to cultivate. ACT is a process that gives you the tools and strategies to develop acceptance. 

To make this clearer, take an individual with generalized anxiety disorder (GAD). It’s normal for people suffering from GAD to try to control their worries, which can make them worse. An ACT therapist, using the core principles of ACT, would encourage accepting anxiety, stepping away from anxious thoughts, and focusing on values. 

For example, if a big work presentation is coming up, instead of avoiding it, an individual would accept the anxiety and focus on the value of sharing ideas and information. They accept that they don’t need to feel completely confident at first. It’s not about removing the anxiety but existing with it, using the tools and strategies ATC teaches you. 

Techniques Used in ACT: A Practical Approach

Techniques and tools used in ACT are focused on supporting and strengthening the six core ACT processes (Acceptance, Cognitive Defusion, Present Moment Awareness, Self as Context, Values, and Committed Action). These techniques cultivate ACT principles in everyday life and work together to promote psychological flexibility. 

Acceptance:

• Willingness exercises 
• Allowing yourself to feel emotions fully 

Cognitive Defusion:

• Repeating a thought until it loses meaning
• Exercises like “Leaves on a Stream” where you imagine your thoughts as leaves floating down the steam. 
• Labeling thoughts to create distance to the thought.  

Present Moment Awareness:

• Mindfulness exercises include mindful breathing, mindful walking, and sitting meditation.  
• Present moment awareness in everyday conversations. 

Values:

• Exercises to identify core values (e.g., questionnaires) 
• Exploring and reflecting on different areas of life 
• Guided discussions 
• Value-based goal setting

Committed Action:

• Goal setting 
• Action planning 
• Behavioral experiments 

This is not an exhaustive list; ACT therapists will use the techniques and strategies that best suit your needs and preferences. You will notice that several metaphors are used in ACT. These can be powerful tools for communicating complex messages and bringing about behavioral change. 

Conditions Commonly Addressed with ACT

ACT is an evidence-based treatment, which means it’s been shown to be effective in rigorous scientific studies. So, you’re making decisions about treatment based on actual data and not guesswork. 

Randomized clinical trials (RCTs) are the gold standard for evaluating a treatment. A meta-analysis examines results from many RCTs to help see the bigger picture. In a review of several meta-analyses, researchers found that ACT is effective in treating a range of problems, including anxiety, depression, and chronic pain. 

Acceptance and commitment therapy can be helpful in treating a range of physical and mental health conditions, including:   

• Anxiety Disorders  
• Chronic Pain 
• Depression 
• Eating Disorders 
• Stress and Burnout 

The Benefits of ACT in Mental Health Treatment

A significant benefit of ACT is the way it helps people to develop psychological flexibility. This flexibility helps individuals to navigate and cope with difficult emotions and thoughts without getting caught up in the thought and stuck. 

In ACT, there’s a central concept called experiential avoidance, which refers to the way humans have a tendency to avoid or suppress difficult thoughts, emotions, and sensations. While it can feel natural to shy away from discomfort, ACT suggests that this avoidance and struggle against these internal feelings can make them worse and lead to psychological suffering. ACT helps to reduce avoidance behavior, helping individuals to live a life more aligned with their values and improving their quality of life. 

Other important benefits of ACT include: 

• ACT encourages you to accept emotions, which fosters balance and reduces overwhelming feelings that are crucial for mental well-being.
• Mindfulness cultivates present-moment awareness, lessening worry and stress for better mental health.
• ACT helps you live a life guided by your values and really find out what’s important to you. 
• Leading a life that aligns with your values can help you have a more meaningful life. 
• ACT helps individuals distance themselves from thoughts, which can be especially helpful for managing negative or intrusive thoughts that often accompany depression and anxiety. 

What to Expect in an ACT Session

ACT sessions are typically hands-on, using techniques to develop psychological flexibility and empower individuals to live a life consistent with their values. These techniques can include acceptance strategies, mindfulness practices, and cognitive defusion exercises. Your first ACT session will likely be more exploratory, focusing on building rapport with your therapist and clarifying your core values. This exploration of values is a crucial foundation for ACT therapy.

Here’s what you can expect in a typical ACT session:

• Check-In: You’ll start by talking about your week and reviewing any homework from the previous session.
• Identifying and Acknowledging Values-Aligned Behaviors: You and your therapist will identify and acknowledge behaviors that are in line with your values, exploring how these actions contribute to a meaningful life.
• Examining Actions Inconsistent with Your Values: You’ll also explore behaviors that have strayed from your values. The focus here is on understanding the influences on these behaviors, including thoughts and feelings, and exploring how these factors contributed to actions that didn’t align with your values. 
• Working with the Six Core Principles: Your therapist will use the six core principles of ACT as a framework to help you work through barriers, develop psychological flexibility, and empower you to take committed action towards a life that is consistent with your values. 

While the core principles of ACT remain constant, the specific exercises, tools, and techniques a therapist uses can vary. Your therapist will tailor each session to your individual values, preferences, goals, and needs. This flexibility makes ACT adaptable to a wide range of challenges. ACT can be delivered in both short-term and long-term formats, depending on your specific circumstances.

Ready to Start Your ACT Journey? 

We understand that finding the right therapist is essential, and we’re here to help you navigate that process. 

At Thriving Center of Psychology, we make starting your journey easy. Instead of spending hours researching and contacting therapists, take 5-minutes to fill out our quick and easy questionnaire to get matched with the right therapist for your specific needs. We look forward to starting this journey with you!