Acceptance and commitment therapy (ACT) is a type of cognitive-behavioral psychotherapy developed in the 1980s. ACT uses mindfulness-based techniques to reduce internal barriers to psychological and emotional healing by identifying fixed and rigid patterns of thought and replacing them with a fluid and adaptable approach to thoughts and emotions.
The goal of ACT is to develop and expand psychological flexibility, which helps people with mental health disorders learn they have power and agency over how they react to and process their thoughts and emotions.
When a patient in ACT treatment develops this flexibility, they can then modify their behavior and reduce the negative and disruptive consequences of their mental health symptoms.
What Type of Patients Does ACT Help Most?
Extensive research conducted over the past thirty years shows ACT is an effective therapeutic approach for patients diagnosed with the following mental health challenges, conditions, and/or disorders
- Major depressive disorder (MDD)
- Anxiety disorders (AD)
- Posttraumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Eating disorders
- Alcohol/substance use disorder (AUD/SUD)
ACT was first conceptualized by therapist Stephen Hayes, based on his personal experience with anxiety and panic attacks. Here’s how he described the realization that led to rethinking his approach to psychotherapy:
At Crownview, our therapists use ACT techniques to teach patients with mental health disorders a set of practical mindfulness skills that help them set and achieve personal goals, define and live by self-directed values, accept their thoughts and feelings, and modify their behavior to align with their goals and values.
The Core Components and Processes of ACT
The ACT treatment process revolves around six core processes:
Acceptance
Acceptance is the counter to the common – but maladaptive – practice of avoiding difficult emotions. Avoidance of difficult or painful emotions is associated with anxiety, depression, and trauma-related disorders. In ACT, acceptance means “…the active and aware embrace of private experiences without unnecessary attempts to change their frequency or form.” Acceptance in ACT is active and involves the proactive exploration of new and helpful responses to thoughts and emotions that were previously avoided.
Cognitive Defusion
Cognitive defusion is the counter to cognitive fusion, which can lead to fixed and rigid behavior, based on predetermined ideas rather than direct experience. For example, the idea or thought “life is painful” can become fixed and fused: life and pain become intertwined in your mind without you realizing it. In ACT treatment, you learn to separate these thoughts from your identity. You learn to experience thoughts from a distance, as a detached observer, which decreases their power. An ACT therapist helps you see a thought as a transient occurrence, as opposed to an objective truth that controls your behavior.
Being Present
This is the component of ACT that draws on mindfulness techniques. The goal of mindfulness is to develop “… our ability to be aware of what is going on both inside us and around us. It is the continuous awareness of our bodies, emotions, and thoughts.” Most importantly, however, this skill teaches you how to be aware of what’s going on in your body, thoughts, and emotions without the immediate impulse to judge them or change them. In ACT, this core skill informs all the others, and allows you to embrace the world as it is, and yourself as you truly are: strong, aware, and capable of healing and growth.
Self-as-Context
In ACT, therapists propose the self exists in at least three contexts: in relation to people and the world, in your concept of who you are, and as an ever-changing, dynamic process that integrates events from the past and present into projections of the future. In ACT, therapists work with you to find a balance between these three components, based on the mindful awareness and the psychological flexibility you develop during treatment.
Values
When you work with an ACT therapist, you define what matters to you most in life, i.e. your values. In ACT, you learn that values aren’t abstract concepts, but rather actions we can live out, from one moment to the next, in your life. An ACT therapist may have you express your values out loud, verbally, or write them down as a list, in order to reinforce them. For instance, if you define kindness as a value, you work with your therapist to align your behavior, i.e. what you do, with your values, i.e. what you believe.
Committed Action
This is the goal of ACT: using everything above – mindful awareness, acceptance of reality, defining values – you take direct action in order to make changes that move your toward goals you create based on your values.
In a nutshell, the unifying concept behind ACT is to allow your values and your goals direct your behavior, rather than your emotions and/or fixed patterns of thought drive your behavior. It takes time an effort, but evidence shows that ACT works.
The Benefits of Acceptance and Commitment Therapy (ACT)
Research shows that ACT can help people experiencing various forms of psychological and emotional distress. The processes help patients with moderate to severe mental health disorders, people learning to cope with difficult life events such as job loss and divorce, married couples seeking to rediscover balance, and in some cases, people seeking change in order to increase success or productivity at work or in a chose discipline.
ACT helps you accept the world as it is and commit to taking action that moves you toward the values and goals you define.
When you engage in ACT treatment, you can learn to recognize the power and agency you have in your life, acknowledge the challenges in your life, and use your strength – and ACT skills – to meet, manage, and overcome difficult psychological and emotional situations. With the right tools and a fluid, adaptable perspective, you can learn to live the life you choose, based on your values and your vision of happiness and success.
Learn More Today
If you or a loved one has a mental health disorder and have not had success in treatment, or never received professional support of any kind, acceptance and commitment therapy (ACT) might be exactly what you need to start on the path toward a brighter future.
Gianna Melendez
Jodie Dahl, CpHT