Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy (ACT) is a relatively new form of behavioural therapy that combines acceptance and mindfulness strategies to help with psychological problems and unhealthy patterns in clients' personal and working lives.  

ACT therapy takes the view that by accepting negative thoughts and feelings, individuals can choose a valuable direction in which to take action and make positive changes.

In this way, acceptance and commitment therapy does not aim to directly change or stop unwanted problems and experiences. Instead it teaches individuals to develop a mindful relationship with them, promoting a psychological flexibility that encourages healthy contact with thoughts, reconnection with the here and now, realisation of personal values, and commitment to behaviour change.

ACT might particularly appeal to those who are striving to live authentically and in-line with their values. Acceptance and commitment therapy can be considered a training in a particular mindset or approach as much as a type of therapy.

Acceptance and commitment therapy explicitly acknowledges that avoiding our problems doesn't work, and in fact often makes our suffering worse. Non-avoidance can be very anxiety-provoking, but often once the first steps have been taken it can be liberating.

What can ACT help with?

  • Anxiety (can be especially helpful for older adults with anxiety)
  • Depression
  • Obsessive compulsive disorder (OCD)
  • Stress
  • Substance use/addiction
  • Psychosis
  • Anyone who feels stuck in how they behave

What to expect in ACT

A session of Acceptance and Commitment Therapy may follow certain steps, including:

Reviewing the week

This is done with the aim of identifying events that do and do not fit in with the client's identified values

Assessing behaviours from the week

What behaviours were triggered as a result of these events? Do these fit in with the client's values or not?

Using the six ACT processes

Using these processes to help the client have a better chance of acting in line with their values in the future.

The six acceptance and commitment therapy processes

Acceptance

As the name suggests, acceptance is a key component of this type of therapy.

Rather than distracting oneself or avoiding things we find challenging, you are encouraged to accept things as they are. For example, rather than trying to get rid of anxious feelings, you will practise being accepting of them.

Techniques that may help with this process include self-compassion focused meditation, finding physical expression for emotions and feelings, working with metaphor.

Cognitive defusion

Cognitive defusion techniques aim to help you separate yourself from your experience, for example, seeing your thoughts as just thoughts.

Identifying values

A process of identifying what is important to you and what the life you want to live looks like.

What is important enough to you that you can use it to motivate you?

Present moment contact

ACT encourages you to stay present in the world around you and not to get sucked into your inner world. This might take conscious and deliberate effort, but gets easier over time.

Commitment to action

What specific actions can you take to move you closer towards your values?

Self as context, self as observer

Embracing this concept allows you to see that your thoughts, feelings and moods are often fleeting against the backdrop of your more constant self.

Tuning into our observing self rather than our thinking self gives us some healthy distance from the feelings that are challenging for us, without needing to 'get rid' of them.

Training as an acceptance and commitment therapist

Acceptance and commitment therapy is usually a course that those who are already qualified and counsellors and psychotherapists do in addition to their main training.

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Last updated October 2024

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