Introduction
You've heard of CBT. But what about ACT? It's another evidence-based therapy approach that's growing in popularity.
In this guide, I'll explain Acceptance and Commitment Therapy.
What Is ACT?
Definition
Acceptance and Commitment Therapy (ACT, pronounced "act") is a type of cognitive behavioral therapy that uses acceptance and mindfulness strategies along with commitment and behavior change strategies.
Created By
Steven C. Hayes in the 1980s.
The Core Idea
Don't try to eliminate difficult feelings. Instead, accept them while taking action toward your values.
The ACT Model
Hexaflex
ACT is organized around six processes:
- Acceptance - Embracing difficult emotions
- Cognitive Defusion - Stepping back from thoughts
- Being Present - Mindfulness
- Self-as-Context - Observing self
- Values - What matters to you
- Committed Action - Taking values-based action
Core ACT Techniques
1. Acceptance
Instead of fighting difficult emotions, allow them.
Exercise: "Welcome" practice - invite in difficult feelings.
2. Cognitive Defusion
Step back from thoughts. Don't get entangled.
Techniques:
- "I'm having the thought that..."
- Labeling thoughts
- Songs and metaphors
3. Mindfulness
Be present. Notice without judgment.
Practices:
- Present-moment awareness
- Observing senses
- Mindful breathing
4. Self-as-Context
The observing self vs. thinking self.
Concept: You are the container for your thoughts and feelings, not the content.
5. Values Clarification
What matters to you? What do you want your life to stand for?
Questions:
- What do you want to be remembered for?
- What gives life meaning?
- Who do you want to be?
6. Committed Action
Take action aligned with your values, even when hard.
Process:
- Set values-based goals
- Take action
- Maintain momentum
What ACT Treats
Applications
- Anxiety
- Depression
- Chronic pain
- PTSD
- OCD
- Substance use
- Workplace stress
Evidence
Strong research support for:
- Chronic pain
- Anxiety
- Depression
- Multiple conditions
ACT vs CBT
CBT
Focus on changing thoughts to change feelings.
ACT
Accept thoughts and feelings while taking values-based action.
Both Effective
Both are evidence-based. Choose based on what connects with you.
The Process
Typical Structure
- Assess current struggles
- Clarify values
- Identify barriers
- Build acceptance skills
- Commit to action
- Maintain and generalize
What to Expect
Sessions
- Discuss challenges
- Practice skills
- Set values-based goals
- Review progress
Between Sessions
- Practice acceptance
- Notice defusion
- Take values-based action
Pros and Cons
Pros
- Evidence-based
- Focuses on values
- Accepts difficult emotions
- Practical
Cons
- Can feel abstract
- May not suit everyone
- Requires practice
Finding an ACT mental health professional
Look For
- ACT training
- Experience with your issue
- Good fit
Questions to Ask
- What is your ACT training?
- How do you incorporate ACT?
Conclusion
ACT offers a unique approach: accept difficult feelings while moving toward what matters. If traditional CBT hasn't connected, ACT might help. It's about living a meaningful life, even with pain.
Want more help? Paula is a free mental health app with ACT-inspired tools. Download it today.
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Related Reading
- What Is Therapy? - Complete Guide
- What is ACT Therapy? Acceptance and Commitment Guide
- What Is DBT Therapy? - Complete Guide
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