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What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT – said as one word) is a form of behavioral therapy that integrates mindfulness with self-acceptance, values clarification, and action. It is part of the Third Wave of CBT (Cognitive Behavioral Therapy), which is sometimes called Meta-Cognitive Behavioral Therapy or Contextual Behavioral Therapy and is based on functional contextualism (Association for Contextual Behavioral Science, n.d.). The acceptance part of the therapy focuses on helping the individual accept both internal and external experiences that are out of their control, rather than attempting to fight or struggle with them. The commitment part of the therapy focuses on what actions the individual can take that might improve their personal life.

In the simplest terms, the philosophy behind ACT is to teach patients to accept what is out of their control and commit to workable solutions that can lead them to live a happier and more fulfilling life. Overall, ACT methods are designed to establish “workable and positive set of psychologically flexible skills” (Association for Contextual Behavioral Science, n.d.).

How Does ACT Work?

How Does ACT Work?

To get the most from ACT, the individual must commit to facing their problem head-on rather than focusing on avoiding their anxiety and stress. A therapist will facilitate the process by beginning with self-reflection, values clarification, and teaching how to become more mindful of both internal and external experiences. The therapist will listen to the individual’s self-talk, or the way they speak to themselves—specifically about traumatic events, problematic relationships, physical limitations, or other issues. Together with their therapist, the individual can decide whether an issue requires immediate action or can be accepted for what it is, often resulting in the individual making behavioral changes that can affect the situation. The therapy breaks down into an activation of a six- step “core process.” The six steps are:

  • Acceptance: The active choice to allow what is unpleasant in one’s life to exist
  • Cognitive Defusion: Changing one’s relationship to, and how one reacts to, their thoughts and feelings
  • Being Present: Being aware and experiencing a moment without trying to change it
  • Self as Context: Understanding the idea that a person’s identity extends beyond their personal experiences
  • Values: Considering the things that are most important and valuable to the individual when working through the process
  • Committed Action: This final step helps individuals commit to their actions to guide them towards a long-term mindset

Who Can Benefit From ACT?

ACT is a therapy that can benefit individuals experiencing many different types of conditions and life-changes. It has shown positive results in treating workplace stress, test anxiety, social anxiety disorder, depression, obsessive-compulsive disorder, and psychosis. It has also been used to help treat medical conditions such as chronic pain, substance abuse, and diabetes.

This type of therapy is not only effective for a wide range of psychological disorders; it is also beneficial as a life-affirming and positive reinforcement of self-determination. ACT, especially when compounded with a daily practice of mindfulness, can provide long-term positive cognitive results.

LifeStance Health specializes in Acceptance and Commitment Therapy (ACT) with multiple locations in 33 states. Services vary by location.

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What Is The Philosophy Behind ACT?

ACT was developed by Steven C. Hayes, a psychology professor at the University of Nevada, in 1986. Hayes described his therapy as, “a psychological intervention … that applies mindfulness and acceptance processes, and commitment and behavior change processes, to the creation of psychological flexibility” (Hayes, n.d.).

Hayes believes that suffering is a natural and inevitable condition and that it is in our human nature to instinctually strive to control our experiences but that this instinct does not always serve us. TED Talks hosted Hayes for a more in-depth look at his development and philosophies on ACT.

Citations:

Association for Contextual Behavioral Science (ACT) (n.d.). About ACT: Psychological Inflexibility: An ACT View of Suffering and Failure to Thrive. https://contextualscience.org/about_act

Hayes, S. (n.d.). The Six Core Processes of ACT. Association for Contextual Behavioral Science. Retrieved from: https://contextualscience.org/the_six_core_processes_of_act#

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Clinically Reviewed By:

Jessica Leonard, PhD
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Dr. Jes Leonard is a psychologist who has been practicing since 2016. She currently serves as the Training Director for the post-doc and practicum training program at Lifestance NH and as the Regional Clinical Assessment Director for Lifestance NH/ME. She graduated from West Virginia University with a doctoral degree in counseling psychology and Ithaca College with a masters of science degree with a concentration in sport psychology. Dr. Leonard believes in the resilience of all humans and has a client-centered approach in assisting clients live a more purposeful and meaningful life and providing tools to manage life stressors. She is trained as a generalist psychologist and specializes in treating trauma, including childhood, sexual, combat, and complex trauma. Dr. Leonard is trained in Acceptance and Commitment Therapy (ACT), Cognitive-Behavior Therapy (CBT), Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Internal Family Systems Therapy (IFS). She also specializes in group therapy intervention and believes that groups can provide a great source of social interaction, support, and hope while also providing a safe environment in which to learn. Dr. Leonard also provides required Bariatric pre-surgical psychological assessment for local Bariatric Surgery Programs. Dr. Leonard enjoys spending time with family and has been actively involved in New Hampshire Psychological Association and assisting newly trained psychologists getting licensed in the state.