Life has ups and downs, and there’s no point in denying what we feel when things don’t go our way. A better plan is to accept our thoughts and emotions while committing to actions that enrich our lives.
Acceptance and commitment therapy (ACT) focuses on these aspects, helping people maximize their potential and embrace challenges. This practice aims to increase psychological flexibility, or the ability to stay present and adapt to the demands of life.
ACT therapists use mindfulness exercises and other techniques to encourage their clients to accept life experiences as they come. With this approach, you may find it easier to overcome stress and mental health conditions like depression and anxiety.
What Is Acceptance and Commitment Therapy?
Developed in the 1980s, ACT is a therapeutic approach that aims to help people move forward through difficult emotions so they can lead better lives. It’s part of the third wave of cognitive-behavioral therapy (CBT), which focuses on how we relate to our thoughts and feelings instead of trying to suppress them.
The premise behind ACT is that we have relatively little control over the memories, thoughts, and emotions that arise in a given situation. However, we’re in charge of our actions—what we say, where we go, and what we do to achieve our goals.
Therefore, we can change our lives by taking appropriate actions and learning to deal with unwanted thoughts and emotions.
“The ACT approach, efficient for trauma like post traumatic stress disorder (PTSD), focuses on the progression of our emotional experiences as humans,” explains Carrie Freshour, a licensed certified social worker-clinical (LCSW-C) with Grow Therapy. “It centers on promoting psychological flexibility—the ability to be in the present moment with openness and awareness while also taking committed action toward one’s values and goals.”
Let’s say a person loses their job unexpectedly. Psychological flexibility allows them to accept the situation, acknowledge their feelings of disappointment, and take proactive steps to find a new job while staying true to their career goals.
“The more you practice accepting the uncomfortable parts of life, your brain becomes more flexible and robust,” points out Nicole Love, a licensed clinical social worker (LCSW) with Grow Therapy.
The Core Principles of ACT
Acceptance and commitment therapy was created by clinical psychologist Steven C. Hayes and his team. His approach consists of six core principles, including:
- Cognitive defusion
- Acceptance
- Self-as-context
- Being present in the moment
- Values
- Committed action
Let’s see what these mean.
Cognitive Defusion
Cognitive defusion describes our ability to perceive memories, thoughts, and other products of the mind for what they are rather than assigning them a meaning. Basically, it’s about observing our thoughts instead of getting caught up in them.
With this technique, you’ll learn to detach yourself from unwanted or negative thoughts. Over time, you will begin to see them as a series of words or images that come and go in your mind.
Acceptance
This practice involves accepting difficult thoughts and emotions instead of trying to suppress them.
Imagine someone is living with chronic pain due to a medical condition. He or she may be thinking, “I can’t stand this pain anymore; it’s ruining my life.”
This way of seeing things can lead to despair, sadness, frustration, and hopelessness.
ACT teaches people to cope with painful conditions by accepting that the pain is part of their life, at least for the time being. Consequently, they’ll allow themselves to feel sad, angry, or worried — but without letting those feelings control their actions.
Self-as-Context
Our thoughts, feelings, and experiences don’t define us. Therefore, we should act as mere observers and separate them from our actions.
Also referred to as “the observing self,” this concept emphasizes that our thoughts and emotions are ever-changing, whereas the core self remains constant.
Let’s say you’re dealing with a tight deadline at work, and your mind is flooded with thoughts like, “This is too much. I’m going to fail.”
Step back and observe these thoughts instead of getting caught up in them. Soon, you’ll realize that they are just passing through your mind without defining your capabilities or the outcome of the task.
Being Present in the Moment
This ACT principle is all about living in the present. By doing so, you will experience the world more directly and stop worrying about “What Ifs.”
The whole point is to focus on what’s happening here and now. Let go of judgment, stop making assumptions, and try to see things as they are in the present moment.
Some simple and helpful ways to bring yourself more into the present space and time include breathing exercises, mantras, or focusing on your physical senses.
Values
From an ACT perspective, values are beliefs or principles that drive our motivation and contribute to a meaningful life. These are not necessarily goals, but rather things that guide our actions and how we perceive the world around us.
For example, you may value health and well-being, so you eat a balanced diet and commit to regular exercise. Someone who values adventure will travel to new places and embrace novel experiences, despite the fear of the unknown.
An ACT therapist helps people clarify what their values are and explore whether their actions and behaviors are aligned with those values.
Committed Action
This process encompasses the actions and behavioral changes that align with your values.
If, say, you want to travel more but are afraid to step out of your comfort zone, you could start by planning short trips. A person who values learning may enroll in courses, attend workshops, or read more, despite a busy schedule.
Taking gradual but concrete steps will ensure progress toward goals even in the face of discomfort and uncertainty.
ACT and the Relational Frame Theory
The above principles are in line with the relational frame theory (RFT), which focuses on the study of human language and cognition.
Imagine you have a puzzle in front of you, with each piece representing a word or concept. In traditional thinking, we put these pieces together based on how they fit.
But RFT suggests that our minds work differently. It’s like having a puzzle where the pieces can connect in various, more abstract ways.
This theory explores how the human mind creates connections between words, concepts, and ideas based on comparisons, similarities, differences, relationships, and other factors.
For example, it’s how we understand that “big” is the opposite of “small” or how we know that “cat” is related to “pet” and “dog” in different ways. These connections are called relational frames.
In RFT, relational framing is based on two factors: the relational context and the functional context. The former determines what you think, whereas the latter focuses on the psychological impact of your thoughts.
For instance, children might pick up on cues that make them feel like they’re not as good as they should be. As a result, they may feel unworthy of love or blame themselves for all sorts of things, such as their parents’ divorce.
The goal of ACT is to undo these connections and help people accept their thoughts and feelings without judgment. At the same time, it enables them to identify and understand their personal values so they can lead a fulfilling life.
How ACT Works
This evidence-based approach to psychotherapy uses mindfulness exercises, metaphors, experiential processes, and other techniques. Their role is to help individuals change their behavior and how they perceive internal experiences.
“Our sessions often revolve around accepting thoughts and feelings, then aligning actions with core values,” explains Kristian Wilson, a licensed mental health counselor (LMHC) with Grow Therapy.
Let’s see an example:
- Thoughts: “I’m not good enough to pursue my passion for art.”
- Feelings: Anxiety and self-doubt
- Behavior: The client’s artwork sits, hidden away from others.
In the above scenario, a therapist may recommend mindfulness and behavioral change strategies.
“We introduce mindfulness as a companion, allowing thoughts and emotions to exist without judgment,” says Wilson. “Together, we uncover the client’s artistic passion and commit to nurturing it,” she added.
Moving forward, Wilson would use cognitive defusion techniques to create a safe space where the client could step back from negative thoughts. At the same time, he or she would actively engage in behaviors that aligned with their values.
“Our goal as therapists is to orchestrate sessions that empower clients on their unique paths to self-discovery and positive transformation,” notes Wilson. “We adapt our interventions based on the client’s progress and feedback.”
In some cases, mental health professionals may combine ACT with dialectical behavior therapy (DBT), rational emotive behavioral therapy (REBT), or other interventions.
For example, both ACT and DBT incorporate mindfulness exercises. In DBT, mindfulness is a core skill, whereas in ACT, it’s a foundational principle. Therapists may integrate mindfulness practices from both approaches to help their clients embrace the present moment and accept their thoughts.
Therapeutic modalities also vary based on the client’s needs. For instance, depression may cause people to avoid activities or experiences that could cause physical or psychological discomfort.
Let’s say you keep postponing an important project or task because it feels too challenging. Or you may hesitate to start a relationship, fearing that you’ll eventually get hurt.
This kind of behavior is known as experiential avoidance and may stem from a fear of criticism or rejection, past traumatic events, procrastination, or other factors.
In such cases, an ACT therapist may use experiential exercises to help their clients overcome mental roadblocks and gain confidence. These may include mindfulness meditation, deep breathing, guided imagery, or activities like painting, drawing, or writing.
Who Can Benefit from ACT?
This mindfulness-based cognitive therapy is meant to improve one’s quality of life. Therefore, it appeals to people of all ages and backgrounds, from teenagers and business professionals to individuals with anxiety disorders.
For example, a randomized controlled trial conducted in Brazil suggests that ACT may help with social anxiety disorder by reducing experiential avoidance and negative feelings. In this trial, participants who attended 12 therapy sessions also developed greater psychological flexibility than the control group.
ACT may also reduce the symptoms of stress and depression, according to a series of meta-analyses published in the Iranian Journal of Psychiatry. Most of the studies reviewed in this meta-analysis showed that ACT is just as effective as CBT.
A literature review published in the Journal of Medical Internet Research found that internet-delivered ACT can be effective for managing anxiety disorders. Additionally, the study reported high satisfaction rates among the participants who entered this program.
A systematic review featured in the journal Frontiers in Psychiatry confirms that ACT may benefit people aged 65 or over. As the researchers note, older adults show greater resistance to anxiety and depression treatment than their younger peers.
ACT may help improve the symptoms of these conditions in older adults, leading to a higher quality of life. In some studies, this form of treatment was better received and had a more significant impact on mental well-being than CBT and other types of therapy.
Freshour recommends it for the treatment of co-occurring conditions like substance use and post-traumatic stress disorder (PTSD), saying it’s a “versatile and powerful intervention.” What makes it so effective is its emphasis on psychological flexibility.
There’s also early evidence that ACT may help with obsessive-compulsive disorder (OCD), a mental illness affecting more than 2% of U.S. adults.
In one study, a patient with OCD experienced major improvements after just eight sessions of therapy. In another study, ACT reduced OCD symptoms in a 39-year-old patient who didn’t respond to medications.
But, as discussed earlier, ACT can benefit most people—not just those living with depression or anxiety.
“Acceptance and commitment therapy can help with life changes, break-ups, career stress, life stress, burnout, and chronic pain,” says Love. “This intervention would be great for someone who is introspective and practices yoga or meditation. You have likely already had experience and familiarity with mindfulness, self-compassion, and being the observer of your thoughts and feelings.”
Find Your Way to a Fulfilling Life
ACT can help you lead a fulfilling life by embracing your thoughts and emotions, no matter how painful they are. Through mindfulness and other practices, you’ll develop a greater sense of self and align your actions with your goals and values.
This short-term intervention may also help with depression, anxiety, OCD, substance abuse, and PTSD. But first, you have to reach out to a therapist who understands your needs.
Grow Therapy connects you with mental health professionals from all over the U.S. Browse our database to explore your options and find the right match. Book a session around your schedule and then meet your therapist in person or online so you can start creating the life you want.
