Acceptance and commitment therapy (ACT)

Written by Grow Therapy

Clinically reviewed by Grow Therapy Clinical Review Team

Acceptance and commitment therapy (ACT) is a form of talk therapy that emphasizes acceptance, staying present in the moment, and living life in line with your values. This therapy modality can be applied in many different ways, benefitting people with many types of mental health concerns. Pronounced as the word “act” rather than initials, ACT is considered a type of third-wave cognitive-behavioral therapy (CBT). This means it incorporates some principles of the older CBT while incorporating third-wave principles like mindfulness and acceptance.

What are the origins of acceptance and commitment therapy (ACT)?

American psychologist Dr. Steven C. Hayes developed acceptance and commitment therapy in the 1980s. His personal experience with panic disorder helped inspire the framework for ACT. Rather than creating another type of therapy that involves trying to change one’s thoughts, Dr. Hayes’ innovative approach focused on how we react to our thoughts, creating a much-needed fresh perspective.

When is acceptance and commitment therapy (ACT) used?

ACT is an evidence-based treatment commonly used for a wide range of mental health conditions, including:

However, the principles of ACT are useful for anyone dealing with any general life struggles or stressors. Additionally, ACT may be used to help people cope with physical health concerns such as chronic pain or other chronic, progressive diagnoses. ACT is most commonly used in individual therapy sessions, but it can also be applied in group therapy sessions.

How does acceptance and commitment therapy (ACT) work?

The goal of ACT therapy is to change your relationship with your thoughts, increase psychological flexibility, and encourage you to live a fulfilling life in line with your values. ACT is based on relational frame theory (RFT), which was also developed by Dr. Hayes.

ACT is based on the idea that psychological suffering doesn’t come from having distressing thoughts and emotions; it comes from trying to control or avoid those thoughts and emotions. Instead, ACT helps people build psychological flexibility by accepting their internal experiences while taking actions that align with their values.

There are six core processes of ACT that help it work so well. When these principles are all practiced together, you can experience greater mental well-being and function in everyday life despite the presence of symptoms. These six principles are:

  • Acceptance – Accepting difficult emotions and thoughts rather than trying to push them away or change them. Ultimately, pain and hardships are an unavoidable part of life. You can’t change this, but you can change how you react to the situations and what actions you take. You’ll learn to accept that you will have a wide range of emotions and thoughts–but you also have the power to not let these emotions and thoughts control you.
  • Cognitive defusion – The practice of detaching yourself from your thoughts rather than assigning meaning to the thoughts or getting swept up in them. You will learn to look at thoughts as just that–thoughts. Cognitive defusion allows you to mindfully notice thoughts and let them go.
  • Self-as-context – Takes cognitive defusion to the next level, looking at yourself with a broader lens, knowing that your thoughts or feelings do not define you. This practice involves the “observing self”–the fact that you are an observer of your thoughts and feelings.
  • Being present – A key aspect of mindfulness, and thus ACT. This is all about being in the present moment, focusing on the here and now rather than ruminating on past experiences or future worries.
  • Values  – Your values are the most important driving forces in your life. An ACT therapist will help you determine what your core values are, and help you stay in line with these values so you can live a meaningful life.
  • Committed action – This puts the “act” in acceptance and commitment therapy. It refers to actively making changes and taking actions in line with your values to make positive changes in your life–no matter what other struggles you’re facing.

What is acceptance and commitment therapy (ACT) like?

ACT consists of weekly therapy sessions, typically around an hour long. There is no set time frame for how many sessions of ACT you’ll need, but some research suggests that 12 to 16 sessions are effective. The duration of therapy will depend on what mental health concerns you’re addressing. In general, therapy may take longer if you have co-occurring conditions.

Since ACT is a form of psychotherapy, also known as talk therapy, you can expect to do a lot of talking in sessions. Over the first couple of sessions, you and your therapist will build rapport. Your ACT therapist will ask questions to get to know you and understand your struggles.

In some cases, an ACT therapist might combine its principles with other therapeutic interventions. For example, ACT can be used in conjunction with dialectical behavior therapy (DBT) since both are mindfulness-based and stress the importance of acceptance.

Sessions may include:

  • Talking about your thoughts and feelings
  • Examining your thought patterns and how you react to them
  • Learning about mindfulness and practicing mindfulness exercises
  • Setting goals for treatment and life in general
  • Determining your personal values
  • Combatting experiential avoidance (attempts to avoid negative thoughts and feelings)
  • Learning how to truly practice acceptance

Everything you do in ACT sessions has a shared goal: developing psychological flexibility, or the ability to be aware of and open to your thoughts and feelings while acting in line with your values. This means you accept your state of being and internal experiences in the present moment rather than try to fight or resist and push forward, keeping in mind what’s most important to you.

Is acceptance and commitment therapy (ACT) effective?

ACT has been evaluated in several randomized controlled trials to ensure that it’s effective. These studies have shown that ACT helps people with a variety of conditions such as anxiety, depression, substance use, and pain. Research has also shown that ACT works well with adolescents as well as adults, and caregivers of children with mental or physical illnesses.

How to find a therapist who practices acceptance and commitment therapy (ACT)

If you think acceptance and commitment therapy might be right for you, it’s important to speak with a licensed and experienced clinician. There are many types of mental health care providers who practice ACT, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more.

On top of finding someone specializing in ACT, you want to make sure they meet your other needs. For example, if you struggle with an anxiety disorder, you’ll want to find an ACT therapist who also specializes in treating anxiety. In addition, finding a therapist who accepts your insurance can make therapy much more affordable.

You can find a therapist who accepts your insurance and specializes in ACT by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Acceptance and commitment (ACT)” from the “Treatment methods” drop-down.

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This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.