What is Acceptance and Commitment Therapy?

Table of Contents

• What is ACT?

• Six Core Processes of ACT

• What to Expect from an ACT Session

• What is ACT used to treat?

• Further Reading

• References

• Free 20 Minute Consultation with FP Counselling

Would you like to live a more rich, full, meaningful life? Would you like to live a life in accordance with your values? Would you like to learn how to become more mindful in your life and psychologically flexible? Then you might be interested in trying Acceptance and Commitment therapy, also known as ACT.

What is ACT?

ACT is considered part of a “third wave” of behavioural therapies, alongside Dialectical Behavioural Therapy (DBT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR). It is under the umbrella of Cognitive Behavioural Therapy (CBT) but it largely differs from CBT. The goal of ACT is to create a rich, full, and meaningful life guided by values whilst learning to accept the inevitable suffering that comes in life. Rather than a focus on trying to control or eliminate difficult thoughts and feelings, ACT aims to assist one to be able to allow, accept, and make room for difficult thoughts and feelings. 

The aim of ACT is not to eliminate symptoms but to change the relationship one has with their suffering, which often leads to a by-product of symptom reduction. ACT may seem counterintuitive upon first glance. You might find it strange that your therapist is telling you that the aim of therapy is not to get rid of your anxiety or depression, but it’s for good reason.

The more we tend to fight with or try to get rid of unwanted thoughts and feelings, the more we struggle with them. This process of struggling with our thoughts and feelings is called experiential avoidance in ACT. Often, typical coping strategies eliminate unwanted thoughts and feelings in the short-term, but rarely are they effective in the long-term and they can even be self-destructive. For example, using alcohol to calm oneself down might be helpful in the moment, but it’s unlikely to improve the person’s situation in the long-term and may even make them feel more anxious. Instead of getting rid of difficult thoughts and feelings, ACT aims to reduce the influence that unwanted thoughts and feelings have over our behaviours.

Six Core Processes of ACT

There are six core processes of ACT which make up a model called the Hexaflex. The Hexaflex model in ACT connects all six core processes which are each aspects of psychological flexibility. Each process in ACT has its own exercises, tools, skills, and metaphors that a therapist will use in session. These are the six core processes:

Cognitive Defusion (Watch Your Thinking)

Defusion means learning how to “step back” and separate from our thoughts, memories, and images. It’s a way of creating space between us and our thoughts so that we can mindfully choose how we want to respond to them.

Acceptance (Open Up)

Acceptance means making room for painful emotions, sensations, and feelings. It involves opening up and allowing the emotions to be rather than fighting, resisting, running from, or getting overwhelmed by them.

Self-As-Context (Pure Awareness)

Self-As-Context is the aspect of yourself that is aware of what we are thinking, feeling, sensing, or doing in any moment. It is the “you” that is aware of all of the thoughts and experiences that you have.

Values (Know What Matters)

Values are what you want your life to be about and what you want your life to stand for. They are the desired qualities that you choose to enact in your career, relationships, health, and other life domains. In ACT, being clear about your values is an essential step to creating a life that is meaningful.

Contacting the Present Moment (Be Here Now)

This means being psychologically present. It is a way of connecting with and engaging with our here-and-now experience by bringing our awareness to the physical world around us or the psychological world within us. It is the opposite of acting on “automatic pilot.”

Committed Action (Do What it Takes)

Committed Action means taking effective action guided by your values. It is doing the things that matter to you to create a more rich, full, and meaningful life. Committed Action sometimes means doing hard things that are worthwhile in the pursuit of having a meaningful life.

What to Expect From an ACT Session

Similar to other therapies, the therapeutic relationship between the therapist and the client in ACT is prioritized. There are efforts to create a compassionate, open, validating, and respectful therapeutic atmosphere by the therapist. ACT takes the stance that therapists and clients are fellow travelers on the same human journey and can both learn a lot from each other, thereby assuming that therapist and client are equals.

ACT tends to be an experiential therapy, meaning that your therapist may guide you through various experiential exercises to help you grasp the concepts and apply them to your life. A typical session in ACT might involve a mindfulness exercise, the use of metaphors, paradoxes, exercises to help you identify your values, and you will come away with tools to use outside of sessions. Your therapist will use these interventions to help you drop the struggle with your suffering and allow you to cultivate a new way of relating to it, so that it no longer has the same impact on your behaviour.

What is ACT Used to Treat?

ACT is considered an evidence-based treatment, which means that it has been shown to be effective in many peer-reviewed scientific studies. ACT has been shown to treat a large range of psychological disorders as well as personal issues that do not meet the criteria for a diagnosis of a psychological disorder. ACT has demonstrated effectiveness in treating anxiety disorders, depression, chronic pain, obsessive-compulsive disorder, psychosis, substance use disorders, body dysmorphic disorder, and more. ACT can also benefit individuals who are struggling with common life issues such as loneliness, low-self-esteem, existential angst, bullying, divorce, etc., or for those who simply want to learn tools to live a more rich, full, and meaningful life.

Further Reading and Free 20-Minute Consultation

There is a lot more to ACT beyond this brief blog post. If you are interested in learning more about the approach, here are some book recommendations for self-help:

• The Happiness Trap – Russ Harris

• ACT Made Simple – Russ Harris

• The Worry Trap – Chad LeJeune

If you would like to try ACT with a therapist, consider trying a free 20-minute consultation with our practice to see if we are the right fit for you.

References

A-Tjak, J.G., Davis, M.L., Morina, N., Powers, M.B., Smits, J.A., & Emmelkamp, P.M. (2014). A Meta-Analysis of the Efficacy of Acceptance and Commitment Therapy for Clinically Relevant Mental and Physical Health Problems. Psychotherapy and Psychosomatics, 84, 30 - 36.

Harris, R. (2009). ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy. Oakland, CA: New Harbinger.

Harris, R. (2011). Embracing your demons: an overview of acceptance and commitment therapy. Retrieved March 15, 2022 from https://www.psychotherapy.net/article/Acceptance-and-Commitment-Therapy-ACT
Hayes, S. (2021, August) State of the ACT evidence. Retrieved March 15, 2022 from https://contextualscience.org/state_of_the_act_evidence