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What is Acceptance and Commitment Therapy?

Acceptance and commitment therapy is an effective skill-based treatment for anxiety and other problems. Learn the basics of ACT and its benefits.

Overview of Acceptance and Commitment Therapy

Acceptance and commitment therapy, known as ACT, combines traditional behavioral and cognitive behavioral therapy that emphasizes acceptance in treatment.

Developed in the 1980s by Steven Hayes, ACT therapy teaches individuals to no longer run from their problems and discomfort. Instead, acceptance and commitment therapy teaches individuals to accept their negative feelings and then commit to changing their lives to improve their conditions.1
Acceptance and Commitment Therapy

Understanding the Key Concepts of ACT

Acceptance and commitment therapy is based on the fundamental concepts of mindfulness and acceptance. Acceptance therapy is rooted in the belief that discomfort, grief, anger, and stress are all unavoidable parts of the human condition. Rather than running from discomfort, acceptance therapy asks individuals to accept their thoughts without judgment. Then, individuals can address them and make changes to better their lives.

Acceptance and Commitment Therapy (ACT)

ACT psychology can be summarized by using the acronym ACT, which can also stand for:
  • Accept thoughts and feelings and be present
  • Choose a valued direction
  • Take action

Examples of Acceptance and Commitment Therapy

Acceptance and commitment therapy differs from other therapies because it is not symptom or experience focused. Instead, ACT focuses on the individual’s responses to inner experiences, and the internal dialogue surrounding them. For example, an individual being treated for depression using ACT may come into the session wanting to address their symptoms of sadness, fatigue, and lack of motivation.

Surrounding Symptoms

Rather than just looking at the symptoms, the ACT therapist will explore the behaviors surrounding them and what you do when they arise. For example, the individual gets back into bed and stays there all day in response to their depression symptoms, which may be worsening. Instead, these response behaviors are explored to see how they affect the quality of life and the experience of symptoms.
Through therapy, values are also explored, and the therapist works with the client to define what is meaningful to them so that they can engage in behaviors that are supportive of their values as a response instead.

How Does Acceptance and Commitment Therapy Work?

Acceptance and commitment therapy works by expanding psychological flexibility and increasing emotional openness. By accepting and addressing negative emotions rather than trying to suppress or control them, individuals can begin changing things within their control. Individuals learn mindfulness skills to become aware of their thoughts. These skills can then be translated to real-life situations. Individuals are also encouraged to accept negative emotions to build a richer and more meaningful life.

Core Processes of ACT Therapy

There are six core processes of ACT therapy. These processes are skills that help individuals gain psychological flexibility, move through difficult emotions, and help individuals cultivate the life they want. These processes include: 2
  • Acceptance: An active process of allowing your inner thoughts and feelings to occur without trying to control them or change them.
  • Direction: Examining your life and taking a new direction to facilitate positive changes
  • Being Present: Staying mindful of your surroundings and external experience, rather than living in your head or fixating on emotion.
  • Self as Context: Learning to see your thoughts about yourself as separate from your actions. You are more than your thoughts, actions, feelings, and experiences.
  • Values: Defining what is important to you and creating guidelines to live by based on values
  • Committed Action: Being willing to take concrete steps to align yourself more closely with your values and sticking to it.

What Can ACT Help With?

ACT Therapy can help with several mental health conditions and is an effective treatment. Stress regulation, OCD, anxiety, depression, chronic pain, and substance abuse can all be treated with acceptance and commitment therapy.

Stress Regulation

ACT psychology can help reduce stress by asking individuals to change their relationship to their obsessive thoughts or anxious feelings. The mindfulness component encourages individuals to pause and look at their experiences and thoughts and evaluate them. ACT therapy also aims to increase psychological flexibility, which is important in stress regulation.

OCD

ACT acceptance can help individuals with obsessive compulsive disorder (OCD) and obsessive compulsive spectrum disorders. Individuals struggling with OCD and its related disorders can see improvements and a reduction in symptom severity in as little as three months. 3

Anxiety

Acceptance and commitment therapy is effective in treating anxiety and generalized anxiety disorder (GAD). In a recent study on individuals with GAD, 77% no longer qualified for a GAD diagnosis after treatment with acceptance and commitment therapy.

Depression

ACT argues that experiential avoidance is a major psychological process in depressive disorders. Experiential avoidance is an unwillingness to remain present with private experiences, paired with attempts to escape or avoid these events and experiences.
Experiential avoidance is not an approach that leads to long-term solutions and tends to prolong problems. ACT works to decrease experiential avoidance and can lead to a reduction of symptoms of depression. 4

Chronic Pain

ACT can also be helpful for individuals with chronic pain or long-term conditions. Acceptance and commitment therapy helps decrease pain interference and disability symptoms, depression, and pain-related anxiety. 5

Substance Abuse

Acceptance and commitment therapy can help manage substance use disorders. ACT encourages individuals to accept their urges and symptoms associated with substance use. Additionally, psychological flexibility and value-based interventions reduce urges and symptoms. 6

Structure of an ACT Therapy Session

While acceptance and commitment therapy have no set structure. The ACT therapist typically will first familiarize themselves with your worldview by building rapport with you. Next, they will help you develop a deeper awareness surrounding the problem. The therapist will also help you identify your core values to take better action in the future and set goals to improve your life. 7

Building Rapport

Initially, the ACT therapist will take some time to get to know you and familiarize themselves with your worldview. By asking questions and allowing you the space to share, the ACT therapist will better understand your past and present experiences with mental health. At this time, your past and current strategies will be explored to better understand your approach to problem-solving.

Deeper Awareness

Once a relationship is established, the therapist will help you work to gain a deeper awareness and understanding of the discomforts you are facing in your life. Using mindfulness techniques, the therapist will also help you identify self-talk surrounding yourself and your life. Doing this will teach you how to identify with your observing self. This will allow you to accept life’s difficulties rather than avoiding them or fighting them.

Core Values

Acceptance and commitment therapy also helps you connect with your core values and determine what is truly important in your life. Without clear values or confusion about goals, it can be difficult to be psychologically flexible.8
Identifying what sort of person you want to be, what is significant, and what you want from your life is a powerful first step in changing it. Knowing your values first allows you to set goals and commit actions.

Actions

Guided by your values, the therapist will work with you to set attainable goals in relation to them to create the life you want. In this phase, accepting what cannot be changed is balanced by action for things you can. Many things in life are flexible and can be shifted with conscious effort. Working with a therapist will help you identify the things you can change and start taking steps to do so.

Commitment

Acceptance and commitment therapy asks individuals to commit to self-compassion and meaningful action. Additionally, individuals are asked to give up on fighting or denying one’s emotional states and rather find opportunities for further self-exploration and empowerment.

Benefits of Acceptance and Commitment Therapy

There are many benefits of ACT, and it has many potential uses. ACT helps individuals enrich their lives, increase resilience, and become more psychologically flexible. Additionally, ACT counseling teaches individuals to use their mental resources effectively and gain the ability to accept negative experiences as a part of the human condition.

Focuses on Enriching the Lives of People

Like many other therapies, ACT is goal based and aims to empower individuals to better their lives. Core values are identified, and their goals are set to prioritize them. The focus of ACT is to help individuals accept the things they cannot change and find the courage and discipline to change what they can.

Recognize and Adapts to Situational Demands

ACT provides individuals with the tools to recognize and adapt to situational demands. Mindfulness techniques incorporated into ACT allow individuals to pause and think about their path of action rather than just reacting.

Helps In Becoming More Psychologically Flexible

ACT increases psychological flexibility. Psychological flexibility is the ability to be present at the moment, maintain awareness of thoughts and feelings without being controlled and respond in a way that honors personal values and goals. Increased psychological flexibility is important in cultivating resilience and building a happy, well-balanced life.

Uses Mental Resources Effectively

Rather than getting lost in rumination or being dragged around by your feelings, acceptance and commitment therapy training teaches individuals to use their mental resources effectively. Individuals are taught to identify their thought processes and then examine them.
Individuals are taught to evaluate their thought processes to determine if they are in alignment with the life they are trying to create. Freeing yourself from destructive patterns also frees up your mental resources and creates room for healthier thought patterns.

Acknowledges Negative Experiences as a Part of Life

The key takeaway from ACT is that suffering and negative experiences are a part of the human condition and are unavoidable. ACT teaches individuals the art of acceptance so that they can handle life’s difficulties with grace.

What is Unique to Acceptance and Commitment Therapy?

Acceptance and commitment therapy techniques differ from those of other conventional therapies. Unlike other Western psychotherapies, symptom reduction is not an explicit goal of acceptance and behavioral therapy. However, the techniques used in acceptance and commitment therapy lead to symptom reduction as a byproduct of the shift in the individual’s focus.
Acceptance and Commitment Therapy

Healthy Normality

Most western psychology is founded on the concept of healthy normality: psychologically healthy humans with a healthy environment and lifestyle will naturally be happy and content. Healthy normality asserts that psychological suffering is abnormal and a function of disease.
ACT challenges this claim, as while almost 30 percent of the adult US population will suffer from psychiatric disorder; there are many causes of psychological suffering that are not rooted in a clinical illness. For example, loneliness, boredom, meaninglessness, and low self-esteem can be causes of psychological distress. Additionally, pain associated with issues surrounding race, sexism, bullying, violence, and divorce are all causes of psychological suffering.

Destructive Normality

Instead of accepting the concept of healthy normality, ACT provides an alternative assumption about human psychological processes. ACT recognizes that the psychological processes of a normal human mind have the potential to be destructive and lead to psychological suffering. ACT also maintains that it is important to understand these processes and work within them to gain insight.

Experiential Avoidance

ACT also maintains that a major cause of human suffering is experiential avoidance. Experiential avoidance is a form of problem-solving. When we approach a problem or something we don’t want in the material world, we figure out a way to get rid of it or avoid it. However, this approach does not work so well in the interior world.
Avoiding unpleasant emotions or thoughts creates more work and suffering in the long run. Rather than running from their private experiences, individuals are encouraged to create space and experience them through therapeutic interventions.

Therapeutic Interventions

Through ACT, individuals learn how to stop fighting their experiences. Instead, they are encouraged to allow them, open them up, and make room for them, allowing them to come and go without struggle. ACT interventions focus on developing an acceptance of unwanted private experiences that are out of personal control, and instead creating a commitment and acting toward living a valued life. This way, acceptance and commitment therapy interventions improve quality of life.

Confronting the Agenda

Many individuals who try acceptance and commitment therapy have an agenda to learn emotional control rather than acceptance. Part of the therapeutic process is asking the client to identify past problem-solving techniques and assess each method. They are asked to assess if the method they chose reduced symptoms in the long term, questions related to costs, and if it ultimately brought them closer to the life they want to live.
Through this, the client learns to recognize that strategies based on emotional control are ultimately ineffective and are often the root of the problem.

Control is the Problem, Not the Solution

Attempting to control negative emotions is often not fruitful and tends to create more suffering. This is because if someone is fixated on trying to avoid difficult feelings, the more overwhelming they will be.
Individuals are taught to hold space for their negative experiences and feelings, to work through them, and then let them go. This way, rather than being overwhelmed or dragged by the emotional experience, they flow with it instead.

Get Acceptance and Commitment Therapy At Alta Centers

If you are ready to stop running from your life, and start accepting and changing it, Alta Centers can help. Our trained medical professionals will help create a unique acceptance and commitment therapy session plan that works for you. Contact us today.