Understanding Acceptance and Commitment Therapy

Acceptance and commitment therapy is a mindfulness-based behavioral therapy that stands out against many of the popular cognitive-behavioral theories that exist in the field today. This type of intervention focuses on the use of mindfulness along with other behavioral skills working in tandem with exercises based on an individual’s experience. Acceptance and commitment therapy (ACT) is an evidence-based practice that is used to address a wide range of mental and behavioral health conditions. 

The History of Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy was founded in 1986 by psychologist Dr. Steven Hayes. It is rooted in several theories that existed prior, the main of which being the Relational Frame Theory. Hayes’s theories worked against popular cognitive-behavioral models that were and continue to be one of the main psychological approaches of our time. Where CBT operates under the assumption that thoughts and feelings are something that needs to be controlled or managed, ACT theories suggest that feelings are normal and that some methods of controlling them are damaging to one’s mental health. In other words, CBT works to reframe thoughts where ACT works to transition a person away from those thoughts. 

What Situations Might ACT be Used in Therapy?

Acceptance and commitment therapy is used to treat a variety of conditions including: 

  1. Depression
  2. Anxiety
  3. Obsessive-Compulsive Disorder
  4. Psychosis
  5. Substance Abuse 
  6. Stress
  7. And more

Core Flexibility Processes of ACT

Acceptance

Rather than avoid difficulty, acceptance, and commitment therapy teaches clients to do just that, accept it. ACT theorizes that difficulty, conflict, and suffering are all natural parts of life and that avoiding it will not help us get past it. The instinct of most psychological pain is to stop it or steer themselves around it. Acceptance is meant to teach clients nearly all psychological pain is a temporary experience. 

Cognitive Diffusion

Cognitive diffusion is where ACT differs most from traditional CBT techniques. This is the process of distancing yourself from your own thoughts rather than reframing them. This is not the same as avoiding them, instead, cognitive diffusion aims to change how one interacts and engages with their thoughts. For example, acceptance and commitment therapy might be applied in a situation where someone is having a self-destructive thought. Distancing or diffusing your reaction to that thought is cognitive diffusion. Instead of getting upset about your thought, you accept that it happened and move on from it. 

Presence

The overall goal of acceptance and commitment therapy is to help individuals gain flexibility in how they react to situations and how they interact with conflict. As struggles, conflicts, and problems occur in our life, we are able to adjust as those things happen rather than be stonewalled by them. The hope of ACT is to give clients the tools they need to view their life objectively and engage in mindfulness. 

Self-as-Context

ACT goes on to theorize that individuals focus too much on themselves and their own thoughts. This therapy aims to remove “I” language and replace it with objective language. For example, If a person were to have a thought come through their mind that suggested they will always be alone, an ACT response would be “I just had a thought about being alone” instead of the “I” response of “I am always going to be alone.” Changing the language also creates distance from the thought and how we view ourselves. 

Values

Everyone has values or principles/standards for behavior. These are qualities and actions that ACT suggests can be used to help a client make decisions about their life. ACT theories operate under the assumption that adhering to our personal values brings fulfillment. The use of presence, cognitive defusion, and acceptance help an individual find the path to adhere to their values rather than be consumed by what is troublesome in life. 

Committed Action

Acceptance and commitment therapy starts with acceptance and ends with committed action. Committed action is the process of following through with the previous steps. This means dedicating your behavior toward accepting conflict as it occurs, distancing yourself from troublesome thoughts, being present and mindful, and adhering to the values you hold close. 

It is the job of the therapist to guide their client through these 6 processes and help them build flexibility in their behavior and thought patterns so they can manage the difficulties that come with being human.

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