Acceptance and Commitment Therapy
Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT—pronounced like the verb act) is a third-wave cognitive-behavioral approach. The creator, Stephen C. Hayes, discovered its promising effects while battling debilitating panic attacks. ACT has been, and continues to be, extensively studied (with over 1,000 peer-reviewed studies) and has been shown to be effective for a variety of mental health conditions such as anxiety disorders, depression, stress, burnout, substance use disorders, eating disorders, and managing emotions related to chronic pain. Sounds amazing, right? So, let me break it down for you!
Acceptance and Commitment Therapy is based on the idea that trying to control negative or painful thoughts and feelings may not be helpful—in fact, it might even be counterproductive! ACT proposes that instead of attempting to manage, control, fix, or change these painful experiences, we need to understand them as natural responses to situations that shouldn’t prevent us from living our lives.
ACT proposes that the most important skill for fostering mental well-being is psychological flexibility. Psychological flexibility is the ability to stay present, fully noticing all our emotions, sensations, and thoughts—including unpleasant ones—while moving toward behaviors that align with our chosen values. Simply put, it’s about being present and adjusting our thinking and behavior when they no longer serve us.
ACT aims to promote psychological flexibility through six core processes:
1. Acceptance
Acceptance involves acknowledging and welcoming the full range of the human experience—thoughts and emotions—without trying to avoid or change them. For example, instead of pushing away anxiety before a big presentation, ACT teaches us to acknowledge it and move forward anyway.
2. Cognitive Defusion
Cognitive defusion helps us detach from distressing thoughts and feelings instead of reacting automatically to them. One way to defuse upsetting thoughts is to write them down repeatedly until they lose their emotional intensity.
3. Being Present
Being present means fully engaging with your current thoughts and feelings without worrying about the past or future.
4. Self as Context
Self as Context is the idea that we are more than our thoughts, feelings, and experiences. Instead of thinking, “I am anxious and afraid, which means I am weak,” you learn to see anxiety and fear as temporary experiences, while your core self remains unchanged.
5. Values
Values act as our compass in ACT. Each person has unique personal values, and the goal is to live and behave in alignment with them, rather than making decisions based on short-term discomfort or fear.
6. Committed Action
Committed action involves taking concrete steps to change our behavior so that it aligns with our values and allows us to lead a more fulfilling life.
What to Expect in Therapy
Choosing ACT is a meaningful step toward a life guided by values rather than fear or avoidance. A therapist trained in ACT will help you understand that all thoughts and emotions, including negative ones, are part of the human experience. Instead of fighting them, ACT teaches you how to move with them.
ACT is a homework-based (or experiential practice-focused) approach. This means your therapist might ask you to practice mindfulness exercises, try new behaviors, or reflect on how your actions align with your values in daily life. Change takes time, and above all, practice.
Working with a trained therapist can provide support and accountability, making it easier to apply these principles.
If you're curious about ACT, consider reaching out. The goal isn’t to get rid of difficult emotions, but to build a life where they don’t control you.
Bibliography
A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J., & Emmelkamp, P. M. G. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy (ACT) in treating anxiety and depression in nonclinical and clinical populations. Behaviour Research and Therapy, 77, 63–78. https://doi.org/10.1016/j.brat.2015.12.004
Powers, M. B., Zum Vörde Sive Vörding, M. B., & Emmelkamp, P. M. G. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 78(2), 73–80. https://doi.org/10.1159/000190790
Hayes, S. C. (2019). A liberated mind: The essential guide to ACT. Avery (Penguin Publishing Group).
