Acceptance and Commitment Therapy

What is Acceptance and Commitment Therapy (ACT)?

Acceptance and commitment therapy (ACT, typically pronounced as the word “act”) is a form of counselling and a branch of clinical behavioural analysis It is an empirically-based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways with commitment and behaviour-change strategies, to increase psychological flexibility. The approach was originally called comprehensive distancing. Acceptance and Commitment Therapy was developed in 1982 in order to create a mixed approach which integrated both cognitive and behavioural therapy. There are a variety of protocols for ACT, depending on the target behaviour or setting. For example, in behavioural health areas a brief version of ACT is called focused acceptance and commitment therapy (FACT).

ACT does not seek to eliminate difficult feelings; rather, the client is encouraged to be present with what life brings them and to move toward valued or desired behaviour. Acceptance and commitment therapy encourages people to open up to unpleasant feelings, and learn not to overreact to them, and not avoid situations where they are invoked. Its therapeutic effect is a positive spiral where feeling better leads to a better understanding of the individual’s own truth. In ACT, ‘truth’ is measured through the concept of ‘workability’, or what works to take another step toward what matters (e.g. values, meaning).

How does Acceptance and Commitment Therapy work?

ACT differs from traditional Cognitive Behavioural Therapy (CBT) in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to “just notice,” accept, and embrace their private events, especially previously unwanted ones. ACT helps the individual get in contact with a transcendent sense of self known as “self-as-context”—the you who is always there observing and experiencing and yet distinct from one’s thoughts, feelings, sensations, and memories. ACT aims to help the individual clarify their personal values and to take action on them, bringing more vitality and meaning to their life in the process, increasing their psychological flexibility.

What is Acceptance and Commitment Therapy used for?

ACT has been demonstrated to be effective for anxiety disorders, depression and addiction.

What can I expect from ACT?

The therapist in ACT is likely to employ six core principles to help clients develop, what is described as psychological flexibility. These principles are:

  1. Cognitive defusion: Learning methods to reduce the tendency to reify (or treat as fixed, real or concrete) thoughts, images, emotions, and memories.
  2. Acceptance: Allowing unwanted private experiences (thoughts, feelings and urges) to come and go without struggling or engaging with them.
  3. Contact with the present moment: Developing an awareness of the here and now, experienced with openness, interest, and receptiveness. (e.g., mindfulness)
  4. The observing self: Accessing a transcendent sense of self, a continuity of consciousness which is unchanging.
  5. Values: Discovering what is most important to oneself.
  6. Committed action: Setting goals according to values and carrying them out responsibly, in the service of a meaningful life.

What mental health issues is ACT most helpful for?

ACT has been demonstrated to be effective for anxiety disorders, depression and addiction.

When doesn’t Acceptance and Commitment Therapy work?

When the client suffers significant communication difficulties or organic or traumatic brain injury that significantly impact on cognitive function.

Things to consider before choosing ACT

The cost, training and experience of the therapist. Many might claim to have a understanding of this approach, but not undertaken specific training.

This content has been researched, prepared and written by Counselling in Melbourne psychologist Dr Malcolm Winstanley-Cross.

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