Acceptance and Commitment Therapy
Be present, do what matters, and open up. These are the core processes that we facilitate in clients through the Acceptance and Commitment Therapy framework (shortened to ACT, which is said as ‘act’ as opposed to A-C-T).
What is ACT?
ACT comes under the umbrella of cognitive behavioural therapies, in that it is an empirically supported treatment, and it targets cognition to influence behaviour change. ACT differs from tradition cognitive therapy - now more commonly referred to as Cognitive Behavioural Therapy or CBT - in that the content of thoughts are not necessarily explored, nor are techniques such as restructuring thoughts taught. Rather, in ACT we aim to teach clients through experiential exercises, to change their relationship with difficult thoughts, emotions, and physical sensations, and instead open up to their experience, be present, and move toward what matters, to live a more meaningful life.
When we are focused on difficult experiences, we have inflexible attention - we are distractible, disconnected, and disengaged. We are often behaving in ways that are unworkable, and not moving toward a life where we live by what we value. We may be fused with memories of the past and worries about the future, as well as beliefs about the self, the world, and others, which can make living a meaningful life difficult.
In ACT, psychological difficulties are understood to be caused by what is referred to as experiential avoidance, which is where we try to avoid or get rid of difficult thoughts, emotions, or physical sensations. Although it may seem that such avoidance techniques work - at least in the short term - in the long term they often do not continue to work, and further suffering may be created. For example, someone who avoids social situations because such situations are anxiety-provoking, will find that over time social situations become even more anxiety-provoking, as they have not been exposed to such situations. Not only that, but they will become less skilled in socialising, and so feared outcomes (such as embarrassing themselves by behaving awkwardly) may become more likely, the more the situations are avoided. Avoidance does not actually ‘get rid of’ the problem, it only causes short-term relief.
In ACT we work to identify these unhelpful processes, and teach skills to help clients to be in contact with the present moment, and defuse from thoughts - step back and watch thinking, rather than get caught up in it. We teach clients to accept the experience of difficult emotions and bodily sensations, and learn how to make room for them. Rather than being fused with their self-concept and thinking mind, clients learn to observe their experiences with awareness and attention. We work with clients to connect with their values, and then take action to work toward them.
ACT can be delivered in a structured or an unstructured way, and in both group and one-on-one settings. Therapy duration varies depends on how it’s delivered, and on the client’s presentation.
Who is ACT suitable for?
Research has shown ACT to be beneficial for the following (but not limited to):
Anxiety disorders (APS, 2018; Twohig & Levin, 2017)
Depression (Twohig & Levin, 2017; Zhenggang et al., 2020)
Chronic pain (Hughes et al., 2017; Veehof et al., 2016)
Insomnia (Salari et al., 2020; Zakiei et al., 2021)
Substance Use Disorder (Osaji et al., 2020)
Psychological and physical distress in cancer patients (Huiyuan et al., 2021; Zhao et al., 2021)
ACT has also been shown to improve academic performance, increase psychological flexibility, and reduce suffering (Gloster et al., 2017; Paliliunas et al., 2018).
ACT may suit clients who are interested in exploring their values, cultivating meaning in their life, and learning to live in the present moment. For clients who are suffering from difficulties where challenging the content of their thoughts is not appropriate or not effective, ACT may be a suitable therapy to facilitate openness and acceptance of their experience. ACT is an experiential form of therapy, so it is also suited to those who would like to engage with practical tools that they can use independently to help them with difficult situations, thoughts, and emotions.
If you would like to know more…
The Happiness Trap by Russ Harris - now in its second edition - is an excellent book to get you started if you are interested in learning more. He offers an online course, and there are some sample chapters of this book located under Free Resources on this website.
I am trained in Acceptance and Commitment Therapy, and offer this style of therapy to clients. If you are interested in learning more or booking a session with me, click here to get in touch.
