Acceptance and Commitment Therapy

Acceptance and Commitment TherapyAcceptance and Commitment Therapy (or ACT, pronounced as the word, not A-C-T), is a comprehensive and empirically-supported model, developed by Steve Hayes, PhD and colleagues. ACT has nearly 200 randomized controlled trials (i.e., methodologically sound studies) supporting its efficacy for numerous life problems including, but not limited to, anxiety, depression, substance abuse, PTSD, weight issues, and chronic pain.

ACT promotes living a values-driven life and teaches strategies to help change our relationship to challenging life events and painful internal experiences (e.g., thoughts, feelings, sensations) that have the tendency to take us away from what matters. ACT does this through six core processes including acceptance, defusion, mindfulness, self-as-context, values, and committed action. These processes, described further below, are primarily taught through the use of metaphors and experiential exercises, which create a rich learning experience with imagery and direct experience.  ACT is active and collaborative and often incorporates out-of-session practice as well.

ACT’s Six Core Processes:

Acceptance: ACT views attempts to control or avoid one’s experiences as unworkable and part of the problem and views acceptance as the helpful alternative.  Acceptance involves an openness and willingness to allow the reality of situations and to experience one’s thoughts, emotions, and sensations as they are in each moment, not as we might want them to be. Opening ourselves up to these experiences can be uncomfortable–incredibly so at times–however, it is the bracing against them or attempt to avoid them that leads to prolonged suffering. Click on the link below to try an acceptance and willingness exercise.

Defusion: Defusion is the process of stepping back from our thoughts and noticing that we HAVE thoughts, we are not our thoughts. Defusion exercises serve to help distance ourselves from our thoughts and the meaning and importance we give to them.  An example of a defusion exercise might include noticing and labeling old thought patterns and referring to them as “playlists.” One playlist might be the “I’m not good enough” playlist and might have songs (thoughts) such as “they think I’m stupid,” “that person did better than me,” “if only I was…” By becoming aware of these thoughts and labeling and grouping them into a playlist, we are provided with some space as well as the choice to disengage from the chatter in our mind and re-engage in our lives.

Mindfulness: Mindfulness means purposefully paying attention to the moment you are in, without judgment (such as good/bad, better/worse). Mindfulness is one of those “simple but not easy” concepts and takes quite a bit of practice, as our minds love to wander to the past (e.g., how we’ve messed up, what we “should’ve” done) or the future (worry about our jobs, family, health, etc). Mindfulness exercises help train our minds and strengthen our ability to have influence and choice in what our mind focuses on–ideally the moment we are actually living!

Self-as-context: Imagine a picture of what you looked like as a baby or young child. And now imagine yourself on your 18th birthday. And on September 11th, 2001. And yesterday. And now imagine yourself right in this moment as you are reading this. There is a “You” that was present for each of these events. Self-as-context exercises serve to establish the perspective and a relationship with this “You” that has remained stable, constant, despite the various moods or life events that have happened.

Values: What do you want your life to be about? Who do you want to be as a spouse, parent, sibling, employee, friend? If you were your best self, how would you spend your free time? ACT considers a person’s values to be their “north stars,” the directions that they can move toward in any moment to live a full, meaningful, and values-based life (as opposed to using our ever-changing emotions and thoughts to guide our choices!).

Committed Action: Doing what matters! Committed action means taking steps toward one’s values, even when internal and external barriers or challenges arise. Therapy would help you determine short-term, medium-term, and long-term goals that help you move in the directions of your values, as well as, identify and work through the challenges or “bumps in the road” that inevitably show up along the way.

For additional information and resources, please see the following websites:

  1. The Association for Contextual and Behavioral Sciences
  2. The Happiness Trap