Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that focuses on accepting what is out of personal control, committing to action that improves and enriches life, and recognizing the importance of living according to one’s values. ACT aims to create psychological flexibility, that is, the ability to contact the present moment fully as a conscious human being and to change or persist in behavior in accordance with chosen values.
The theoretical and philosophical roots of ACT can be traced back to the 1980s when its principles started to take shape within the field of behavior analysis. The therapy grew out of Relational Frame Theory (RFT), a theory of human language and cognition, and it’s one of the so-called “third wave” of cognitive-behavioral therapies. Steven C. Hayes, Kelly G. Wilson, and Kirk Strosahl are widely recognized as the founders of ACT. It’s been subjected to a significant amount of empirical research and has been shown to be effective for a variety of psychological disorders.
ACT posits that psychological suffering is usually caused by experiential avoidance, cognitive entanglement, and resulting psychological inflexibility that lead to a failure to take needed behavioral steps in accord with core values. ACT aims to reverse these conditions and thus alleviate suffering, not by eliminating difficult feelings or situations, but by transforming our relationship with these challenges.
ACT includes six core processes that contribute to its therapeutic effects:
- Contact with the Present Moment: This involves awareness of the here-and-now, experienced with openness, interest, and receptiveness.
- Cognitive Defusion: Learning to perceive thoughts, images, memories, and other cognitions as what they are – mere thoughts – and not what they seem to be – threatening truths.
- Acceptance: Making room for unpleasant feelings, sensations, urges, and other private experiences; allowing them to come and go without struggling with them.
- Observing the Self: Accessing a transcendent sense of self, a continuity of consciousness that is unchanging.
- Values: Discovering what is most important, what truly matters – deep in the heart.
- Committed Action: Setting goals, guided by the defined values, and taking effective action to achieve them.
Mindfulness practices are a key part of ACT. The therapy utilizes mindfulness techniques to develop psychological flexibility. Mindfulness in ACT is not about emptying the mind, but rather about helping individuals stay in contact with the present moment and carry out values-based actions, even when difficult thoughts and feelings arise.
Values clarification is a significant part of ACT, helping individuals determine what truly matters to them in life. It allows them to set life directions based on these values and motivates them to carry out behaviors consistent with these values. Such values-driven actions enable individuals to lead meaningful and fulfilled lives despite the presence of pain and stress.
ACT can be integrated with other therapies such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and mindfulness-based cognitive therapy (MBCT). These therapies all aim to modify the relationship between an individual and their thoughts, which is also a key goal of ACT. While ACT has its distinct characteristics, its principles can be integrated into other therapeutic models to enhance their effectiveness.