Introduced in the 1980s, acceptance and commitment therapy (ACT) is an approach designed to help a person overcome perceived negative thoughts and feelings in order to accept a greater sense of wellbeing and purpose. The Association for Contextual Behavioral Science further defines this practice as using acceptance and mindfulness strategies paired with commitment and behavioral approaches. The idea behind this is that our perceptions are largely influenced by our language, which can contribute to a certain degree of “psychological inflexibility.” Our experiences and thoughts associated with particular events can be changed by identifying and accepting those emotions or events and moving through them, not necessarily past them.
The goal isn’t exactly to forget or eliminate those negative feelings, thoughts, or events from our history but merely to understand and manage them.
Acceptance and commitment therapy isn’t meant to be a long-term treatment approach, but it is meant to teach a person coping strategies to employ on a long-term basis. Rather than conceptualizing the past and future through our perceived reality, ACT teaches a person to live in the present and enhance psychological flexibility.
Core Components of ACT
There are six main strategies or components to acceptance and commitment therapy. The first four, according to SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP), are considered approaches to mindfulness – that is, our awareness in how we perceive and process our thoughts and feelings. The latter two are strategies geared to change or alter behavioral actions.
- Acceptance. Being in the present requires letting our feelings happen and accepting them as they are. Rather than disseminate or eliminate our feelings and thoughts, ACT urges us to alter the way we manage difficult experiences. Part of the acceptance process lies in the willingness and readiness to experience certain emotions or events and resist the impulse to act. If a person with anxiety begins to feel anxious or panicked, that person would be encouraged to sit through that feeling and allow the anxiety to come and go without acting upon it.
- Cognitive defusion. Through cognitive defusion, we attempt to lessen our negative thoughts by altering how we view and describe certain events or feelings. Using negative language does shape the way we perceive things, so in using ACT one is encouraged to restructure the language used. For example, instead of saying “I am terrible” or “I am bad,” one is urged to say “I am thinking that I am terrible.” The way in which we word our emotions can have a lot to do with how we process those emotions.
- Being in the present. Many people avoid being in the present through a process called “experiential avoidance.” Experiential avoidance occurs when a person takes steps to avoid a particular situation or attempts to force the form or frequency of perceived negative events. A person with social anxiety disorder may take sometimes harmful steps to avoid being in the company of large crowds in order to avoid the overpowering anxiety he experiences.
Rather than focusing on the past or future, as we frequently tend to do, ACT tells us to focus on the experience occurring in the present.
This component correlates heavily with the two before it in such that it tells us to alter our language and way of thinking about thoughts, feelings, and events. Our language should be used to describe events or feelings, not judge or predict them. All too often do we find ourselves attempting to determine an outcome rather than identifying what is currently happening. A person with obsessive-compulsive disorder, for instance, may feel that if he does not turn the door handle exactly five times, he will experience something bad. The preoccupation with what might happen overtakes sensibilities and thoughts. This approach aims to help a person focus more on how he feels about the event occurring and not what has happened or will happen.
- Self as context.Through maintaining a sense of awareness, a person can be able to better cope with negative experiences of the present and past, allowing him to move forward with the future. By fostering a sense of acceptance, an individual can flow more easily through experiences without a sense of negative attachment.
- Values. Values in acceptance and commitment therapy comprise qualities of purposeful action. Sometimes a person can misrepresent feelings and values based on avoidance, compliance or fusion. For instance, a person might say “I should do this because my family wants me to,” thus placing the value on the family’s acceptance or approval rather than what that person truly values. The American Psychological Association notes that these shifts in values can cause a person to be psychologically inflexible. By identifying what one really values and the motives behind that worth, one can then work on building more flexibility.
- Committed action. By identifying our chosen values, a person can then take effective action in moving forward. This step helps an individual to align his values with identifiable goals that can be achieved. Committed action in ACT is akin to behavioral therapy in such that behaviors and actions are changed as a result of commitment to those values and goals.
Who Can Be Helped by ACT?
Acceptance and commitment therapy has been shown to be effective in helping those with anxiety, depression, substance abuse and stress. According to NREPP, ACT also helps to reduce symptoms of depressive disorders and the intensity of certain anxiety disorders like OCD, relieve distressing symptoms associated with psychotic episodes (such as delusions and hallucinations), and improve general mental health.
At FRN, we are proud to have expert clinicians and counselors on staff, and we employ up-to-date medical practices to help with mental health disorders. Suffering from depression, anxiety, or substance abuse is no easy experience, and we know and understand that. Through a variety of therapies, our staff can help you overcome and move through the negative experiences and emotions that plague your day-to-day life. Call us today to learn more about how we can help you.
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton