Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that has been gaining popularity over the past few years. As opposed to other therapies that help individuals learn to challenge uncomfortable thoughts, feelings, or experiences, ACT helps people accept these moments as difficulties that come with life. ACT’s overarching philosophy advocates that discomfort will come and go throughout life. We can either choose to struggle against them or try to accept them and instead strive to commit to actions that align with our personal values. The focus of ACT is, therefore, not solely on reducing discomfort but instead on increasing psychological flexibility and living a meaningful life, even in the presence of discomfort or pain.
There are six key components of ACT. All of these principles are aimed at helping develop ‘cognitive flexibility,’ which can be defined as the ability to contact the present moment more fully as a conscious human being and to change or persist in behavior when doing so serves valued ends. This skill is important not only in reducing suffering but also in living meaningfully, according to the ACT model. The Six techniques of ACT are the following:
- Acceptance: Acceptance is taught as a means to counter ‘avoidance.’ When faced with discomfort, we often try to change, avoid, or escape these experiences, which can create greater difficulty than just accepting them as they are. Instead of avoidance, ACT promotes acceptance as a means to experience your thoughts and feelings. In therapy, ACT clients are given tools and strategies on how to work with the discomfort rather than challenge or avoid it.
- Cognitive Defusion: Cognitive defusion techniques attempt to help you change how you relate to your thoughts. Often when we have negative thoughts, we can get ‘caught up’ or ‘fused’ to them. We can’t let them go, and instead they dominate our mental life. Instead of getting caught up in your thoughts or seeing them as facts, ACT strives to help you ‘de-fuse’ from your thoughts, learning to view them as just words or mental events that don't have to control your behavior.
- Being Present: ACT helps you develop mindfulness as a skill. Mindfulness is the practice of being intentional and of being fully engaged in the here and now. By being present, you learn to accept your thoughts and feelings and view them without judgment. You also try to focus on the present moment rather than dwelling on past conflicts or worries about the future. ACT describes this stance as being a ‘self-as-process,’ where one practices observing one’s mind and feelings from a defused, nonjudgmental space.
- Self-as-Context: ACT encourages clients to understand that one’s sense of self, or the inner ‘I’ is not an objective, stable construct. Instead, our sense of selves exists in relationship to others, the environment, and our own history. The sense of self is, therefore, constantly moving and shifting. As such, ACT encourages you to try not to identify yourself as your experiences ("I am sad"), and instead learn to view them as events that happen to you ("I am noticing sadness").
- Values: In ACT, you learn that your values are not objects that can ever be obtained but are instead qualities and principles you can choose to embody in each and every moment. In ACT, you explore what truly matters in your life, such as relationships, health, or personal growth, and use these values to guide your actions. You will also explore how different values may conflict with each other and how to resolve situations where understanding your values differs.
- Committed Action: In ACT, you learn how to commit to and take effective actions that align with your values, even when it is difficult. It’s about setting goals and making choices that reflect what’s meaningful to you, despite challenges or discomfort. You may learn in ACT how to utilize effective behaviors or skills to help take actions that better align with your values.
In ACT, the therapist incorporates all six of these concepts to help you overcome obstacles and discomfort while living a meaningful life consistent with your values. Although therapists may utilize some of these techniques in other therapies, ACT in particular, makes use of the following techniques to help you develop these skills:
- Exploration of Values
- Mindfulness Exercises
- Behavioral Strategies
- Cultivating an Ongoing Practice through Homework
ACT has been found effective for both adults and children, and evidence suggests it helps treat issues related to anxiety, depression, trauma, stress, and medical conditions such as chronic pain or chronic illness. It may also be of particular use for adolescents currently exploring their own sense of self and identity and may benefit from learning how to take effective actions that align with their emerging values. If you are interested in learning more about ACT or related therapies, you can contact Dr. Robokos to discuss resources that may be useful for you or your family.