I use Acceptance and Commitment Therapy (ACT), also known as Acceptance Therapy, to help clients develop psychological flexibility—the ability to be present, open up to unpleasant feelings, and take actions aligned with their values. ACT therapy is often an approach that is combined with other Humanistic approaches and is considered a core “third wave therapy“. This approach is quite flexible and easy to deliver virtually and in person, and most people find that it leaves them with a helpful toolkit of strategies to use when stresses recur or barriers pop up. Thus, this approach can be relatively short-term and solution-focused.
Acceptance and Commitment Therapy can work well with couples and families, and I also use it in some specialty work, including Fear of Flying and Public Speaking Anxiety. This approach can be delivered virtually and in person.
Acceptance and Commitment Therapy Key Features
Here’s a breakdown of ACT’s key components:
- Acceptance: Acknowledging and accepting one’s thoughts and feelings rather than trying to suppress or eliminate them. This doesn’t mean liking or agreeing with those thoughts and feelings but rather allowing them to exist without struggling against them.
- Cognitive Defusion: Learning to see thoughts as what they are—just thoughts—rather than as facts or instructions. It involves distancing oneself from unhelpful thoughts by recognizing that they are mental events, not necessarily accurate representations of reality.
- Being Present: mindfulness practice and being fully aware and engaged in the present moment without judgment. This helps individuals observe their thoughts and feelings without getting entangled.
- Values Clarification: Identifying what matters most in life, clarifying personal values, and setting goals aligned with those values. This step helps individuals understand what they truly want and stand for.
- Committed Action: Taking purposeful actions that align with one’s values, even in the presence of discomfort or difficult thoughts and emotions. This involves setting specific, achievable goals and committing to behavioral changes.
Acceptance and Commitment Therapy encourages individuals to embrace their thoughts and feelings while moving toward a meaningful life. It can be a powerful and effective approach for many people, one with lasting benefits.
Acceptance Therapy Techniques
Here are some key techniques used in Acceptance and Commitment Therapy:
Mindfulness in Acceptance Therapy
Mindfulness techniques are central to ACT therapy. I’ll help you observe your thoughts, feelings, and sensations non-judgmentally, allowing you to create psychological distance from your challenges and barriers. We might do some cognitive defusion work described above during these exercises. One technique I often use is repeating a distressing thought until it loses its impact or mentally singing it in a funny voice. We’ll also practice mindful breathing, body scans, and mindful eating to increase present-moment awareness and reduce reactivity to thoughts and emotions.
Self-as-Context in ACT Therapy
This involves helping you develop a sense of self separate from your thoughts and feelings. You learn to see yourself as the context in which your experiences occur rather than being defined by those experiences.
Metaphors and Parables in ACT Therapy
I often use metaphors and stories to illustrate key concepts, making them more accessible and memorable. You’ll also start to think of your own personal metaphors to use in your daily life. This can be a fun exercise for couples and families.
Experiential Exercises and Homework
Through Acceptance Therapy, you’ll develop a toolkit of activities designed to help you experience mindfulness, acceptance, and other principles directly outside of sessions. Examples might include visualization exercises, role-playing, or behavioral experiments. These are particularly useful in couples approaches and family treatment using acceptance and commitment therapy.
ACT Therapy and Values-Based Exposure
You’ll engage in exposure exercises aimed at helping you confront feared situations or emotions in the service of your values. This can help reduce avoidance behaviors and increase psychological flexibility.
Depending on each client’s needs and preferences, these techniques are typically flexible and tailored. One goal of acceptance and commitment therapy is to emphasize developing a lasting toolkit that can be used outside sessions to enhance their effectiveness.
ACT Therapy Uses
This method is used to treat various mental health issues, including anxiety, depression, substance abuse, chronic pain, and more. While it’s not specifically tailored to address specific disorders, it can be effective as a complementary or standalone therapy for several conditions. I also wrote a post with more detail about how I use ACT Psychotherapy for specific diagnoses.
ACT Therapy and Anxiety
ACT Therapy can help individuals with anxiety disorders by teaching mindfulness and acceptance techniques to cope with anxious thoughts and sensations, allowing them to engage in meaningful activities despite their anxiety. Incorporating these strategies helps individuals develop skills to manage anxiety more effectively, reducing the impact anxiety has on their lives and allowing them to pursue what is meaningful to them. It doesn’t seek to eliminate anxiety altogether but rather changes the relationship with anxiety, reducing its interference with living a fulfilling life.
Acceptance Therapy and Depression
This approach assists individuals in managing depressive symptoms by promoting acceptance of difficult emotions, clarifying values, and encouraging committed actions that align with personal values, even when feeling low. By focusing on psychological flexibility and helping individuals reconnect with what’s important in their lives, this method can effectively reduce the impact of depressive symptoms. It aims to change the relationship with depression, allowing individuals to live more fully and take steps toward a richer, more fulfilling life despite the presence of depressive thoughts and feelings.
ACT Therapy can be particularly useful for Seasonal Affective Disorder.
Acceptance and Commitment Therapy and Chronic Pain
For those experiencing chronic pain, acceptance and commitment therapy focuses on accepting pain sensations without allowing them to dominate one’s life, fostering mindfulness, and encouraging engagement in activities that bring fulfillment. Acceptance and Commitment Therapy helps individuals lead fuller lives despite chronic pain by fostering psychological flexibility and promoting engagement in valued activities. It teaches skills to manage the emotional impact of pain and encourages individuals to focus on what they can control, thereby improving their overall well-being and functioning.
ACT Therapy and Eating Disorders
In the case of eating disorders, ACT Therapy can help individuals manage distressing thoughts related to body image and food, emphasizing values-based actions and defusing harmful thoughts. Acceptance and Commitment Therapy doesn’t directly target symptom reduction but aims to change the individual’s relationship with their thoughts and feelings, fostering a more flexible and values-based approach to life. Eating disorder treatment can complement other therapeutic approaches, promoting long-term behavioral changes and improved psychological well-being.
Often, a multidisciplinary approach, often involving medical, nutritional, and psychological interventions, is typically necessary for comprehensive eating disorder treatment.
Acceptance and Commitment Therapy Results
The results of Acceptance Therapy can vary from person to person, but many clients find it helpful in managing difficult thoughts and emotions, improving mental health, and enhancing overall well-being. This has included the following changes:
Increased Psychological Flexibility
This approach aims to enhance psychological flexibility, allowing people to be more open, mindful, and able to adapt to different situations. This leads to reduced avoidance and greater emotional resilience. People feel more adept at managing stressors, letting go of psychological pain, and facing each day. “Homework” feels good and productive.
ACT Therapy and Improved Coping Strategies
Through acceptance and commitment therapy, people often learn effective coping strategies to manage stress, anxiety, depression, and other mental health challenges. They develop skills to respond to difficult thoughts and feelings in a healthier way. By identifying personal values and committing actions toward stressors, people often experience a greater sense of purpose, satisfaction, and fulfillment in various areas of life.
Reduced Symptoms Through Acceptance and Commitment Therapy
Many people treated with Acceptance Therapy report reductions in symptoms related to anxiety, depression, PTSD, chronic pain, and other psychological difficulties. Behavioral changes align with personal values, and people start engaging in activities that are meaningful to them, even in the presence of discomfort or difficult emotions.
Acceptance and Commitment Therapy and Improved Relationships
As people become more aware of their thoughts and feelings and learn to respond to them differently, their relationships can benefit from increased empathy, understanding, and effective communication. This is why I often use a form of ACT Therapy with couples and families.
The effectiveness of Acceptance Therapy can depend on various factors, including your willingness to engage in the therapeutic process, the nature and severity of the issues being addressed, and the consistency of practice outside sessions. Overall, I have seen this approach help many individuals lead more fulfilling lives by fostering psychological flexibility and empowering them to live following their values.
Conclusions and My Work
Acceptance Therapy is versatile and focuses on enhancing psychological flexibility, making it applicable to various mental health challenges. It aims to improve one’s relationship with thoughts and emotions rather than directly treating specific symptoms. Its principles can be adapted and integrated into treatment plans for different diagnoses, often proving beneficial in promoting overall well-being and resilience.
Acceptance and Commitment Therapy in My Practice
I use various exercises and metaphors to help individuals understand and apply these principles, making Acceptance and Commitment Therapy an experiential and practical method. It can be used as a stand-alone, but more commonly, I weave these principles into other aspects of my work in my integrative practice.
How I Use Acceptance Therapy
This approach can be used with individuals, couples therapy, and families with older children (especially when the children in the family are older). It can be used in person or virtually. I use it in several clinical specialties, including Fear of Flying, Executive Coaching, and Sports Psychology.
Please contact me anytime if you have questions about Acceptance and Commitment Therapy or want to discuss how I could use ACT Therapy to help you with your unique goals.
