Since the 1980s, Acceptance and Commitment Therapy has been successfully helping clients deal with various mental health conditions. It’s a relatively new type of psychotherapy that is often considered “third wave” therapy.
There is an increasing number of studies that prove ACT’s effectiveness among people with depression, anxiety, substance use, and other types of problems. As theorists believe, the main reason is ACT’s focus on personal growth and quality of life.
In this article, we’ll briefly review ACT, discuss its key benefits, effectiveness, and core processes, and see how ACT works.
What is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that considers acceptance as a key factor in dealing with negative thoughts and maladaptive behaviors. The therapy emphasizes commitment to healthy and adaptive activities and assists people in achieving psychological well-being.
According to the American Psychological Association (APA), Acceptance and Commitment Therapy is a form of Cognitive Behavioral Therapy (CBT). During the treatment, therapists encourage the clients to focus on their thoughts and feelings and accept them instead of replacing them or feeling guilty about them.
The main purpose of ACT is to help clients clarify their goals, create positive changes in their lives, and develop adaptive ways of responding to difficult times and life challenges. Usually, it’s used for various types of mental health conditions. It’s most effective for depression, stress, anxiety disorders, and substance abuse disorders.
ACT is often used in combination with mindfulness-based cognitive therapy (MBCT). On the one hand, developing mindfulness skills is one of the main goals of the ACT treatment, and on the other hand, MBCT is also focused on the practice of self-acceptance.
The desired outcome of ACT is to develop strategies to avoid the stressful thoughts and feelings that usually worsen mental health problems.
How Does ACT Work?
Acceptance and Commitment Theory is based on the assumption that suppression of negative feelings leads us to more distress. This theory is in line with Freud’s theory of defense mechanisms. The reason is that repressed thoughts and feelings are accumulated in our unconscious in the form of energy. After some time, we can no longer handle this energy, and that’s when mental health issues develop.
As ACT theorists prove, attention to our values, mindful actions, and commitment to our behaviors are effective alternatives to repressing our thoughts. During therapy sessions, a therapist and a client try to take steps in order to change the client’s behavior. While this also characterizes cognitive behavioral therapy, the difference is that clients learn to accept their psychological experiences too.
Typically, Acceptance and Commitment Therapy lasts for 8–16 sessions, depending on the particular problem and the client’s goals. Sessions usually last 50 minutes and are held once a week.
Both the client and the therapist have an active role in the process of therapy. The therapist collaborates with the client and encourages them to articulate their goals. They have a non-judgemental, empathetic attitude towards the client and help them understand their difficulties by using specific psychological techniques.
Basic Processes of ACT
One of the most commonly used models of Acceptance and Commitment Therapy (ACT) consists of the following six core processes (Hayes et al., 2006):
- Acceptance – a method of encouraging clients to perceive their negative thoughts and feelings as they are. Acceptance is the active choice of allowing maladaptive experiences into your life instead of restructuring them.
- Cognitive Defusion – a process of detaching yourself from negative inner experiences. As a result, you perceive your thoughts as just thoughts without any negative attitude. Through cognitive defusion, the client becomes less fixated on their unwanted life experiences.
- Being Present – a practice of being mindful of the environment around you and learning how to switch attention from internal feelings to the outside world. The main goal is to be aware of the here-and-now moment without estimating or judging it.
- Self as Context – an idea of perceiving your thoughts separately from your behaviors. It means that a person’s “self” is outside of their current experience. We’re humans as a whole and not a sum of our thoughts, emotions, or behaviors.
- Values – the main goal of ACT is to work towards our values. It’s qualities or areas of our lives that are important enough to motivate our actions. Our values manage our steps, and we live according to our values.
- Committed Action – it means changing our maladaptive actions in our lives, in general, according to the previous five principles. Committed actions are based on our values and lead us to realize our long-term goals.
Benefits & Effectiveness of ACT
Recent studies prove the effectiveness of Acceptance and Commitment Therapy either as a monotherapy or in combination with other therapies (Osaji et al., 2020). Specifically, the therapy significantly reduced symptoms in substance use patients and, in some cases, helped them discount subsequent abstinence. Moreover, in a 2018 study, ACT also reduced anxiety and depression symptoms in the participants who received ACT therapy (Heydari et al., 2018).
As a result of the success of ACT studies, today it’s considered a “third-wave” of psychotherapy. This term distinguishes ACT from more traditional forms of therapy, including dialectical behavioral therapy (CBT), schema therapy, and mindfulness-based cognitive therapy (MBCT), which are referred to as “second-wave” therapies. The main difference between them is that ACT focuses on accepting maladaptive thinking patterns as part of our lives, while “second-wave” therapies try to change unwanted experiences.
The key benefit of ACT is its success in treating various mental health conditions, such as depression, anxiety disorders, or substance use disorders. However, it also has some additional benefits:
- ACT increases psychological flexibility – Aside from dealing with their current problems, clients also learn to adapt to further events in the future. They become psychologically flexible, meaning they accept their thoughts and feelings when they’re useful and avoid them if they aren’t.
- ACT focuses on living a meaningful life – One of the main purposes of ACT is to improve the quality of life. During the therapy, clients realize that they are more than their condition. Even if their symptoms aren’t completely reduced, they acknowledge the power within themselves, which increases subjective well-being.
- ACT raises awareness about negative experiences – sometimes clients can’t get rid of negative thoughts and behaviors. Consequently, ACT aims to help people realize feeling bad is normal, it’s a part of our lives and how we respond to it affects our mental health condition.
When is ACT Used?
Acceptance and Commitment Therapy has been proven to be effective with the following conditions:
- Social anxiety
- Work-related stress
- Obsessive-compulsive disorder (OCD)
- Substance use disorder
- Eating disorders
Sometimes it’s also used to help patients with medical conditions such as diabetes or chronic pain.
ACT is considered one of the most innovative and powerful therapies available today. It has the potential to reduce symptoms of various mental health conditions, as well as produce positive results in the long term. It can be used either on its own or in combination with other types of therapies such as CBT or MBCT.
If you are suffering from maladaptive thoughts, feelings, or behaviors, Acceptance and Commitment Therapy could help you improve your emotional state and improve your quality of life. If you’re looking for experienced therapists, you can get in touch with the team at Health for Life Counseling Grand Rapids to find out more about ACT and whether it’s suitable for you.