Clinically Reviewed by Linda Whiteside, LPCC

Medically Reviewed by: Dr. Ryan Peterson, MD

What Is Acceptance and Commitment Therapy?

Table of Contents

Acceptance and Commitment Therapy (ACT) is a special kind of therapy that helps people feel more in control by accepting and facing their negative thoughts, feelings, symptoms, or situations instead of trying to get rid of them.

It combines mindfulness, acceptance, and behavior change techniques to help individuals live fulfilling life based on their core values. It’s gaining popularity among mental health professionals and has been proven effective through research.

Origins and Development of Acceptance and Commitment Therapy

ACT was developed in the late 1980s and early 1990s by Steven C. Hayes, Kelly G. Wilson, and Kirk D. Strosahl. The therapy is grounded in relational frame theory, a comprehensive theory of human behavior and cognition. It emphasizes the importance of understanding how people relate to their internal experiences and the world around them.

Central Goals and Principles of Acceptance and Commitment Therapy

The primary goal of ACT is to increase psychological flexibility —the ability to be present in the moment, adapt to changing circumstances, and take effective action in line with one’s values. ACT is built around six core principles: acceptance, cognitive defusion, being present, self-as-context, values, and committed action.

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How Does Acceptance and Commitment Therapy (ACT Therapy) Work?


The Six Core Processes of ACT

  1. Acceptance: The practice of acknowledging and accepting difficult thoughts, feelings, and sensations without trying to change them or avoid them. It’s about being present with whatever is happening at the moment, without judgment or resistance. One exercise used in acceptance is called “mindful breathing,” which involves focusing on the sensation of breathing and allowing thoughts and feelings to come and go.
  2. Cognitive defusion: The detachment from negative thoughts and beliefs that can hold one back. It involves learning to observe thoughts without getting caught up in them or taking them too seriously. One technique used in cognitive defusion is called “thought diffusion,” which involves imagining thoughts as clouds pass by in the sky.
  3. Being present: Being fully present in the moment rather than getting caught up in thoughts about the past or future. It’s about being aware of the here and now without judgment or distraction. One technique used in present-moment awareness is called “body scan,” which involves focusing on different parts of the body and noticing any sensations or feelings that arise.
  4. Self-as-context: The recognition that we are more than our thoughts and feelings. It’s about developing a sense of perspective and distance from our internal experiences so that we can observe them without getting caught up in them. One exercise used in self-as-context is called “the observer self,” which involves imagining yourself as an observer watching your thoughts and feelings from a distance.
  5. Values: The clarification of what is most important to us in life and using that as a guide for our actions. It’s about identifying our values and living according to them, even when difficult or uncomfortable. One exercise used in values is called “values exploration,” which involves reflecting on different areas of life (e.g., work, relationships, health) and identifying what is most important to us in each area.
  6. Committed action: Taking deliberate, value-driven actions in the direction of our values, even when it’s difficult or uncomfortable. It’s about setting goals and taking steps to achieve them, even in the face of obstacles or setbacks. One technique used in committed action is called “values-based goal setting,” which involves setting goals that align with our values and taking small, manageable steps to work towards them.

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Cognitive Defusion and Acceptance Techniques

Cognitive defusion techniques help individuals distance themselves from their thoughts, so they can observe them without becoming entangled in their content. On the other hand, acceptance techniques encourage individuals to embrace their emotional pain and discomfort rather than trying to avoid or control them. Both cognitive defusion and acceptance strategies aim to reduce experiential avoidance—a common maladaptive coping mechanism that contributes to psychological suffering.

The Role of Values and Committed Action in ACT

Values play a central role in ACT, as they provide the foundation for committed action. By clarifying their values, individuals can identify what truly matters to them and make decisions that align with those values. Committed action involves taking concrete steps to pursue one’s values, even in the presence of difficult thoughts and emotions.

Structure of an ACT Therapy Session

ACT (Acceptance and Commitment Therapy) differs from other mindfulness-based therapies like mindfulness-based cognitive therapy and mindfulness-based behavioral therapy. It focuses on developing acceptance skills to deal with stress, pain symptoms, anxiety disorder, and social anxiety disorder.

In contrast, other therapies may focus on changing or eliminating negative thoughts and emotions. This difference in approach has been studied in randomized controlled trials and recommended for clinical practice by the World Health Organization.

Additionally, ACT has been shown to be effective in treating chronic low back pain and improving behavioral outcomes by teaching clients to practice acceptance of their thoughts and emotions. Overall, the structure of an ACT therapy session emphasizes developing the skill of acceptance, which differs from other approaches in Western psychology.

Typical Session Format and Components

ACT therapy sessions typically begin with a discussion of the client’s goals and the therapist’s explanation of the ACT model. The therapist then guides the client through various experiential exercises, such as mindfulness practices and cognitive defusion techniques, to help them develop the skills needed to foster psychological flexibility. Throughout the session, the therapist and client collaborate in a collaborative manner, with the therapist providing support and guidance while the client actively engages in the therapeutic process.

The Role of the Therapist in Guiding the Session

The ACT therapist is crucial in guiding clients to understand and use the six core principles of ACT. The therapist uses experiential exercises and creates a non-judgmental atmosphere to help clients learn skills for psychological flexibility. The therapist also helps clients recognize their values and make plans for committed actions.

The Collaborative Relationship Between Therapist and Client

A crucial aspect of ACT therapy is the collaborative relationship between the therapist and the client. This partnership is characterized by open communication, mutual trust, and shared responsibility for the therapeutic process. The therapist supports the client in their journey towards psychological flexibility. In contrast, the client actively participates in the therapy, applying the skills and techniques learned in the sessions to their everyday life.

Mindfulness and ACT Therapy

Mindfulness is the practice of paying attention to the present moment non-judgmentally and with curiosity. In the context of ACT, mindfulness is essential for cultivating psychological flexibility, as it helps individuals develop greater awareness of their thoughts, feelings, and physical sensations and fosters acceptance of these experiences without trying to control or avoid them.

Techniques for Cultivating Mindfulness in Therapy

Mindfulness techniques utilized in ACT therapy include focused attention on the breath, body scanning, and observing thoughts and emotions as they arise. By practicing mindfulness regularly, clients can enhance their ability to be present at the moment and respond to their experiences in a more adaptive manner.

The Relationship Between Mindfulness and Psychological Flexibility

Mindfulness and psychological flexibility are intimately connected, as mindfulness helps individuals develop the skills necessary to achieve psychological flexibility. Mindfulness helps clients become aware and accepting of their internal experiences, allowing them to effectively manage their thoughts, emotions, and sensations and take committed action in line with their values.

What Can ACT Therapy Help With?

ACT (Acceptance and Commitment Therapy) can help with reducing stress and pain symptoms through developing ACT skills in psychological therapy. These skills involve practicing acceptance of thoughts and emotions and have been studied in randomized clinical trials to improve outcomes by working with the normal human mind in a way that differs from other approaches in Western psychology.

Common Psychological Issues Addressed by ACT

ACT therapy has been proven effective in treating many mental health conditions, including

  • anxiety disorders,
  • depression, chronic pain,
  • substance abuse,
  • stress,
  • and obsessive-compulsive disorder (OCD).

The versatility of ACT makes it applicable to various populations and settings, such as individuals dealing with work-related stress, relationship issues, or coping with chronic illness.

If you’re seeking assistance with areas where ACT can be helpful, such as work-related stress, relationship issues, or coping with chronic illness, we are here to support you. Call us today at (323) 307-7997 or send us a message from our contact page to schedule your personalized consultation.

ACT’s Effectiveness in Treating Various Mental Health Conditions

Numerous randomized controlled trials have demonstrated the efficacy of ACT in treating various mental health conditions. For instance, ACT has been shown to significantly reduce depressive and anxiety symptoms, improve the quality of life for individuals with chronic pain, and enhance smoking cessation outcomes.

The Versatility of ACT for Different Populations and Settings

Due to its focus on psychological flexibility and its grounding in mindfulness and acceptance techniques, ACT can be easily adapted to different populations and contexts. ACT has been used successfully with children, adolescents, adults, and older adults, as well as in group settings, individual therapy, and online interventions.

Is ACT Therapy Effective?

Research Findings on the Efficacy of ACT

ACT is considered an empirically supported treatment, with a substantial body of research demonstrating its effectiveness in treating various mental health conditions. Multiple randomized controlled trials and meta-analyses have provided robust evidence for the efficacy of ACT in addressing issues such as anxiety, depression, chronic pain, and substance use disorders.

Comparisons With Other Therapeutic Approaches

When compared to other therapeutic approaches, such as cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT), ACT has been shown to be equally or more effective in many cases. While each therapy has its unique features and focus, ACT’s emphasis on psychological flexibility and mindfulness sets it apart, providing a comprehensive approach to enhancing mental health and well-being.

Factors Contributing to the Success of ACT

The secret to ACT’s success lies in a few key factors.

First off, ACT is built upon contextual behavioral science and relational frame theory. These fancy-sounding terms mean that it’s based on a scientific understanding of how people behave and communicate.

Another important factor is psychological flexibility. This means helping people to be more open-minded and adaptable in their thinking and actions. In today’s world, where things are constantly changing, this skill is more valuable than ever.

Lastly, ACT incorporates mindfulness and acceptance techniques. These practices help people to stay present and non-judgmental, even in difficult situations.

It’s a powerful combination of these therapeutic approaches that can be customized to meet the unique needs of each client.

How to Find an ACT Therapist

Criteria for Choosing an ACT Therapist

When choosing an Acceptance and Commitment Therapy (ACT) therapist, it’s important to consider several factors. Here are some criteria to help guide your decision:

  • Credentials and qualifications: Look for mental health professionals who are trained and experienced in ACT, clinical psychology, and other relevant behavioral therapies.
  • Evidence-based practice: Consider therapists who use evidence-based treatments and who have experience working with the specific mental health condition you’re seeking treatment for. Look for therapists who have experience using ACT interventions with positive outcomes in randomized controlled trials and randomized clinical trials.
  • Focus on ACT processes and skills: Choose a therapist who is committed to teaching acceptance and mindfulness exercises, as well as other ACT processes and skills.
  • Personal values and meaningful life activities: A good ACT therapist will help you identify your personal values and how to engage in meaningful life activities aligned with them.
  • Understanding of psychological processes: An effective ACT therapist will have a deep understanding of the psychological processes that underlie your mental health condition and be able to help you develop effective strategies to manage symptoms.
  • Ability to work with a wide range of conditions: ACT is a transdiagnostic behavioral intervention, meaning it can be applied to a wide range of mental health conditions, including anxiety disorders, depression, borderline personality disorder, chronic pain, substance use disorder, and others. Choose a therapist who has experience working with diverse conditions and populations.
  • Focus on the present moment: ACT aims to help individuals focus on the present moment and engage in committed action to build a meaningful life. Look for therapists who emphasize the importance of being present and practicing acceptance.
  • Utilization of ACT resources: There are many resources available for individuals seeking ACT therapy, including workbooks, online courses, and self-help materials. A good ACT therapist will be knowledgeable about these resources and able to recommend them to you as needed.

By considering these criteria, you can find an ACT therapist who is well-equipped to help you build psychological flexibility and live a more fulfilling life.

Resources for locating qualified ACT practitioners

Several resources are available to help individuals locate qualified ACT therapists. The Association for Contextual Behavioral Science (ACBS) maintains a directory of ACT practitioners worldwide, while other professional organizations, such as the American Psychological Association, may also provide referrals. Additionally, online directories and mental health forums can be useful in identifying therapists who specialize in ACT.

Questions to ask potential therapists

Before committing to work with an ACT therapist, it’s essential to ask questions to ensure they’re a good fit for your needs. Some relevant questions might include:

  1. What is your experience and training in ACT?
  2. How do you incorporate mindfulness and acceptance techniques into your therapy sessions?
  3. Can you provide any examples of how you’ve used ACT to help clients with similar issues to mine?
  4. How do you tailor your approach to meet the specific needs of each client?

Questions Around ACT Therapy

ACT therapy is used to treat a wide range of mental health conditions, including anxiety disorders, depression, chronic pain, substance abuse, stress, and obsessive-compulsive disorder. Its versatility allows it to be adapted to various populations and settings, making it suitable for individuals dealing with work-related stress, relationship issues, or coping with chronic illness.
While both ACT and cognitive behavior therapy (CBT) are rooted in behavioral and cognitive therapy, there are key differences between the two approaches. ACT focuses on psychological flexibility and emphasizes mindfulness and acceptance techniques, whereas CBT primarily concentrates on modifying negative thought patterns and maladaptive behaviors.
The six core principles of ACT are acceptance, cognitive defusion, being present, self as context, values, and committed action. These principles work together to promote psychological flexibility, allowing individuals to more effectively manage their thoughts, emotions, and behaviors in alignment with their values.
An example of ACT therapy in practice might involve a client struggling with anxiety. The therapist could guide the client through mindfulness exercises to help them become more aware of their anxious thoughts and feelings. The client would then learn acceptance and cognitive defusion techniques to reduce the impact of these thoughts on their behavior. Finally, the therapist and client would collaborate to identify the client's values and develop a plan for committed action in alignment with those values.
ACT therapy differs from dialectical behavior therapy (DBT) in its primary focus on psychological flexibility, mindfulness, and acceptance. While both approaches share some similarities, such as the emphasis on mindfulness, ACT is more focused on helping clients achieve a rich and meaningful life by increasing their psychological flexibility, whereas DBT primarily targets emotion regulation, interpersonal effectiveness, and distress tolerance.

Get Help Now

Don’t let stress, pain, or anxiety hold you back from living your best life. Take the first step towards improved mental and physical well-being by calling NuView Treatment Center today at (323)307-7997. Our team of qualified mental health professionals is ready to help you or your loved one navigate the challenges of life with greater ease and resilience.

Contact us now to learn more about how we can help.


Acceptance and Commitment Therapy is a versatile and empirically supported treatment that aims to promote psychological flexibility and improve mental health and well-being. By integrating mindfulness, acceptance, and values-based approaches, ACT helps individuals manage their thoughts, emotions, and behaviors more effectively. This therapy is suited for a wide range of mental health conditions and can be tailored to meet the unique needs of each client.

If you or a loved one is struggling with mental health issues, Acceptance and Commitment Therapy may be a beneficial approach to consider. Its emphasis on psychological flexibility and personal values can help individuals develop the skills needed to navigate life’s challenges more effectively. As with any therapy, it’s essential to find a qualified and experienced ACT therapist with whom you feel comfortable and can establish a collaborative relationship.

Ost LG. The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis. Behav Res Ther. 2014 Oct;61:105-21. doi: 10.1016/j.brat.2014.07.018. Epub 2014 Aug 19. PMID: 25193001.

Twohig MP, Levin ME. Acceptance and Commitment Therapy as a Treatment for Anxiety and Depression: A Review. Psychiatr Clin North Am. 2017 Dec;40(4):751-770. doi: 10.1016/j.psc.2017.08.009. PMID: 29080598.

Gaudiano, B. A. (2010). Evaluating acceptance and commitment therapy: An analysis of a recent critique.International Journal of Behavioral Consultation and Therapy, 5(3-4), 311–329.

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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