Acceptance And Commitment Therapy (ACT)

Introduction

Acceptance and commitment therapy, commonly abbreviated as ACT, is an action-oriented psychotherapy. It enables clients to deal with negative thinking patterns, emotional responses, events, and symptoms.

The crux of ACT therapy is acceptance. Acceptance that comes with going past denying or avoiding these negative patterns in thinking, emotions, and behaviors, and agreeing that they are appropriate responses to some events in life. At the same time, acceptance also comes with a commitment to move forward in life by changing behaviors that need to be changed despite the feelings.

At NuView, we build on the ACT approach and enable our clients to experience and accept their thoughts and emotions, and facilitate a commitment toward moving forward in life.

What Is Acceptance And Commitment Therapy (ACT)?

Acceptance and commitment therapy is a third-wave cognitive behavioral therapy. It is mindful and action-oriented in that it stays focused on the present and actively deals with negative thinking patterns, emotional responses, symptoms, or behaviors. It aims for clients to accept and process negative thoughts and emotions. Acceptance can be considered in terms of the 4 A’s – acknowledge, allow, accommodate, and appreciate. With acceptance, clients can commit to moving past these negative thoughts and emotions and going forward in life by focusing on developing healthy and productive behavioral patterns.

ACT therapy was developed by Steven C. Hayes in the 1980s. It has a bit of a personal backstory. The idea of ACT emerged from Hayes’ own history of panic attacks, as he believed he must come to terms with them instead of running away from them. He believed that it is important to experience emotions as they are instead of simply dwelling on managing them or changing them. He believed with experience comes acceptance, and with acceptance comes the commitment to move forward in life.

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How Does ACT Therapy Work?

Acceptance and commitment therapy works on the basis of its three pillars – being open, centered, and engaged. In a nutshell, these three pillars mean that the ACT therapy:

• Requires being open – accept life as it is and welcome the experiences of it.
• It is centered – stay in contact with the present rather than delving too much into the past.
• It is engaged – action-oriented with a commitment toward changing behaviors that are maladaptive and moving forward in life.

While the three pillars inform ACT therapy, it also uses six processes:

Acceptance – It involves experiencing and accepting one’s thoughts and emotions, no matter how distressing they can be, instead of denying or avoiding them.

Cognitive Defusion – Cognitive defusion is distancing oneself from distressing thoughts and emotions, which also changes the reactions to them. It involves observing the thought from a neutral point of view, singing out that thought in a silly manner, and noting down the automatic reaction to it.

Self As Context – Self as context means the self acting as an observer. This involves learning to observe thoughts as being separate from actions. When this happens, one can engage with their thoughts and feelings without becoming too caught up with them.

Contact With The Present Moment – It means being mindful; staying in contact with one’s thoughts, feelings, and surroundings makes them more aware of how their past experiences or conditioning affect them in a negative manner.

Values – It refers to identifying values or principles that are important in one’s life, basically what they stand for. Identifying values will serve as a motivation for being engaged and taking action.

Committed Action – This refers to taking action to change one’s life for the better and moving closer to the values identified in the previous step.

When Is Acceptance And Commitment Therapy Used?

Acceptance and commitment therapy can be used to treat different psychological conditions and also help cope with certain physical conditions.

• Anxiety disorders
• Obsessive-compulsive disorder
• Depression
• Substance use disorders
• Eating disorders
• Psychosis
• Stress management
• Chronic pain

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What To Expect In Acceptance And Commitment Therapy (ACT)?

When starting with acceptance and commitment therapy, knowing what to expect from the sessions will help allay a few fears.

The first visit is similar to a first appointment with the doctor. Clients will be asked some questions to understand their background, challenges, and their reasons for seeking out ACT therapy. Then there will be some forms to fill out, like medical history, medication details, privacy forms, insurance details, and a client-therapist agreement.

The subsequent sessions will involve identifying personal values, identifying behaviors that are not aligned with those values, and applying the six processes to help clients take action and move forward in their lives. Mindfulness exercises can also be incorporated into the sessions.

What Acceptance And Commitment Therapy Can Help With?

Acceptance and commitment therapy can help with a number of things, as it has many benefits:

• Equips clients with the flexibility to acknowledge and accept different thoughts and emotions and even get rid of the maladaptive ones.
• Allows to distance reactions from thoughts and feelings, which, in turn, helps in changing behaviors that are not useful or desirable.
• Helps avoid impulsive behaviors by drawing attention to inner thoughts and feelings.
• Enables clients to view themselves with awareness and compassion.
• Teaches mindfulness, allowing clients to stay in contact with the present.

How Effective Is ACT Therapy?

Acceptance and commitment therapy is effective. Initial studies have shown that ACT therapy has been effective in the treatment of anxiety, depression, substance use, and among transdiagnostic groups. It has also been effective in coping with physical conditions like chronic pain.

While there is strong evidence regarding the effectiveness of ACT therapy, it is also limited. More research is required to identify its weaknesses and areas of improvement. It also may not be suitable for all, as it requires a degree of self-awareness and introspection, which can be difficult for some clients, especially with cognitive impairments.

How To Find A Good ACT Therapist

With acceptance and commitment therapy, the first step is to find a good ACT therapist. A good ACT therapist can be a licensed psychologist, psychiatrist, or social worker with advanced training in ACT therapy. This can be time-consuming and also seem uncertain at times. At the NuView Treatment Center, our medical and clinical team is committed to aligning clients with the right therapist. We take time to consider our clients’ unique experiences, needs, and goals so as to help them find the therapist who can facilitate their mental health journey toward balance and healing.

We also encourage our clients to voice any questions or concerns regarding the therapy and confer with a family member, friend, or primary health practitioner as well.

Frequently Asked Questions

What are the 4 A's of acceptance and commitment therapy?

The 4 A’s of acceptance and commitment therapy are – Acknowledge, Allow, Accommodate, and Appreciate.

What are the three pillars of acceptance and commitment therapy?

The 3 pillars of acceptance and commitment therapy are to be open, centered, and engaged.

What are the 6 processes of acceptance and commitment therapy?

The 6 processes of acceptance and commitment therapy are acceptance, cognitive defusion, self as context, contact with the present moment, identifying values, and committed action.