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Acceptance and Commitment Therapy

Introduction

The standard idea of therapy usually involves a single person speaking with a therapist or other mental health professional about their fears, concerns, feelings, or past traumas. The therapist may offer some kind of feedback, a different perspective, or homework suggestions like journaling or meditation, all of which are intended to help the person find solutions and practice new interpersonal skills. This type of talk therapy can be highly successful, but it is not the only model of therapy that’s available and effective.


Acceptance and commitment therapy (ACT) is another type of therapy that is based on cognitive-behavioral therapy. Instead of focusing on repairing past mistakes, acceptance and commitment therapy focuses on helping a client accept their hardships and personal flaws while directing their energy toward making positive life changes to achieve their goals.

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What Is Acceptance and Commitment Therapy?

Acceptance therapy is often described as an action-oriented approach to therapy. Instead of denying or struggling with inner emotions, clients learn to view even difficult feelings as appropriate for the time and situation. Regardless of personal challenges such as loss or mental health disorders, the goal is to move forward.1

ACT Theory and Application

The theory behind ACT is that it’s counterproductive to try to change the way a person thinks or challenge their personal perspective, even if that perspective is causing difficulty in their life. For example, a typical approach to treating substance use disorder is to help a person understand the series of events that led them to treatment. The belief is that examining and healing past traumas helps build a foundation for future sobriety.


The acceptance and commitment training approach focuses on techniques and actions that help improve the person’s present and future life without a deep examination of the past. ACT therapists encourage people to accept what is and commit to making positive changes. The theory is that by taking action first, a change in attitude or emotion will happen naturally.

History of Acceptance and Commitment Therapy

Acceptance therapy is a relatively new therapeutic approach. It was developed by psychologist Steven C. Hayes during the 1980s. Hayes was a professor at the University of Nevada at the time and was struggling with panic attacks. The ideas that eventually merged into acceptance and commitment therapy came from his personal experience.

He rejected the idea that his emotions needed to be “fixed” or changed and chose to accept them as a part of his life experience. He credited self-acceptance and mindfulness practices as the psychological tools that helped him make this transformative shift.2

“Third Wave” of Behavioral Therapies

Mindful acceptance and commitment therapy is part of what is sometimes referred to as the “third wave” of behavioral therapies. The first wave was developed in the 1950s and 60s, and second wave therapies, specifically cognitive-behavioral therapy, came about in the 1970s. Other third-wave modalities include dialectical behavior therapy, mindfulness-based stress reductions, and mindfulness-based cognitive therapy.

What to Expect from Acceptance and Commitment Therapy

According to the Centers for Disease Control, nearly 20% of adults in the U.S. sought help from a therapist in 2019, and one in five adults live with a mental health disorder. With so many people needing mental health support, it is unrealistic to expect the same approach to work for everyone. Fortunately, practicing ACT skills may prove more effective for some people than other techniques.3

Relevant Decisions

During an ACT session, clients can discuss any challenges they are facing and decide:

  • Whether the problem requires immediate action
  • Whether the problem can be changed or if it is better to accept it
  • How to modify the situation with behavioral changes

The therapist may help the person recognize what has not worked in the past in order to stop repeating unhelpful patterns and behaviors. Once current challenges have been recognized and accepted, the person can begin developing a plan for acceptance and commitment therapy activities that help them meet their wellness goals.

Six Core Processes of Acceptance and Commitment Therapy

The core processes of acceptance and commitment therapy are designed to promote the psychological flexibility that allows people to move forward despite past or current challenges. The six processes are detailed below.

Acceptance

The first process in acceptance therapy is to fully acknowledge and accept all of your thoughts and emotions instead of denying, avoiding, or trying to change them.

Cognitive Defusion

This process involves changing the way you react to unsettling feelings or thought patterns. The theory is that changing your reactions will lessen any harmful effects. Your ACT therapist will provide acceptance and commitment training techniques to assist with cognitive defusion.

Being Present

Being present refers to the practice of mindfulness. Observing your feelings and thoughts without judgment is one way of being present and is part of mindfulness ACT therapy.

Self as Context

This process refers to self-identity and the idea that individuals are more than their experiences, feelings, and thoughts.

Values

Instead of trying to avoid distress, the values principle encourages people to define their personal values and take action to live by them, even when distress is present. This can be achieved with acceptance and commitment therapy activities.

Commitment

The last core process of acceptance-based therapy is to take concrete steps that will align your thoughts and actions with your values. This can include setting new goals, developing personal skills, and exposing yourself to difficult experiences.

What Acceptance and Commitment Therapy Can Help with

Major depression is one of the most commonly occurring mental health disorders in the United States, with nearly fifteen million adults experiencing at least one major depressive episode in 2020.4


Substance use disorders are also common in the U.S. It is estimated that more than twenty million people are struggling with substance use disorder.5

Mindful Acceptance and Commitment Therapy

Along with medications, alternative therapies, and traditional therapies, mindful acceptance and commitment therapy provides tools that may prevent relapse and help individuals continue moving forward, even when their wellness journey does not go as planned. Many therapists suggest acceptance therapy for conditions like anxiety because it is uniquely designed to divert attention away from anxiety while increasing awareness and encouraging individuals to live meaningful lives.

Conditions ACT Can Benefit or Treat

Along with anxiety disorders, acceptance and commitment therapy is also frequently used to help treat:

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

Benefits of Acceptance and Commitment Therapy

Acceptance and commitment training is an effective part of an overall treatment program for many types of mental health disorders. Its main benefit is helping people from getting stuck in the past and rehashing the same thoughts over and over. Other benefits of ACT therapy skills include:

  • Focuses on enriching lives, regardless of symptoms
  • Helps people become more psychologically flexible
  • Acknowledges that negative experiences are a part of life
  • Emphasizes goal setting
  • Is more interactive than some other types of therapy
  • Encourages accountability, regardless of the past

Acceptance and commitment therapy techniques help people build the new skills they need to cope with challenges without regressing to old, unhelpful habits they no longer want to rely on.

Other Treatment Options

An ACT treatment plan may be used as a complementary approach or as a stand-alone therapy, depending on the person’s needs and response to ACT. Other modalities may include:

  • Cognitive-behavioral therapy
  • Trauma therapy
  • Dialectical behavior therapy
  • Support groups, including ACT group therapy
  • Residential care

The limitations of ACT therapy are typically focused on the way the material is presented, not on the core principles themselves.


Whether you’re considering acceptance therapy for anxiety, OCD, substance use disorder, or other mental health concerns, ACT can be an effective tool to help improve your mental health and reach your personal goals.

Acceptance and Commitment Therapy at Genesis Recovery

At Genesis Recovery, we are here to support and guide you or your loved one to optimal wellness and recovery. Our certified therapists will equip you with the necessary tools and techniques to establish and maintain long-term mental health. Contact us today to begin healing.