Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT)
“If we are not fully ourselves, truly in the present moment, we miss everything.”Thich Nhat Hanh
What do you value most in this one precious life of yours? Health? Loving relationships? Adventure? Stability?
You can value something and not be practicing it. For example, just because you value health doesn’t mean that you are taking actionable, workable steps towards living in alignment with that value. For folks who are struggling to live their life in a meaningful way, for those who find themselves stuck, avoiding, and/or making futile attempts to control what cannot be controlled, we have something for you. Read more below about the powerful approach of Acceptance and Commitment Therapy.
What is Acceptance and Commitment Therapy (ACT)?
Acceptance and Commitment Therapy (ACT; pronounced as the word “act”) is an evidence-based therapy that, according to Steven Hayes (a co-developer of the therapy), “uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility.”
ACT posits that emotional suffering is the result of psychological inflexibility. That one's futile attempts to control what cannot be controlled and the ongoing attempts to get rid of painful thoughts and feelings are at the root of suffering.
Interestingly, ACT does not have symptom reduction as a goal. This is based on the view that efforts to eliminate ‘symptoms’ actually creates a clinical disorder in the first place. As soon as difficult thoughts and feelings are labeled a ‘symptom’, it immediately sets up a struggle with it because a ‘symptom’ is by definition something ‘pathological’; something that shouldn't be there. In ACT, the aim is to transform our relationship with our difficult thoughts and feelings, so that we no longer perceive them as ‘symptoms’. Instead, we learn to perceive them as harmless, even if uncomfortable, passing inner experiences. Ironically, it is through this process that ACT actually achieves symptom reduction—but as a by-product and not the goal.
ACT is a behavioral therapy meaning it’s about taking action guided by core values and behaving like the sort of person you want to be. In ACT, clients will clarify what really matters, and then use those values to guide, motivate, and inspire workable behaviors. The goal of ACT is to maximize human potential for a rich, meaningful life while effectively handling the pain that inevitably comes with it.
“In ACT, our main interest in a thought is not whether it’s true or false, but whether it’s helpful; that is, if we pay attention to this thought, will it help us create the life we want?” Russ Harris, The Happiness Trap: How to Stop Struggling and Start Living
Who is ACT for?
ACT has been used for a variety of presenting complaints such as stress, anxiety, trauma, substance use, obsessive compulsive disorder, eating disorders, depression, grief, chronic pain, among others. Many individuals can benefit from this approach as increased psychological flexibility leads to greater capacity to adapt/cope with life’s changing demands and overall improved quality of life.
This approach may be especially attractive for people who have tried other treatments/interventions and had moderate or minimal success in addressing their presenting issues. One of ACT’s main difference from other approaches is that it doesn't try to replace unwanted thoughts, emotions, sensations, urges, memories, or any other internal experiences with more positive ones. Instead, the therapy gives clients a new way to respond to them. Learning to think positively can be useful but it doesn't stop negative thoughts from coming.
“If you always do what you’ve always done, you’ll always get what you’ve always got.”Moms Mabley
Core Flexibility Processes
In ACT, it’s understood that inflexibility is the root of unhappiness. Therefore, the main aim in ACT is to help individuals increase psychological flexibility. Psychological flexibility means contacting the present moment and changing or maintaining behaviors based on the context (the situation) and your personal values.
ACT focuses on each of the following processes to increase psychological flexibility:
- Cognitive Defusion
- Flexible Attention to the Now (Contacting the present moment)
- Flexible Perspective Taking (Self-as-context)
- Committed Action
Acceptance (Open Up) - involves active and aware embrace of our inner experiences (e.g. thoughts and feelings) as they emerge. It strives to “make room” for unwanted or painful thoughts and feelings, instead of attempting to change, reduce, or avoid them.
Cognitive Defusion (Watch Your Thinking) - distancing, separating, or “taking a step back” from our thoughts, memories, and images, and noticing them without judgment or getting “caught up” in them.
Contacting the Present Moment (Be Here Now) – consciously paying attention, engaging, and connecting with what is happening in the moment (being present). Noticing what comes up for us and being psychologically present.
Self-as-context (Pure Awareness) – also known as “the observing self,” it’s that constant aspect or part of us that is aware of what we are thinking, feeling, doing, and sensing in any moment. This is the “you” that experiences and observes; which is different from our thoughts, feelings, judgements, memories, fantasies, sensations, etc.
Values (Know What Matters) – this is what is important to you. According to Russ Harris (2009) values are defined as “desired qualities of ongoing actions.” In ACT they serve as a compass that points to the direction towards where we want to go in life; and consequently, they guide us in choosing ongoing behaviors that are aligned with our values.
Committed Action (Do What it Takes) – this involves commitment in taking action directed towards your personal values. In other words, taking effective action that is congruent with your values.
In essence, ACT’s goal is to help people engage in actions that are aligned with their values in order to “create a rich, meaningful life while accepting the pain that inevitably goes with it.”
ACT is an action-oriented approach that draws from experiential and cognitive-behavioral strategies. Sessions typically include the use of experiential and practical exercises that focus on:
- Developing acceptance of unwanted inner experiences which are out of our control
- Commitment and action toward living life according to our values
Sessions may include the following interventions:
- Exploration of values
- Experiential exercises
- Imagery exercises
- Role plays
Here is an introductory video to better understand what you may expect from this approach:
What to Expect from ACT
Through ACT interventions, therapists strive to help clients change their relationship with their inner experience (e.g. thoughts, emotions, sensations, memories, etc.). ACT’s approach may be best summarized through this acronym:
A - Accept your reactions (thoughts and feelings) and be present
C - Choose a valued direction
T - Take action
How to start ACT with us
- The first step is to give us a call: (954) 488-2933
- Our practice offers complimentary 15-minute phone consultations. During this consultation we will learn more about your needs and goals. You’ll be matched with one of our expert therapists
- Next, you’ll meet with your therapist for an initial session. There, your ACT therapist will get a thorough understanding of your unique background, history and what you’d like to accomplish. She’ll share her ideas for an action plan and collaboratively, you’ll decide next steps
- ACT may include other team members as appropriate. You might be recommended to visit a general physician, psychiatrist and/or dietician as part of your treatment plan
- ACT is typically very experiential in nature. Therapy sessions may include the use of mindfulness exercises, metaphors, role plays and other interventions to aid clients increase their psychological flexibility