September 1st, 2020

Acceptance and Commitment Therapy (ACT): An introduction

By Dan Whale

  • Anxiety
  • Depression
  • Stress
  • Obsessive Compulsive Disorder
  • Body Dysmorphic Disorder
  • Therapy

ACT focuses on developing a rich and meaningful life, whilst accepting that unpleasant and unwanted experiences are inevitable. These ‘unpleasant internal experiences’ may be thoughts, images, memories or feelings.

ACT teaches you that trying to fight against unpleasant internal experiences is both ineffective and counterproductive. This is because trying to get rid of them is usually a battle which we cannot win - and therefore only causes further distress. Instead, in ACT we learn to identify these experiences as a normal, albeit unpleasant, part of life.

By nurturing this accepting stance, whilst also committing to the values that are most important to us, we’re more able to move forward with our lives. Research shows that changing our perspective in this way is also very likely to lead to a reduction in unpleasant internal experiences.

Why might a therapist suggest ACT

Developed in 1982 by Steven C Hayes, ACT has been used to treat a wide range of mental health difficulties, such as depression, anxiety, OCD, BDD, stress, chronic pain and more. ACT is a commonly used and well researched intervention, which is part of the “third wave” (more recently developed) cognitive behavioural therapies.

How it works

There are six ‘core processes’ of ACT. Your therapist will help you implement these throughout your treatment.

Acceptance: Acceptance is the alternative to trying to change or fight against unpleasant thoughts and feelings. It is the choice to allow these experiences to exist and to continue regardless.

Defusion: Defusion describes techniques that allow us to react differently to unpleasant internal experiences, without being caught-up in them. These are often based in mindfulness practices.

Contact with the present: Though it sounds easy, simply ‘being present’ in a situation can be harder than we think. We are used to operating on auto-pilot, which often involves getting stuck in the past or worrying about the future. ACT teaches skills to enhance contact with the current situation.

The observing self: This is the idea that we are not just our thoughts and feelings - there is more to us than that. Thoughts and feelings come and go, but the observing self is stable and always there. Developing this perspective enables us to remain robust in the face of unpleasant internal experiences.

Values: Your therapist will work with you to establish clearly defined values. Having a strong understanding of what is most important to you improves your ability to make decisions and stick to certain behaviours - especially in challenging scenarios.

Committed action: Finally, ACT helps you to commit to actions that will help with your long-term goals.

What we know so far

ACT is an evidence-based therapy and research has shown it to be effective in treating a wide variety of mental health difficulties. A 2015 meta-analysis indicated that ACT is more effective than treatment as usual or placebo and that ACT may be as effective in treating anxiety, depression, addiction, and long-term health conditions as more established psychological interventions.

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Whilst ACT has its roots in CBT, it offers something slightly different and it has a solid evidence-base for treating many difficulties. If you think ACT might be a good option for you, speak to us today and we can connect you to a therapist which offers this approach.

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