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Acceptance and Commitment Therapy (ACT)

Updated: Aug 17, 2023


A person standing in front of a board with "keep going" written on it, representing the principles of Acceptance & Commitment Therapy.
Embrace the journey of Acceptance & Commitment Therapy – a path to growth, resilience, and inner strength. Just like the message on the board says, "keep going," as you navigate the terrain of emotions, mindfulness, and values alignment.

What is ACT?

Acceptance and commitment therapy [ACT] is one of the recent mindfulness-based behavior therapies effective with diverse clinical conditions. In contrast to the assumption of 'healthy normality' of Western psychology, ACT therapy assumes that the psychological processes of a normal human mind are often destructive and create psychological suffering. An important aspect of ACT therapy is that it is closely associated with an active basic research program examining the nature of human language and cognition (Relational Frame Theory), a practice that recalls an earlier era of behavior therapy when behavioral principles were consciously applied to clinical treatments. The model appears to be broadly supported based on the correlational component, process of change, and outcome comparisons.


Still, the literature is not mature, and many questions have not yet been examined. Evidence suggests that ACT therapy works through different processes than active treatment comparisons, including traditional Cognitive-Behavior Therapy (CBT). There are not enough well-controlled studies to conclude that ACT therapy is generally more effective than other active treatments across the range of problems examined.


Instead of avoidance, ACT therapy taught the patient willingness and defusion to cope with challenging psychological contexts. Willingness is the deliberate embrace of complex thoughts, feelings, bodily sensations, and the like. Exposure exercises are used to contact troublesome private experiences.

Two individuals, one in red and one in black, engaged in a close conversation, symbolizing the connection and collaboration in Acceptance & Commitment Therapy.
In Acceptance & Commitment Therapy, the journey is shared, and progress is built through understanding, connection, and partnership. Together, we weave the threads of acceptance and commitment into a tapestry of growth.

The Process of ACT Therapy


Here is an overview of the process of ACT therapy:

1. Initial Assessment: The therapist initiates by performing an initial examination to understand the patient's history and current life cases. This helps establish a therapeutic relationship between the patient & therapist and builds a smoother road for future sessions.


2. Psychoeducation: In this phase, the therapist explains to the patient all about ACT therapy and how it will work. Briefing concepts such as the importance of acceptance, mindfulness, values, and committed action in achieving psychological well-being.


3. Clarifying Values: During this step, the patient is motivated to explore and clarify their personal values – what they want from life. This methodology helps them gain clarity on what they want to achieve from life and how they want to shape their life.


4. Mindfulness Skills: Mindfulness techniques are the next step in ACT therapy. It was used to make the patient more conscious of their thoughts, emotions, bodily sensations, and present moment without judgment. In this phase, patients may be taught to watch their thoughts float by without trying to alter them; they may be asked to repeat thoughts until they lose all meaning; or they may be asked to think of thoughts as external objects and will be asked a variety of perceptual/sensory questions about them (e.g., What color are they?).


5. Cognitive Defusion: undermines evaluation and teaches healthy distancing and nonjudgmental awareness. When this phase is successful, the patient will notice reactions from the level of an observer and will take a more willing stance toward unwanted thoughts.


6. Acceptance: In this phase, the patient will start developing an attitude of acceptance toward their emotional experiences, even if those experiences are discomfiting or distressing. This involves allowing emotions to come and go without trying to suppress or avoid them.


All ACT therapy techniques are in the service of helping the patient live life by their values. The exercises and metaphors in the values phase are geared toward assisting patients in identifying what they want to stand for in their lives in various domains (relationships, health, citizenship, and so on). Once values are identified, specific goals that fit these values and behaviors that might produce these concrete goals are identified. Finally, the barriers to those actions are identified and dealt with through other ACT methods (e.g., defusion, acceptance, and willingness).


7. Commitment to Values-Based Action: The final phase of the ACT, the commitment phase, involves working with the patient to apply what they have received in therapy to living life according to their chosen values, even if it involves experiencing psychological pain. This phase focuses on the patient’s willingness to participate in whatever may come up and helps them commit to acting per their values.


Commitment is presented as an ongoing, never-ending process of valuing and recommitting. It assumes that the old change agenda has been abandoned, some willingness has been contacted, and a cherished life direction has been identified. The commitment stage looks the most like traditional behavior therapy, as the patient passes through cycles of values, goals, actions, barriers, and dissolution of barriers. When this phase is completed, therapy is terminated. However, patients often come in with ACT for “tune-up” sessions after termination.


A boy standing on a beach at sunset, playfully attempting to hold the sun between his index fingers and thumb, symbolizing the hopeful essence of Acceptance & Commitment Therapy.
Just as the sun's warmth slips through our fingers, Acceptance & Commitment Therapy teaches us to hold our thoughts and emotions lightly, allowing them to pass by.

Conclusion

The theory behind ACT is that it is counterproductive to try to control painful emotions or psychological experiences; suppression of these feelings ultimately leads to more distress. ACT believes there are valid alternatives to changing your thoughts, including mindful behavior, attention to personal values, and commitment to action. By taking steps to change their behavior while, at the same time, learning to accept their psychological experiences, patients can eventually change their attitudes and emotional states.


If you have any questions regarding ACT, you can contact the experienced counselors and therapists from Project C Foundation can help:

☆ Bani Dhillon-Specialization: Interpersonal relationship, Marital Counselling, Personal Management, Stress Management, Personality Development, Effective Communication Skills, and Group Therapy.

☆Jaanvi Sharma-Specialization: Clinical psychology, NLP


Written By:

Larissa Alphonso


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