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What Is Acceptance and Commitment Therapy (ACT)?

Learn about acceptance and commitment therapy (ACT), how it works, and its effectiveness in this article.

What Is Acceptance and Commitment Therapy (ACT)?

Acceptance and commitment therapy, also known as ACT, is a type of psychotherapy. The goal of ACT is to increase what is known as psychological flexibility.

Psychological flexibility refers to the ability to adapt to new situations and circumstances through healthy coping and awareness. As a result, ACT, like many other types of psychotherapy, focuses on encouraging mindfulness and creating a better understanding of how an individual’s thoughts affect their daily lives.

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Structure of an ACT Therapy Session

For most forms of therapy, there is a set structure. This means that while session to session may vary, all sessions have a general cohesive plan. However, acceptance and commitment therapy lacks this unified structure. Therefore, instead of having a single structure, ACT focuses on guiding the individual through certain phases.

  • Phase One: Build Communication and Rapport With the Patient: The first phase of ACT is to talk about the issues that bring the individual into therapy. The first few sessions will focus on building a connection between the patient and the therapist as well as developing context for the distressing issues. This may also include discussing past treatments that weren’t successful.
  • Phase Two: Establish Understanding of the Mind: Next, acceptance and commitment therapy will focus on creating a better understanding of the mind. Thus, this phase includes learning more about patterns in thoughts and behaviors, accepting reality, understanding where change is and isn’t possible, identifying core values, and committing to living a life that focuses on mental well-being. 
  • Phase Three: Develop Psychological Flexibility: Overall, acceptance and commitment therapy works to generate psychological flexibility. This allows for the mind to accept different perspectives, which include those geared towards more self-compassion and care. 

Role of ACT in Psychology and Mindfulness

One of the essential aspects of acceptance and commitment therapy is learning to accept that certain negative events, such as grief, loss, pain, and disappointment, are a part of the human experience. As a result, rather than try and change these factors, ACT focuses on creating mindfulness.

Mindfulness involves creating an inner environment where the patient is better equipped to handle distress at the moment and work through it in a healthy manner by committing to mental well-being. The methods of ACT can thus be applied to psychology and physical distress, such as chronic pain, because it focuses on better understanding the mind and body as a whole.

Key Component of ACT

The key component of ACT is psychological flexibility. Psychological flexibility is an invaluable tool for navigating mental health, as it allows individuals to engage in mindfulness by opening the mind to an increased awareness of thoughts and actions. It can also help individuals learn to adapt various perspectives to understand why they feel or behave in certain ways.

For example, one study found that 30% of participants who exhibited psychological flexibility had less anxiety and depressive symptoms than the 70% who did not show psychological flexibility. 1

Hexaflex

ACT is built on a structure known as the hexaflex, which prioritizes existing in the present, acceptance, diffusion of situations, understanding personal values, committing to active healing, and focusing on the idea of self separate from experience. These are also key concepts in mindfulness and psychology, where individuals are encouraged to view the mind as it is and understand that past experiences are influences, not definitions for identity.

Useful ACT Techniques and Skills

Stress, pain, and sadness are all normal emotions. While they can be uncomfortable to experience, it can be unhealthy to suppress these emotions. However, for some, intense emotions can be unsafe or persistent. This is where acceptance and commitment therapy is beneficial.

ACT aims to create a healthy inner environment so individuals have a better understanding of what they’re feeling. As a result, this therapy can help them learn to regulate and express their emotions in a healthy manner. A recent study found that patients with depression and mixed mental disorders showed a significant reduction in symptoms, with more than half recovering from their condition. 2

Techniques and Applications

Acceptance and commitment therapy techniques and skills can be beneficial for anyone, including those pursuing other treatment options. Additionally, these techniques can act as a preventative treatment by regulating the mind before mental health issues arise.

Some of the techniques and skills utilized in acceptance and commitment therapy can include:

  • Writing acceptance exercises
  • Practicing mindfulness
  • Valued directions worksheets
  • Life deviation scores and goal setting
  • Committed actions

What Conditions Does ACT Treat?

ACT can be a useful treatment for most mental health disorders, as it focuses on teaching fundamental mindfulness skills.

Some of the conditions that ACT can be helpful for include:

Acceptance and Commitment Therapy (Act)

The Effectiveness of Acceptance and Commitment Therapy

Acceptance and commitment therapy is a relatively new form of therapy. Compared to other forms of therapy that have existed for several decades, ACT was developed in the 1980s. Since its development, there have already been several studies dedicated to its effectiveness.

One study in 2020 focused on determining whether or not ACT was beneficial for students with social anxiety disorder. Social anxiety disorders are some of the most common anxiety disorders, and they can cause difficulties in regulating emotions. In this study, acceptance and commitment therapy proved to be a beneficial treatment option that helped individuals to reduce symptoms of social anxiety and learn to regulate their emotions. 3

Can ACT Help Heal Depression and Suicidal Ideation?

Additionally, another study focusing on treating depression and suicidal ideation in veterans showed ACT to be an effective treatment method. The study found that symptoms of depression and suicidal thoughts significantly reduced, and the patients’ mindfulness and experiential acceptance improved gradually over time. 4

What to Expect From Acceptance and Commitment Therapy

Although there isn’t a single structure to acceptance and commitment therapy, there is a foundation of key principles that guide the sessions.

ACT typically occurs over the course of several sessions, although it doesn’t tend to last as long as other types of therapy, such as cognitive behavioral therapy. Individuals in ACT will learn more about the hexaflex model and the six key principles of ACT, as well as how to apply them in their own lives through certain skills and techniques. 

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