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Acceptance and Commitment Therapy (ACT)

Developed by Dr. Steven Hayes, Acceptance and Commitment Therapy (ACT) is an evidence-based treatment approach like Cognitive Behavioral Therapy (CBT) that examines how our behaviors, thoughts, and emotions interact in the context of our environment.

ACT looks to accomplish two things:

1.  Develop a stance of acceptance and willingness to experience unwanted thoughts and feelings since these parts of the human experience cannot always be controlled, and
2. Deepen our understanding of what our values are, build goals around those values, and develop a plan to take committed actionable steps towards those goals.

ACT-based skills have been empirically supported in the treatment of various problem areas including anxiety disorders (Panic Disorder, OCD, generalized anxiety, separation anxiety, specific phobias, PTSD), depression, substance abuse, grief, chronic pain, eating disorders, and more. ACT looks at how we try to exert control over unwanted thoughts and feelings through experiential avoidance (i.e. avoiding, procrastinating, compulsion, numbing with substances, binge-watching, etc). An ACT perspective does not view the presence of symptoms as a disorder, but rather the efforts to avoid these unwanted thoughts, feelings, and sensations that create barriers between us and living a full life. To help develop skills towards acceptance and value-based action, ACT emphasizes mindfulness skills, cognitive defusion, staying with the present moment, taking a stance of accepting what is not in our control, and moving towards what matters.

The studies behind ACT have found six core processes that are the target of mindfulness, value-based action, and acceptance interventions:

  • Contact with the present moment: Noticing how our thoughts can bring us to the past or future and reconnecting with the present through mindful awareness skills.
  • Self as Context: The practice of observing that we are not our thoughts and that we can learn to observe our thoughts as
    content rather than applying judgment labels (e.g. this is a bad or good thought).
  • Cognitive Defusion: The process separating our evaluations from the actual experience. For example, when thinking something like “I can’t do this” rephrase it as “I’m noticing the thought that I can’t do this.”
  • Acceptance: Accepting the parts of our experience that are not within our control by shifting how we frame and label our thoughts and feelings.
  • Values: Clarifying valued life goals that provide a sense of purpose.
  • Committed Action: Identifying goals that align with our values, clarifying what steps are needed to act on these goals, and taking behavioral actions to achieve value-based goals.
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ACT can be practiced in harmony with other therapeutic interventions such as Exposure and Response Prevention (ERP) as it encourages distress tolerance and resisting the urge to avoid for the purpose of getting back to our lives. ACT adds focus on developing acceptance through mindfulness and taking committed action towards what we value in life.

For more information, visit the Association of Contextual Behavioral Science at  https://contextualscience.org/act

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