Living with a mental health condition can feel exhausting. And, constantly fighting against or avoiding your thoughts and emotions can make the world feel even more draining.
Acceptance and commitment therapy (ACT) offers a different approach to coping. Rather than trying to “get rid” of uncomfortable thoughts or feelings, ACT helps people change how they respond. This evidence-based behavioral therapy fosters meaningful change and supports people experiencing conditions such as anxiety, depression, trauma, and stress.
If battling against difficult thoughts is draining your energy and quality of life, a mental health professional can help you decide whether ACT is the right “fit” for you.
This guide can also help you better understand acceptance and commitment therapy and how it works by exploring:
Our minds and bodies are inherently wired to try to protect us from pain. Sometimes this happens automatically (like pulling our hand away from a hot stove), sometimes intentionally (like avoiding a difficult conversation).
Although emotions like anger or grief may feel “bad,” they are also natural feelings to have and part of what makes us human, not something to avoid.
So how can you learn to respond to these uncomfortable emotions differently? An approach called “acceptance and commitment therapy” (ACT) may help. In the following sections, we take a look at where ACT came from and how it aims to improve well-being.
ACT is a therapeutic approach that falls under the umbrella of “third wave” CBT therapies.2,3 It differs from traditional cognitive behavioral therapy (CBT) in some key ways. For example, CBT focuses on challenging or changing negative thoughts, feelings, beliefs, or behaviors, while the cornerstone of ACT is understanding how we relate to these thoughts and emotions.
The Goal of ACT
The aim of ACT isn’t to “stamp out” or suppress uncomfortable feelings, but to move forward in life in the face of these painful experiences by developing psychological flexibility.1
Psychological flexibility is the ability to accept difficult thoughts and feelings without being controlled by them. By doing this, you can choose behaviors and actions that are in line with values you hold close, even when life feels challenging.4 This is why ACT is sometimes known as a “psychological flexibility therapy.”
Psychological flexibility is important for overall well-being as it allows people to adapt to changes, shift their perspective, balance life’s demands, and stay true to their values. ACT helps you to build this flexibility through practising mindfulness techniques, encouraging acceptance, and fostering value-driven behaviors.3 These allow a person to observe their thoughts and feelings in a non-judgmental way, giving them space to respond to situations rather than having knee-jerk reactions.
With a clearer understanding of ACT, let’s take a closer look at its core principles next.
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Acceptance means noticing difficult emotions without judgment or avoidance, and allowing them to be there without letting them control your actions.
Cognitive defusion means stepping back from unhelpful thoughts. For instance, realizing that the thought I’m a failure is just a thought – not a fact – can reduce its power over your choices.
Mindfulness – paying non-judgmental attention to the present moment – is central to ACT (a mindfulness based therapy). It helps you notice thoughts, feelings, and sensations as they happen, rather than, for example, becoming lost in worries about the future.
Self-as-context means seeing yourself as more than just your thoughts or emotions. It’s recognizing that you are a whole, stable person, experiencing life without being defined by what’s happening on the inside.
ACT is a values based therapy, meaning it helps you identify the things that matter most to you: your values. Clarifying your personal values can give you a clearer sense of direction in life.
ACT encourages you to take meaningful steps toward your value-driven goals, even when it may feel uncomfortable or challenging.
These six processes work together to help people increase psychological flexibility, resilience, and feel a greater sense of purpose in life.
Having covered some of the basics of ACT, you may be interested to know how it can be used practically to support mental well-being. We cover the most common mental health challenges ACT can help treat in the next section.
Its focus on acceptance, values, and taking action can make it especially helpful for conditions such as anxiety, depression, and trauma. The benefits of the approach for each of these conditions is explored in the following paragraphs.
Through ACT, people can learn techniques to change how they respond to anxiety, with studies showing that ACT can significantly reduce anxiety symptoms.2,5 For instance, ACT can help people with anxiety notice anxious thoughts without immediately reacting to them. The mindfulness element then teaches clients how to stay present rather than being drawn into rumination, while the focus on values enables people to discover how to move forward through fear.
ACT Therapy for Depression
Depression can frequently lead people to withdraw from others and give up activities that used to bring them meaning or joy. To counteract this, ACT focuses on helping people reconnect with what matters most to them, even when motivation may be very low. Values play a big role in this, and committing to taking steps toward them can help people regain their sense of purpose.5
Furthermore, studies show that ACT can significantly reduce symptoms of depression, with results similar to CBT.2
ACT Therapy for Trauma
Trauma may cause people to avoid triggers, intrusive memories, or overwhelming emotions connected to the event they experienced. ACT provides a framework to relate to experiences differently, using present-moment awareness, self-as-context, and acceptance to help a person regain a sense of control.
Research also shows that ACT can effectively reduce avoidance behaviors and improve emotional regulation in trauma survivors and those with post-traumatic stress disorder (PTSD).2
In addition to the disorders mentioned above, research shows that ACT can also support people with obsessive-compulsive disorder (OCD), stress, chronic pain, psychosis, and low self-esteem.2,4,5
By helping people accept their experiences and be guided by their values, ACT can pave the way to building resilience, reducing avoidance, and re-engaging fully with life.
One question many people ask before engaging with therapy is “What is a session actually like?” This is covered next.
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What a Typical Session Involves
When you first arrive for an ACT session, you’ll meet your therapist and can discuss your personal goals with them and ask questions. Your therapist will then be able to give you an idea of how they work professionally, what you can expect, and what you’ll be working on during each session.6
A key part of therapy is building the therapeutic relationship (between you and your therapist), so that you can feel supported and unjudged, allowing you to safely explore difficult experiences.
ACT sessions are tailored to your needs and goals, combining conversation, mindfulness, and ACT therapy exercises to increase self-awareness while supporting what matters most to you.
Mindfulness and Present-Moment Awareness
One of the key ACT therapy techniques is mindfulness. It can help you notice thoughts, feelings, and sensations when they arise, without feeling the need to immediately react to them. With time and practise, this can reduce feelings of overwhelm and allow you to have more intentional responses to events.2
Some examples of mindfulness exercises include visualization, mindful breathing, and body scans.
Working With Thoughts: Cognitive Defusion
ACT uses a technique known as “cognitive defusion” to help you detach from unhelpful thoughts. This allows you to gain some distance and perspective, letting you see thoughts for what they really are: just thoughts, not facts. Realizing this can reduce the impact that thoughts have, whether they take the form of scaremongering or an inner critical voice.5
Some examples of cognitive defusion exercises are watching your thoughts like clouds in the sky, labeling thoughts, or saying, “I’m having the thought that…”
Clarifying Values and Taking Committed Action
Value clarification is central to ACT. Identifying what gives your life meaning, such as being kind, pursuing personal growth, or creative expression, can help you create goals or dreams that you would find fulfilling. Knowing your values and goals can also make it easier to decide what actions to take to live a life that is moving in your chosen direction.5
ACT sessions may involve a variety of exercises designed to improve psychological flexibility, such as grounding techniques, visualizations, or behavior experiments. But these exercises are not limited to the therapy room – it’s important to practice them between sessions so that they can support you out in the world.
ACT can be delivered in a range of settings, including outpatient therapy, group programs, and residential treatment, meaning skills may be practised outside of sessions in a variety of ways. For instance, if you are receiving outpatient therapy, you might practise exercises at home. On the other hand, if you receive ACT residential treatment, you may be encouraged to practise skills during workshops or during your free time at the treatment center. ACT inpatient mental health programs offer 24/7 support for people finding it hard to manage day-to-day activities or if you feel unsafe, with tailored recovery and skill-building.
Now that you have a better idea of what ACT involves, how do you know if it is the right option for you?
Acceptance and commitment therapy helps many people dealing with mental health issues and stress. However, it might not be the right fit for everyone. So, who may benefit most from ACT?
ACT may be a good fit if you:
ACT may be less suitable if you:
A mental health professional can help you explore whether ACT is the right approach for your needs and preferences, or whether a different type of therapy may be a better starting point.
Living with mental health challenges can feel overwhelming. If you’ve been carrying a heavy emotional load on your own, know that it is possible to lighten it – and we are here to support you.
If you’re considering ACT and would like support exploring whether it’s the right approach for you, our team is here to help. At AMFM, our experienced mental health professionals offer ACT-informed care across our settings, including residential care, and create treatment plans personalized to your needs and goals.
Contact us today to learn more about ACT therapy options and how we can support you on your journey toward mental well-being.
Complete the form to receive a prompt call back from a member of our experienced and compassionate admissions staff. All communication is 100% confidential.
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At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
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