An Overview of Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT) is an emerging treatment commonly classified in the “third wave” of therapies. This evidenced based approach focuses on acceptance and mindfulness strategies to increase client commitment to behavioral change. While the first two generations of behavioral therapy target symptom reduction, ACT complements traditional methods with increased psychological flexibility. This model offers a healthy and effective guide to action through six core ACT processes.
The Psychological Flexibility Model
Psychological Flexibility: the ability to contact the present moment more fully as a conscious human being and to change, or persist in, behavior when doing so serves valued ends.
Acceptance is all about opening up and creating space. As opposed to avoidance, acceptance empowers the person to stop struggling with painful feelings and previous personal events. Futile efforts to evade symptoms can effectively be supplanted by values-based decisions.
Defusion, or “cognitive defusion”, attempts to create separation between a person and their negative thoughts. This technique changes how one relates to these thoughts by offering new perspective and context. Defusion decreases the believability and attachment to debilitating thoughts and feelings.
Being present promotes a conscious connection and active engagement with the present moment. A state of “going through the motions” or “auto-pilot” reduces psychological flexibility and distracts from values. Being present makes way for a non-judgmental contact with psychological and environmental events.
Self as Context
This ACT process cultivates awareness of self through mindfulness, metaphors, and examination. Self-as-context gets in touch with the “I” that experiences thoughts, feelings, and life events. Growing evidence suggests high importance in separating the thinking self from the observing self.
Acceptance and Commitment Therapy would have no direction without values. Uncovering values through ACT processes is an essential part of creating a meaningful life. Standards, ideals, and principles are the compass by which behavior can be modeled and life decisions can be made.
The psychological flexibility afforded by ACT processes creates the ability to take committed action and make values-based decisions. At this stage, traditional behavioral therapy such as goal setting, exposure, skills-training, etc. can have their maximum benefit. ACT protocols typically involve committed action toward short, medium, and long-term goals determined by values.
ACT and Relational Frame Theory
ACT is based on Relational Frame Theory; a psychological theory of human language and cognition. This modern approach to behavioral therapy provides further understanding of the link between language and behavior.
“Acceptance and Commitment Therapy (ACT) is one of a number of new interventions from both behavioral and cognitive wings that seem to be moving the field in a different direction. ACT is explicitly contextualistic and is based on a basic experimental analysis of human language and cognition, Relational Frame Theory (RFT). RFT explains why cognitive fusion and experiential avoidance are both ubiquitous and harmful. ACT targets these processes and is producing supportive data both at the process and outcome level. The third-wave treatments are characterized by openness to older clinical traditions, a focus on second order and contextual change, an emphasis of function over form, and the construction of flexible and effective repertoires, among other features. They build on the first- and second-wave treatments, but seem to be carrying the behavior therapy tradition forward into new territory.”
“Clients undergoing this treatment type may note that acceptance and commitment therapy is a little easier to use. It has less homework than CBT and DBT. Much of the training occurs directly in sessions, which may bear some resemblance to typical ‘talk therapy’. ACT therapists are empathetic and client-centered.
An aspect of ACT that many people enjoy is its focus on mindfulness, which is drawn from Buddhist philosophies. DBT shares this emphasis with ACT, and both work on helping clients be present in the moment. People who are mindful may feel they are more aware of themselves, their thoughts, and their feelings at any given time. They often report a richer experience of living when they are able to be attentive to the now.
Another of the benefits of acceptance and commitment therapy is that it isn’t a therapy exclusive to people who have an illness. Many people like this therapy form as a self-help method. There are a few good self-help books on the topic, and one of the best of these books is usually judged to be ACT expert Russ Harris’ The Happiness Trap.
In small trials, anxiety disorders, depression, and schizophrenia have all responded favorably to acceptance and commitment therapy. ACT has also been found beneficial in treating people with chronic disease and substance abuse issues. Sports psychologists who have used ACT report that it also has benefits for athletes.”