Acceptance Commitment Therapy (ACT)

What is ACT?

Acceptance Commitment Therapy (ACT) is a form of cognitive behavioural therapy that uses mindfulness and behavioural activation to increase psychological flexibility. ACT is made up of six key factors. These include; values, getting in contact with the present moment, committed action, defusion, self as context and acceptance. The goal of ACT is psychological flexibility for the individual, meaning teaching the client to become more flexible in their approach to their internal belief system and to focus on a valued life, to make informed decisions with regard to their behavior by asking themselves ‘does this action move me toward or away from valued living?’. ACT is not about changing the content of the clients thoughts, its more about changing the relationship they have with them.

The following six key factors of ACT are designed to help the individual achieve psychological flexibility.

Values

Generally the first step is to ask the individual to identify their core values but this will depend on the person and their situation at the time. Getting the client to identify their values can be a long process. Often people don’t know what their values are or have even given them much thought, they may have them confused with goals, rules, or someone else’s values. Values can never achieved or obtained, they are like a compass for life giving the individual direction which helps them choose their behavior. Once the values are identified the person is asked to establish if they are living a value based life? This helps them to identify if and where they are ‘stuck’ and are they are choosing behavior that is either moving them toward or away from a value direction.

Getting in contact with the present moment (mindfulness)

Mindfulness or getting in contact with the present moment and giving it your full attention is a state of being that the individual can develop at any stage of their lives. Mindfulness is always focused on the present and not the past or the future, its being fully aware and accepting, without judgment, of the here and now. Mindfulness is used to help the person get in touch with, and make room for, uncomfortable feelings and emotions as they arise. The individual learns to be the observer, to be aware of their thoughts, feelings and emotions and how they are affecting their life choices at any given time.

Self as context

Negative self talk can have a huge influence on the mental well being of the individual when they believe or become their negative self talk, ie; I am a bad person, I am ugly, nobody likes me, I’m too fat or too stupid. The person can become fused with this self talk and believe it to be true, they become their thoughts. There are various techniques to help them to let go of unhelpful self evaluation and gain a sense of self.

Committed Action

Once the values are identified goals can be set to help the individual move towards living a valued life. They are asked to identify any obstacles (thoughts, feelings, emotions) that will arise once they start to make changes, they understand that this discomfort will show up. Taking committed action means the person is willing to feel the discomfort and make room for these uncomfortable feelings, thoughts and emotions as they arise. It is not easy and it takes committed action for the person to choose the behaviour during this time of discomfort that will move them in a valued direction.

Defusion

Defusion is a technique that allows the individual to ‘unhook’ themselves, or defuse from their uncomfortable or unhelpful thoughts. It teaches them to recognize that these are just thoughts they are having and not facts. Often people are fused with their “I’m not good enough” story, this story is made up of past events, thoughts and influences that have occurred in their life and they believe them to be true. These beliefs can cause the individual to get stuck which can hinder them from moving forward. When a person believes their thoughts as true they allow the thoughts to become their behavior. By being the observer of the thoughts they are able to defuse from them and see them for what they really are and not what they say they are. Defusion isn’t about trying to get rid of unhelpful thoughts, rather its about recognizing that they are just that, unhelpful thoughts.

Acceptance

Acceptance is very closely related to mindfulness. Its about being aware of uncomfortable and painful thoughts, feeling and emotions when they arise and making room for them rather than trying to avoid them. Asking the individual to accept uncomfortable and painful thoughts, feelings and emotions can be quite confronting for some, especially when they have lived their lives around certain harmful behaviours that have helped them cope with this discomfort. It is also about understanding that the emotions themselves cannot harm us, it’s the choices we make in that moment to deal with the discomfort that will either move them toward or away from valued living. Again, there are many techniques to help the individual accept and make room for these uncomfortable or painful moments.