Acceptance and Commitment Therapy (ACT)If you are interested in counseling using ACT, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.
|
|
What is Acceptance and Commitment Therapy?Acceptance and Commitment Therapy, commonly known as ACT (pronounced as the word "act"), is an evidence-based treatment approach that has been shown to be effective for a wide range of mental health concerns including anxiety, depression, chronic pain, OCD, trauma, grief, substance use, and more. ACT is considered a "third wave" cognitive behavioral therapy, meaning it builds on the foundations of traditional CBT while incorporating elements of mindfulness, acceptance, and values-based living.
Unlike traditional CBT, which focuses primarily on identifying and changing unhelpful thoughts, ACT takes a different approach. Rather than trying to eliminate or argue with difficult thoughts and feelings, ACT teaches individuals to change their relationship with those experiences. The goal is not to think more positively or feel less pain. The goal is to develop the psychological flexibility to live a meaningful, values-driven life even in the presence of difficult thoughts, feelings, and experiences. ACT is grounded in a well-established body of research and is supported by hundreds of randomized controlled trials across a wide range of clinical populations. It is considered an empirically supported treatment by the American Psychological Association. |
|
What is the Core Philosophy Behind ACT?
ACT is based on the idea that psychological suffering often comes not from difficult thoughts and feelings themselves, but from our attempts to avoid, suppress, or eliminate them. When we spend significant energy fighting against internal experiences, pushing away anxiety, suppressing grief, arguing with self-critical thoughts, we often find that those experiences become more persistent and more powerful, and that the effort of avoidance itself keeps us stuck and narrows our lives.
ACT draws on a concept called psychological flexibility, which refers to the ability to be present with whatever thoughts and feelings arise, without being controlled by them, while continuing to move toward what matters most to you. Psychological inflexibility, being fused with unhelpful thoughts, avoiding difficult feelings, and losing touch with your values, is understood in ACT as a core driver of psychological distress.
ACT does not ask you to pretend difficult things are not difficult. It asks you to make room for them while reclaiming your ability to act in accordance with your values regardless of what your mind is telling you.
ACT draws on a concept called psychological flexibility, which refers to the ability to be present with whatever thoughts and feelings arise, without being controlled by them, while continuing to move toward what matters most to you. Psychological inflexibility, being fused with unhelpful thoughts, avoiding difficult feelings, and losing touch with your values, is understood in ACT as a core driver of psychological distress.
ACT does not ask you to pretend difficult things are not difficult. It asks you to make room for them while reclaiming your ability to act in accordance with your values regardless of what your mind is telling you.
What Are the Core Processes of ACT?
ACT is organized around six core psychological processes that together build psychological flexibility. These processes are interconnected and are woven throughout treatment rather than addressed in a strict sequence.
Acceptance involves actively making room for difficult thoughts, feelings, sensations, and memories without trying to change, suppress, or avoid them. Acceptance is not resignation or giving up. It is the willingness to have your experience as it is, so that you are no longer spending energy fighting against your own internal life.
Cognitive Defusion involves changing your relationship with your thoughts rather than the content of the thoughts themselves. In ACT, we often become "fused" with our thoughts, treating them as facts or commands. Defusion techniques help create distance between you and your thoughts so that you can observe them as mental events rather than truths that must be acted upon.
Present Moment Awareness, often cultivated through mindfulness practices, involves bringing flexible, open, and curious attention to the present moment rather than being caught in rumination about the past or worry about the future.
Self as Context, sometimes called the "observing self," refers to the part of you that is aware of your thoughts and feelings but is not defined by them. From this perspective, you are not your anxiety, your depression, or your self-critical thoughts. You are the person wh o notices them.
Values Clarification involves identifying what truly matters to you -- not what you think you should care about, or what others expect of you, but what you genuinely value in the areas of relationships, work, health, personal growth, and community. Values in ACT are not goals to be achieved but directions to move toward.
Committed Action involves taking concrete steps in the direction of your values, even in the presence of difficult thoughts, feelings, and discomfort. This often involves behavioral activation, goal setting, and a willingness to tolerate the discomfort that comes with meaningful action.
Acceptance involves actively making room for difficult thoughts, feelings, sensations, and memories without trying to change, suppress, or avoid them. Acceptance is not resignation or giving up. It is the willingness to have your experience as it is, so that you are no longer spending energy fighting against your own internal life.
Cognitive Defusion involves changing your relationship with your thoughts rather than the content of the thoughts themselves. In ACT, we often become "fused" with our thoughts, treating them as facts or commands. Defusion techniques help create distance between you and your thoughts so that you can observe them as mental events rather than truths that must be acted upon.
Present Moment Awareness, often cultivated through mindfulness practices, involves bringing flexible, open, and curious attention to the present moment rather than being caught in rumination about the past or worry about the future.
Self as Context, sometimes called the "observing self," refers to the part of you that is aware of your thoughts and feelings but is not defined by them. From this perspective, you are not your anxiety, your depression, or your self-critical thoughts. You are the person wh o notices them.
Values Clarification involves identifying what truly matters to you -- not what you think you should care about, or what others expect of you, but what you genuinely value in the areas of relationships, work, health, personal growth, and community. Values in ACT are not goals to be achieved but directions to move toward.
Committed Action involves taking concrete steps in the direction of your values, even in the presence of difficult thoughts, feelings, and discomfort. This often involves behavioral activation, goal setting, and a willingness to tolerate the discomfort that comes with meaningful action.
What Does an ACT Session Look Like?
ACT sessions are collaborative and experiential. Your therapist will work with you to understand the patterns that are keeping you stuck, clarify what matters most to you, and develop practical skills for building psychological flexibility. Sessions may incorporate mindfulness exercises, metaphors and experiential exercises designed to illustrate ACT concepts, values clarification work, and behavioral planning.
ACT uses a great deal of metaphor and imagery to help make its concepts concrete and accessible. For example, the "passengers on a bus" metaphor helps illustrate how difficult thoughts and feelings can feel like demanding passengers trying to take over the wheel, while you, the driver, still have the ability to choose the direction of travel. The "quicksand" metaphor helps illustrate how struggling against difficult feelings can pull you deeper, while relaxing into the experience allows you to stay afloat.
Homework and between-session practice are typically part of ACT treatment, as the skills developed in sessions need to be practiced and applied in daily life to be most effective.
ACT uses a great deal of metaphor and imagery to help make its concepts concrete and accessible. For example, the "passengers on a bus" metaphor helps illustrate how difficult thoughts and feelings can feel like demanding passengers trying to take over the wheel, while you, the driver, still have the ability to choose the direction of travel. The "quicksand" metaphor helps illustrate how struggling against difficult feelings can pull you deeper, while relaxing into the experience allows you to stay afloat.
Homework and between-session practice are typically part of ACT treatment, as the skills developed in sessions need to be practiced and applied in daily life to be most effective.
What Can ACT Help With?
ACT has a strong evidence base across a wide range of presenting concerns. At OakHeart, our clinicians use ACT or incorporate ACT principles in the treatment of anxiety disorders, depression, OCD, ADHD, grief and bereavement, chronic pain and illness, substance use, trauma, infertility and pregnancy loss, and adjustment to major life transitions. ACT is also well suited for individuals who feel they have tried other approaches without finding lasting relief, or for whom the focus of traditional CBT on changing thoughts has not felt like a good fit.
How is ACT Different from CBT?
ACT and CBT share important common ground. Both are structured, skills-based, evidence-based approaches. Both emphasize the role of thoughts and behaviors in psychological wellbeing. Both involve active participation and between-session practice.
The key difference lies in how they approach difficult thoughts. Traditional CBT typically asks: is this thought accurate? What is the evidence for and against it? Can we replace it with a more balanced thought? ACT takes a different approach: regardless of whether this thought is accurate, is holding onto it tightly and acting on it moving you toward the life you want? ACT is less focused on the truth or accuracy of thoughts and more focused on whether psychological fusion with those thoughts is serving you.
For some individuals and presentations, traditional CBT is the better fit. For others, ACT resonates more deeply. Many clinicians at OakHeart are trained in both approaches and will work with you to identify which framework, or which combination, best fits your needs and goals.
The key difference lies in how they approach difficult thoughts. Traditional CBT typically asks: is this thought accurate? What is the evidence for and against it? Can we replace it with a more balanced thought? ACT takes a different approach: regardless of whether this thought is accurate, is holding onto it tightly and acting on it moving you toward the life you want? ACT is less focused on the truth or accuracy of thoughts and more focused on whether psychological fusion with those thoughts is serving you.
For some individuals and presentations, traditional CBT is the better fit. For others, ACT resonates more deeply. Many clinicians at OakHeart are trained in both approaches and will work with you to identify which framework, or which combination, best fits your needs and goals.
Is ACT Right for Me?
ACT tends to be particularly well suited for individuals who have found that trying to control or eliminate their anxiety, depression, or other difficult feelings has not worked or has made things worse. It is also a strong fit for individuals who feel disconnected from what matters to them, who want to develop a more compassionate relationship with themselves, or who are navigating circumstances that cannot be changed, such as chronic illness, grief, or infertility, and need support building a meaningful life alongside those realities.
If you are interested in learning more about whether ACT might be a good fit for you, our team at OakHeart is happy to discuss your needs and help you find the right approach and the right clinician.
Our team of licensed psychologists, counselors, and social workers in North Aurora and Sycamore, Illinois provides ACT and other evidence-based treatments to clients throughout Kane County, DeKalb County, DuPage County, and the surrounding Chicago suburbs, including in-person and telehealth options throughout Illinois.
If you are interested in learning more about whether ACT might be a good fit for you, our team at OakHeart is happy to discuss your needs and help you find the right approach and the right clinician.
Our team of licensed psychologists, counselors, and social workers in North Aurora and Sycamore, Illinois provides ACT and other evidence-based treatments to clients throughout Kane County, DeKalb County, DuPage County, and the surrounding Chicago suburbs, including in-person and telehealth options throughout Illinois.
References
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York: Guilford Press.
Levin, M. E., Krafft, J., & Twohig, M. P. (2024). An overview of research on acceptance and commitment therapy. Psychiatric Clinics of North America, 47(2), 419-431.
Twohig, M. P., & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: A review. Psychiatric Clinics of North America, 40(4), 751-770.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York: Guilford Press.
Levin, M. E., Krafft, J., & Twohig, M. P. (2024). An overview of research on acceptance and commitment therapy. Psychiatric Clinics of North America, 47(2), 419-431.
Twohig, M. P., & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: A review. Psychiatric Clinics of North America, 40(4), 751-770.
