Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that emphasizes accepting difficult situations and feelings, rather than trying to escape or suppress them. It evolved out of cognitive behavioral therapy (CBT).
ACT encourages the acceptance of pain, grief, disappointment, and anxiety as an inevitable part of life. The idea is that this acceptance can help you tolerate difficulties and move forward productively.
Being able to adapt productively to things you find hard is called psychological flexibility.
Another important part of ACT is looking inside yourself and identifying your core values, then acting in ways that align with them when you come up against challenges.
Research has shown that ACT can help people in a surprising number of ways — helping you improve mental health issues, have better social relationships, and even maintain healthy habits.
How ACT can improve your well-being
High quality research over the years has shown that ACT can have a strong positive effect on many different mental health issues, including anxiety, depression, post-traumatic stress disorder (PTSD), chronic pain, stress, and many more.
Numerous studies have found that ACT helps in a few key ways:
- Psychological flexibility you develop in ACT can give you greater capacity to handle difficult life situations
- Improved emotional regulation
- Greater life satisfaction
- Reduced mental health symptoms
ACT and anxiety
To understand how ACT works, it may be helpful to look how an ACT therapist would typically help you with anxiety.
In ACT, the therapist would show you different ways you can sit with your anxiety, existing peacefully alongside it.
This might include learning to notice it when it happens, opening yourself up to experiencing the thoughts, feelings, and sensations it brings, and letting go of trying to control or avoid it.
Your ACT therapist might also guide you to reengage in activities you value that can cause you anxiety, encouraging you to use your new skills to tolerate the anxiety as it happens.
It’s all about changing your relationship with anxiety, not eliminating it.
Yet this approach still has the effect of reducing anxiety symptoms.
What is psychological flexibility?
Psychological flexibility is at the heart of ACT. It’s what you learn to develop for yourself during this type of therapy.
It’s the ability to face challenging emotions and situations with openness. It’s about staying present in the moment and consciously acting in ways that are aligned with your personal values, even if it’s difficult.
It’s worth noting that this can be very challenging! Instead of staying present when things get tough, many people’s first instinct is to avoid the stressful situation or person. Many people want to lash out at others or shy away instead of consciously responding to challenging situations in ways that reflect their values.
Psychological flexibility is the ability to stay present and tolerate the discomfort of difficult situations, continuing to stay true to yourself through it. It helps you face life’s most difficult challenges and it’s critical for mental health.
Psychological flexibility is important because it allows you to remain open to your experiences and stay present, even when faced with emotional or cognitive distress. It helps you avoid getting “stuck” in a cycle of trying to avoid internal discomfort, or control the situation when you can’t.
In contrast, researchers say that psychological inflexibility is a major source of human suffering. People with psychological inflexibility tend to avoid experiences, have difficulty adapting to change, and suppress negative emotions or thoughts.
The 6 core processes of ACT
ACT uses six overlapping therapeutic processes to build psychological flexibility.
You learn how to use these processes during therapy. They work together to help you manage unwanted thoughts or behavior and choose a better way forward:
- Acceptance: Opening yourself up to unpleasant feelings, embracing them and accepting them, not denying them or pushing them away. This can involve practicing self-compassion if you’re having negative thoughts toward yourself.
- Cognitive defusion: Perceiving yourself as separate from thoughts or feelings that come up. This allows you to assess them better before acting. It’s about learning not to take your thoughts as absolute truths, but instead treating them with curiosity.
- Being present: Being psychologically present and consciously connecting with what is happening right now in a nonjudgmental way.
- Self-as-context: Developing the clear understanding that your personal identity is separate from your changing thoughts and feelings.
- Values clarification: Defining your core beliefs and using them to guide your actions and decision-making.
- Committed action: Setting goals and taking steps that are guided by those personal values. Persisting even when you face obstacles.
ACT vs. CBT
How is ACT different from cognitive behavioral therapy (CBT)?
ACT is considered a modern form of CBT. It’s part of a “third wave” of behavioral treatments that focus on addressing the root of the problem and aren’t just about easing symptoms.
The aim of traditional CBT is to identify and restructure a person’s “maladaptive” or “negative” thoughts. In contrast, ACT emphasizes accepting these thoughts without judgment.
Instead of trying to change the content or frequency of your negative thoughts, ACT is about changing the way you treat those thoughts and how you let them affect your behavior.
High quality studies on the effects of ACT in people with anxiety showed that it reduced anxiety as much or more than CBT.
How ACT can affect your relationships and social life
The skills you learn in ACT, like psychological flexibility, have significant implications for how you interact with others.
ACT helps you behave in ways that match your personal values. Many people may find that their social relationships improve as a result. For example, ACT may help you:
- Take part in social activities that align with your life goals and values that you would have previously avoided out of anxiety.
- Pursue career ambitions you might have avoided in the past.
- Open yourself up to having relationships that you value but you might have avoided before.
Is linked to better emotional regulation and resilience, providing individuals with the essential tools needed to navigate the complexities of interpersonal conflict and long-term commitment.
Can ACT work for couples therapy?
ACT can be used for couples therapy, but its greatest strengths may lie in improving your relationships indirectly when you use it as an individual therapy.
One systemic review and meta-analysis looked at whether ACT was effective in couples therapy.
The study found that people who received ACT as a couple did experience improvements compared with those in control groups. But ACT wasn’t more effective than other well-known types of couples therapy, such as cognitive behavioral couple therapy (CBCT), emotionally focused couples therapy (EFCT), and schema therapy.
The study also found ACT was less helpful than other types of couples therapy for certain uses, like conflict resolution.
ACT and healthy habits
If you think about it, building a healthy habit is essentially making a consistent commitment to live according to your core values and goals.
The six core processes of ACT help you do exactly that — even when the going gets tough.
High-quality studies have found ACT effective for helping people make healthy habit changes, including smoking cessation and weight management.
The idea is that it helps people stay committed to their health values even when they experience cravings or setbacks.
Health and science writer and founder of Relationship Smart, Stephanie believes the world of our minds is real, important, and studyable, and that our social relationships are core to our well-being — much more than we give them credit for. She created Relationship Smart to explore the endless ways our relationships affect us, and to answer all your burning questions about them with scientific rigor and sensitivity.