ACT Therapy: The Theory Behind Acceptance and Commitment Therapy

What is ACT Therapy?

ACT (Acceptance and Commitment Therapy) is a type of psychotherapy that focuses on helping people accept difficult thoughts and feelings while committing to actions aligned with their values. The goal is to create a rich and meaningful life even when painful internal experiences arise.

The Theory Behind ACT

ACT is based on a theory of human suffering called Relational Frame Theory (RFT). RFT proposes that people learn early on to relate various concepts and experiences to each other, which allows complex thinking but also leads to psychological inflexibility. When people get stuck relating thoughts, feelings, and bodily sensations back to themselves, they may struggle to live according to their values.

For example, after getting fired a person may have self-judgmental thoughts pop up over and over, relating getting fired back to being worthless or a failure. These thoughts trigger difficult feelings that further confirm the negative self-view. From an ACT perspective, suffering comes from getting entangled with thoughts and feelings rather than acting based on core values.

The Core Principles of ACT

ACT aims to increase psychological flexibility – the ability to fully contact the present moment and change behavior when needed to align with chosen values. There are six core principles of ACT:

Cognitive defusion – Creating distance from thoughts rather than getting caught up or fused with them
Acceptance – Opening up to internal experiences rather than avoiding them
Contact with the present moment – Paying attention to the here and now rather than the past or future
Self-as-context – Viewing oneself as the context for internal experiences rather than being defined by them
Values – Discovering what gives life meaning and purpose for each unique individual
Committed action – Setting goals guided by values and following through skillfully

These six components work together to increase psychological flexibility – the process of opening up to inner experiences, seeing them for what they are, and doing what matters most in each moment.

ACT in Practice

In therapy sessions, ACT practitioners use metaphors, experiential exercises, mindfulness skills, and values clarification activities to help clients gain psychological flexibility. They don’t aim to directly challenge or change difficult inner experiences, which often backfires. Instead, they teach clients how to gently hold those experiences while moving toward valued living.

Outside of therapy, people can cultivate psychological flexibility through regular mindfulness practice, setting values-based goals, and engaging in exposure exercises. Maintaining perspective and responding skillfully when painful thoughts and feelings inevitably arise allows for a vital, engaged life.

The Benefits of Psychological Flexibility

Extensive research has found that psychological flexibility provides many benefits, including:

Lower levels of depression, anxiety, and stress
Higher quality of life
Improved work functioning
Healthier relationships
Better chronic illness self-management
Reduced risk of rehospitalization for mental health issues

By focusing less on controlling inner experiences and more on engaging in values-based living, people gain resilience and the capacity to handle life’s inevitable ups and downs. ACT offers pathways for building these vital skills.

Frequently Asked Questions About ACT

What does ACT stand for?

ACT stands for Acceptance and Commitment Therapy. It’s an evidence-based psychotherapy that uses acceptance, mindfulness, and values-based living to increase psychological flexibility.

How does ACT work?

ACT works by teaching clients skills for handling painful thoughts, feelings, memories, and physical sensations more effectively so they can live according to their values. The focus isn’t on changing difficult inner experiences but changing one’s relationship to them.

How is ACT different from CBT?

While CBT aims to modify irrational thoughts and maladaptive behaviors, ACT targets the way one relates to thoughts and feelings and the degree to which those inner experiences dominate actions. ACT has more focus on values, spirituality, relationships, and finding meaning.

Does ACT therapy really work?

Yes, decades of research have found ACT to be highly effective for conditions like depression, anxiety, PTSD, chronic pain, substance abuse, eating disorders, psychosis, and workplace stress. It also helps people cope with illness and other life difficulties.

What should I expect in my first ACT therapy session?

In the first session, the therapist will ask about your current life situation, history, values, and what you hope to get out of therapy. They may do an assessment of psychological flexibility. You’ll start learning ACT core principles and set goals for therapy.