Approach
What is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy, said as the word "act", is a form of talk therapy developed in the 1980s by the psychologist Steven Hayes and his colleagues. It belongs to the cognitive behavioural family of therapies. Its aim is psychological flexibility: staying in contact with what you are thinking and feeling, and still doing what matters to you.
The idea behind it
Most of us try to get rid of uncomfortable thoughts and feelings, or wait until they pass before we act. That effort takes a lot of energy, and the thoughts and feelings tend to come back anyway. ACT is less about trying to get rid of them and more about changing your relationship with them, so they take up less room and you have more say in what you do next.
The name describes the two halves of the work. Acceptance means making room for difficult thoughts and feelings instead of fighting them. Commitment means choosing what matters to you and taking steps toward it, even on the days the difficult stuff is loud.
The six skills ACT builds
1
Acceptance
Letting a feeling be there without struggling against it. This is different from liking it or giving up.
2
Noticing thoughts as thoughts
Called defusion in ACT. Seeing "I am going to fail" as a sentence your mind produced, rather than a fact you have to obey.
3
Being in the present
Paying attention to what is happening now, in the room and in your body, rather than replaying the past or rehearsing the future.
4
The part of you that notices
There is a you that has thoughts and feelings, and a you that notices them. ACT strengthens the second one.
5
Values
Getting clear on what you care about: the kind of parent, friend, student or person you want to be. Values give the work direction.
6
Committed action
Small, concrete steps in the direction of those values, chosen with the difficult thoughts and feelings along for the ride.
What it looks like in a session with me
Mostly conversation, with short exercises when they help and things to try between sessions. We get curious about patterns, make space for what is underneath them, and find practical ways to approach things differently.
With kids the same principles apply, but the work often looks different. We might use games, art, movement, play or activities to build connection and explore what is going on in ways that feel natural to them.
I also draw from Internal Family Systems, emotion-focused approaches, CBT and DBT, depending on the person and what we are working on.
Is there research behind it?
Yes. ACT has been studied in several hundred randomised controlled trials since the 1990s, for anxiety, depression, chronic pain, stress and other concerns. The Society of Clinical Psychology, a division of the American Psychological Association, lists ACT among the treatments with research support. The Association for Contextual Behavioral Science keeps a public list of the trials.
Is it right for you?
ACT is my main approach with children, teens and adults. Whether it fits your situation is something we work out on the consultation call, where you tell me what is going on and I explain how I would approach it.