Acceptance And Commitment Therapy (ACT): How It Works And Benefits

Acceptance and commitment therapy (ACT) is a type of talk therapy developed in the 1980s by psychologist Steven C. Hayes and colleagues. It can help people accept difficult thoughts and feelings rather than fight them, then take action guided by their values. The goal is psychological flexibility, or the ability to stay present and keep moving toward what matters.

What is acceptance and commitment therapy (ACT)?

Developed in the 1980s by psychologist Steven C. Hayes and his colleagues, ACT blends mindfulness and acceptance with values-based behavior change. It may help you change your relationship with unwanted thoughts so they hold less sway over your choices. ACT is pronounced like the word "act," and it can be conducted online or in person.

The Association for Contextual Behavioral Science (ACBS) describes ACT as applying mindfulness, acceptance, commitment, and behavior change processes to build psychological flexibility.

According to a 2025 narrative review of ACT published in the journal Cureus, ACT is rooted in relational frame theory. This theory focuses on how human language and thinking link ideas together.

So, what is ACT therapy at its core? Acceptance means acknowledging what's out of your control, and commitment means committing to moving forward.

If you've read about how cognitive behavioral therapy works, ACT may feel familiar. Both can help people stay grounded in the present and work through overwhelming emotions.

ACT may also help reduce the impact of distressing thoughts, a process known in clinical psychology as cognitive defusion.

To see why these ideas matter, it can help to look at what ACT is ultimately working toward.

What is the goal of ACT? Psychological flexibility

Instead of trying to remove painful thoughts, ACT helps you notice them, stay present, and keep acting on your values when emotions run high. This capacity is called psychological flexibility, and ACBS describes increasing it as the central aim of ACT.

To get there, ACT draws on behavioral methods, mindfulness exercises, and acceptance strategies, with coping skills tailored to your situation. People working through anxiety, stress, or substance use may benefit from this focus on mindful behavior change.

Psychological flexibility can take practice, so think of yourself as a filter. When a feeling surfaces, let it pass through you like a liquid, without judging it or yourself. Give it time to wash through you like a wave breaking over the shore, then process what you feel.

These skills come to life through six processes that therapists often use in sessions.

What are the six core processes of ACT?

ACT is built around six core processes: acceptance, cognitive defusion, being present, self-as-context, values, and committed action. Together, they form what's known as the psychological flexibility model. Each skill supports the others, so progress in one area may help the rest.

To learn more, see this summary of ACT's core components.

Knowing these processes can make it easier to picture where ACT might fit in your own care.

What does ACT help with?

People turn to ACT for several mental health conditions and everyday challenges.

Concerns ACT may help with include:

• Anxiety disorders, including social anxiety disorder
• Depression
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Eating disorders
• Substance use disorder, including alcohol use disorder
• Stress
• Chronic pain

How well ACT works for each concern is a question researchers continue to study.

Does acceptance and commitment therapy work? What research suggests

Evidence to date suggests ACT can be helpful for a range of conditions.

A 2020 review of 20 meta-analyses in the Journal of Contextual Behavioral Science found ACT efficacious for all conditions examined. These included anxiety, depression, substance use, and pain.

Because ACT and CBT reach similar results on average, it can help to understand how the two approaches differ.

ACT vs. CBT: What's the difference?

Both approaches belong to the cognitive behavioral family, but they relate to thoughts differently. CBT often focuses on identifying and changing unhelpful thoughts, while ACT focuses on accepting those thoughts and acting on your values. Neither is better overall, and the right fit may depend on your goals and preferences.

In CBT, a therapist may guide you through common CBT techniques to identify and change negative thoughts. ACT takes a more experiential approach, encouraging you to separate thoughts from behavior and act on your core values.

ACT also overlaps with dialectical behavior therapy (DBT), another third-wave approach that blends acceptance with change-focused skills.

Similarly, mindfulness-based cognitive therapy (MBCT) combines mindfulness training with cognitive therapy. A 2023 review in the journal BMC Complementary Medicine and Therapies recognizes ACT, DBT, and MBCT as representative third-wave CBT approaches. If ACT sounds like a good match, knowing what happens in sessions may make the first step feel easier.

What happens in an ACT therapy session?

Sessions often blend conversation with hands-on exercises. There's no fixed timeline, so the length of ACT may depend on your goals and how you respond.

Here's what the process may look like:

1. In your first session, your therapist may ask what brought you in and what you'd like to change.
2. Together, you may explore your values, or what matters most to you in relationships, work, and health.
3. Your therapist may guide you through defusion exercises, mindfulness, or metaphors that make abstract ideas easier to grasp.
4. Between sessions, you may practice these skills at home.
5. Over time, you and your therapist may review your progress and adjust your goals as needed.

Your commitment begins when you start sessions, and consistent attendance can help you get the most from ACT. Many of these skills can also be practiced on your own, as the next section explores.

ACT exercises you can practice

You can try many ACT therapy techniques on your own, such as gentle self-reminders, mindful observation, and values-based goal setting. Self-practice may build on what you learn in therapy. A trained therapist can still offer guidance and feedback that may be harder to find alone.

Reminders for difficult moments

When you process a hard feeling, it can help to avoid getting stuck in a cycle of rumination. When you let these thoughts pass, you may find a peaceful pond on the other side instead of a warring ocean.

Here are some reminders an ACT therapist might suggest you say to yourself:

1. You are in control of your own body, even if you are not in control of your surroundings.
2. It's okay not to be good at everything you try, and you don't have to be good at something to find joy in it.
3. Your strengths and your weaknesses are valuable as opportunities to learn and grow.
4. You don't have to act on every single thought, so let them flow like a river back to its source.
5. What happened years ago is not happening right now.

Grounding your senses can be another way to practice.

Mindfulness for intrusive thoughts

Shifting attention to your surroundings in the present moment is central to many mindfulness-based therapy techniques. To practice, try turning your attention to your senses with questions like these:

• What do you hear?
• What can you smell?
• Is there something in your vision, or have you closed your eyes to focus on your other senses?
• Are you cold or warm?
• How does your food taste?

These sensations aren't meant to prompt more emotions, but to help defuse the unfavorable ones. If it's hard to become present, try lighting a scented candle or running cold water over your hand. Clarifying values can then give that calm a direction.

Determining your values

Goal setting is an important component of acceptance and commitment therapy. Being mindful more often can help you clarify the goals you'd like to achieve, however big or small. Maybe you want to publish a book, go a full day without panicking, or get into your work without mental disruption.

What habits would you like to curb that are holding you back? For another angle on values, explore the ACT ideas behind the happiness trap. Whether ACT feels like the right fit can depend on a few personal factors.

Who may benefit from ACT?

ACT may suit people who want to relate differently to difficult thoughts and live more in line with their values.

A few things can help ACT work well:

• Openness to experiential exercises, such as noticing feelings rather than pushing them away
• Comfort with abstract ideas and metaphors
• Willingness to practice skills between sessions
• A licensed therapist trained in ACT

People working through self-criticism, negative self-talk, or difficulty managing emotions may find ACT's approach helpful. If you're considering an ACT therapist, it can help to ask about their training and experience with this approach.

If ACT doesn't feel like the right match, exploring other common types of therapy may help you find an approach that does. Another common question is whether ACT can be delivered online.

Online acceptance and commitment therapy

Internet-delivered ACT has shown promise, particularly for anxiety. A 2019 systematic review in the Journal of Medical Internet Research examined 20 studies of internet-delivered ACT for anxiety in adults. Eighteen reported significant anxiety reduction, though the authors noted that study quality was limited.

If ACT's focus on values and present-moment skills appeals to you, online therapy with a licensed therapist can fit around your schedule. BetterHelp's network includes 30,000+ licensed therapists, and you can switch therapists if the fit doesn't feel right. Whichever format you choose, the core ideas of ACT stay the same.

When using insurance, certain BetterHelp features may be limited or unavailable, including chat-based sessions, groups/classes, and select self-help tools.