Acceptance And Commitment Therapy

Medically reviewed by April Justice, LICSW
Updated May 30, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

Acceptance and commitment therapy, or ACT (pronounced as "act"), is a therapy approach to accepting and improving one's quality of life. Acceptance and commitment therapy, like cognitive behavioral therapy (CBT), helps people focus on the present and move forward from overwhelming emotions to improve mental health. In ACT therapy, acceptance means acknowledging what's out of your control and commitment means committing to moving forward. 

Acceptance and commitment therapy can be conducted online and in person. It can help diffuse the impact of negative emotions (known in clinical psychology as cognitive defusion) and reshape your thinking to treat depression, anxiety, and other similar mental disorders. The Association for Contextual Behavioral Science has a wealth of resources on ACT therapy and behavior therapy.

Getty/AnnaStills
Life's challenges can be difficult to overcome without support

What's the goal of acceptance and commitment therapy?

ACT or acceptance and commitment therapy aims to diffuse negative thought patterns and unnecessary emotional dwelling. Acceptance and commitment therapy is a form of behavioral and cognitive therapy. It uses a variety of approaches drawn from behavioral therapies, mindfulness exercises, cognitive therapy, acceptance, and commitment methods, to name a few. 

With a licensed professional, you'll learn coping mechanisms and skills specifically tailored to your situation explained through the lens of cognitive behavioral therapy methods. These can be used to help you feel acceptance in the present and can be applied throughout your life to handle tough experiences and stay present. The content of these sessions during treatment may focus on helping you accept your situation and commit to changing your perspective or behaviors. 

Those who experience traumatic flashbacks, substance use disorder, or generalized anxiety from everyday actions can benefit from the focus on mindful behavior changes that come from ACT therapy. It encourages people to stay present and accept the present. It's difficult to move through life without mentally existing in the here and now, so ACT provides the guidance necessary for clients to stop fighting with their thoughts. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

ACT can help you learn a new behavior, change strategies to cope, identify personal values, and feel better overall. This can have positive ripple effects on you, others in your life, and your relationships.

How this mode of counseling works

Acceptance and Commitment Therapy has become a promising treatment for a variety of challenges including anxiety, eating disorders, and substance abuse. ACT works in three areas: accept the emotion and be mindful, choose a direction, and then act accordingly. The first part involves the radical acceptance of things that are out of your control, as focusing on things outside of your control may cause more distress. In the second and third areas, you are taking charge and committing to the action that aligns with your values and will push you forward instead of remaining stagnant in a muck of emotions.
Rawpixel
You might envision yourself as different than who you are in reality. By shaving away the negative pieces, you can find your true self underneath. You are not part of the apprehensive thoughts and feelings that frequently pop up during the day. You are so much more than your psychological experiences. When you commit to this type of therapy, you will discover the amazing stillness that can come from it, and the power of this psychological stillness. The more you practice mindfulness techniques, the better you may become at handling those curve balls that life likes to throw.
ACT is based on six primary guiding principles or ACT skills. They are:
  • Acceptance – accepting the situation so that a plan for action can be made.
  • Cognitive defusion – changing the way you view or interact with thoughts so that their negative or unhelpful aspects are lessened.
  • Contact with the present moment – also called psychological flexibility, means learning to be more mindful and present in the current moment to gain a greater sense of self and events without judgment.
  • The Observing Self – you are not your thoughts or feelings, and you can learn to consciously observe, experience, and process them without attaching your self-value or identity to them.
  • Values – “chosen qualities of purposive action” without “avoidance, social, or fusion.”
  • Committed action – developing and choosing effective action and concrete goals related to the chosen values.

Acceptance and commitment therapy requires a certain degree of psychological flexibility. Think of yourself as a filter. When a feeling comes to the surface, allow it to pass through you like a liquid. Don't obsess over the feeling or judge it or yourself, and don't give it the ability to warp into another aggravating thought. Give it time to wash through you, imagining it like a wave that will eventually break over the shore. Once it passes, you can sit down and process what you felt.

Reminders for ACT

During the processing stage, it's imperative not to get stuck in a cycle of rumination. Those who live with anxiety and depression symptoms are particularly prone to delving into this rabbit hole, which therapy, acceptance and commitment therapy included, attempts to avoid – in this method, through behavior modification. You want to diffuse (the first principle) these negative thoughts instead of agitating them.

An anxious brain is on constant alert, cycling through different scenarios in which things can go from wrong, or even alright, to worse. When you allow these thoughts, feelings, and emotions to pass, you can find a peaceful pond sitting on the other side of your thoughts instead of a warring ocean.

Here are some reminders to consider:

  1. You are in control of your own body even if you are not in control of your surroundings.
  2. It's okay to not be good at everything you try. That's what trying is for, 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. Do not act on every single thought. Let them flow like a river back to its source.
  5. What happened years ago is not happening right now.

These are just some examples of what an acceptance and commitment therapy (ACT) therapist might ask you to say to yourself during these moments. Use whichever ones work best while you're focusing on being mindful.

Mindfulness and how to achieve it

Our bodies are not able to be both anxious and calm at the same time; it’s not biologically possible. Research now confirms that practicing mindfulness has a host of benefits and is able to essentially hijack our biology; by breathing deeply and slowly, we sort of “trick” our body and brain into slowing down, relaxing, and letting go of the tension and anxiety and noticing physical sensations. Additionally, because of the incredible neuroplasticity of our brains, regularly practicing slowing down and being in the moment alters our brain structure and how it functions, making it easier over time to slow down and be mindful. This kind of behavioral therapy technique can have positive effects on our mental health by allowing us a sense of stability and control.

Imagine being able to quiet those intrusive thoughts that plague you during the day and trade them for your surroundings in the present moment. There can be a sense of calmness in this action. You may feel lighter, perhaps even a bit more in control of your own body and breathing than you thought. You may feel your shoulders relax and your head start to feel clear. You can hear yourself breathe through the silence surrounding you.

To achieve a state of mindfulness, one must focus on the present situation. What do you hear? What can you smell? Is there something in your vision or have you closed your eyes to focus more on your other senses? Are you cold or warm? How does your food taste? These sensations aren't to prompt more emotions, but to help diffuse the unfavorable ones. Once you can separate yourself from those uncomfortable feelings, you can focus more on going about your day without them.

Though many achieve mindfulness through meditation, you can achieve mindfulness simply by observing and taking in what is around you. This can be accomplished at work, at home, or on the go. If you're finding it difficult to become present, try changing the sensations you're picking up on. Perhaps light a scented candle to help you focus or run cold water over your hand to snap you into that moment. These strategies can help you practice and get better at being mindful, while acknowledging and accepting that everyone processes challenges differently.

Keep in mind that mindfulness in acceptance and commitment therapy will vary from person to person. Certain physical conditions like chronic pain may require adjustments to meditation techniques (such as adding additional cushioning or shortening sessions of mindfulness to avoid stiffness or fatigue). Consult with your therapist and doctor to accommodate any conditions you think may affect your ability to practice meditation and mindfulness.
Determining your values

Goal setting is an important component of acceptance and commitment therapy. Being mindful more often can help you clarify the important goals in your life that you would like to achieve, however big or small. It could be publishing a book or surrounding yourself with happier people. Maybe you want to go a full day without panicking, or you want to be able to get into your work without mental disruption. What habits would you like to curb that are holding you back?

iStock/kali9
Life's challenges can be difficult to overcome without support

How does ACT help?

Through acceptance and commitment therapy, you can discover your most valued desires. Clearing negative emotions and memories by bringing your attention to the present can pave way for other things in life that serve you and your growth. What once was a difficult battle could become a clear path for you to walk.

It can be scary discovering there's a world outside of that haze of thinking. What else can you finally do that you haven't been able to? How will you be able to turn the page? Paint that picture? Write that book? Travel to new places? Everything may feel possible when you make room for your true self to thrive without the weight of frightful emotions and worries. This is how therapy, including acceptance and commitment therapy, has helped the lives of millions.

How to commit
Commitment starts from the very beginning. It's hard work making changes in your life, but acceptance and commitment therapy can gently guide you in that direction. Once you've become calm enough to identify what is important to you and a problem you may be facing, you can start taking the steps necessary to achieve your goals. This is something that will require long-term work. One thing to keep in mind: Every day will prove to be a challenge, but acceptance and commitment therapy will give you the tools to cope with it.

As much as acceptance and commitment therapy can help, therapy only helps someone who is willing to dedicate themselves to the practice. Consistent attendance—whether in person or virtually— in addition to engaging in sessions and exercises is the key to reaping the benefits of this psychotherapy. Your commitment begins when you start acceptance and commitment therapy sessions. Then, it's your commitment to yourself that keeps you continuing therapy each session you attend. And from there, commitment lies in your desire to be healthy and safe.

You deserve to be healthy and happy in your life—remember that when you begin therapy like ACT or CBT. Keep pushing forward because you deserve growth and relief.

Utilizing online ACT

There is evidence supporting the use of online acceptance and commitment therapy when dealing with a variety of mental health concerns. Various studies have shown ACT therapy to be an effective approach to reduce chronic pain and emotional pain. In a broad-based review published in the Journal of Medical Internet Research, the effects of online ACT on those experiencing symptoms of anxiety were examined. The results of 20 studies where online ACT was utilized for a variety of anxiety disorders, including generalized anxiety disorder, social anxiety disorder, and illness anxiety disorder. Researchers noted that these treatments significantly reduced symptoms of anxiety, concluding that ACT could be effectively administered through online platforms. The report also states that online ACT aims to reduce common barriers to therapy treatment, including geographical or place constraints, high costs, and perceived stigma.

As outlined above, if you are experiencing complicated emotions related to anxiety or other mental health conditions, online ACT can help. With BetterHelp, you can participate in therapy from the comfort of your home, without dealing with the traffic of a city, sitting in a waiting room, or missing work just to make an appointment. Online therapy is available no matter if you live in the city or the country. The ACT practitioners and mental health professionals at BetterHelp can provide you with acceptance and commitment therapy that works for you. Read below for counselor reviews, from those who have sought help in the past.
Counselor reviews
“Rhonda is great. She helped me cut through my mental clutter, and use breathing, visualization, and sensory mindfulness to mitigate and address some of life's issues.” 
“Theresa was very helpful in understanding what I was going through. She was able to take what I was feeling and struggling and find ways I could cope through various thinking exercises and mindfulness activities. She helped me to overall be mindful of my thoughts. Theresa was a big help in my process of overcoming my anxiety.”

Takeaway

If having a clearer mind and balanced lifestyle sounds appealing to you, it may be beneficial to try acceptance through ACT therapy. To begin getting effective and convenient help, reach out to a professional and ask for support today.

Explore mental health and healing in therapy
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started