Acceptance & Commitment: Everything You Need to Know About ACT

When studying to become a therapist, there is a lot of pressure and focus on what your theoretical orientation is. There is psychoanalysis, which is very Freudian, the popular and widely used CBT, the newer up-and-coming DBT, and other theories like Gestalt, person-centered, and emotion-focused. While most therapists embrace an eclectic approach, borrowing from various theories to best fit the needs of their clients, it’s also important to find a lens with which to conceptualize your client’s struggle, a modality that can guide the treatment planning, and an approach that refines the therapeutic process. I floundered for a while to find a theory that fit my worldview; most theories felt like a foreign language I was trying to teach myself with little to no luck. Enter: ACT. Acceptance and Commitment Therapy is one of those therapy modalities that is rising in popularity and for good reason. So let me give you a brief introduction to what ACT is and how it’s used.

Psychological Flexibility

ACT aims to maximize the potential for a meaningful life while understanding that handling pain and difficulty is an inevitable part of it. The biggest goal of ACT is to increase one’s psychological flexibility, or one's resilience. Resilience is often described as the ability to return to baseline quickly after facing stressors or challenges that throw us out of our normal functioning state. The better our psychological flexibility, the more resilient we are, the less life’s challenges have an impact on our wellbeing. Think back to that famous quote about how we can’t change the direction of the storm, we can only adjust our sails, and that is the basic idea of ACT. Helping us change our sails in order to ride the storms of life with more ease and groundedness.

The 6 Core Components

ACT utilizes six core therapeutic processes: contacting the present moment, defusion, acceptance, self-as-context, values, and committed action. The first four components are the mindfulness process, while the last two are the processes that help us put all these concepts into action.

The 4 Mindfulness Processes

Contacting the present moment requires that we be here now. This means paying attention to our experience in the present moment and adjusting our focus depending on what is useful. Being fully present requires that we connect with ourselves and our surroundings and engage fully with the space we inhabit.

Defusion, or cognitive defusion, requires us to watch our thinking. This means separating ourselves from our thoughts and taking a step back. This allows us to see our thoughts for what they are, loosen our grip on these thoughts, and again, shift our focus depending on what is useful. It requires us to understand that while we experience our thoughts, we are not our thoughts; we can allow them to guide us without allowing them to dominate us.

Acceptance means opening up. When we fight our reality, we stay powerless to change our response to it. Acceptance means making room for all of the emotions and experiences, even the unwanted ones. Instead of resisting reality, we surrender to it and identify the next step that brings us closer to our desired goal or outcome.

Self-as-context may be one of the trickiest and most advanced mindfulness processes of ACT. This process requires us to identify that there are two distinct parts of the mind, one part that thinks and another part that notices. There is a doing self and an observing self. There are aspects of us that are aware of what we are thinking, feeling, and doing in any given moment.

The Commitment Part

ACT is rooted in the idea that we should all be striving to live more in line with our values and that living in line with our values allows us to overcome resistance, avoidance, and difficulty that can come with decision-making. In ACT, values are explored, prioritized, and used to create goals that bring clients closer to their meaning and purpose.

Committed action is the doing part. This means prioritizing your value-based goals to get you closer to your desired outcome. Each time a client faces indecisiveness, resistance, or avoidance, they are reminded of their values. Clinicians help clients identify the “choice point,” which is the moment they can choose to act in line with their values and bring them toward their desired outcome, or act in opposition to their values, pushing them away from their desired outcome. Any resistance, avoidance, or difficulty acting in line with your values is explored, discussed, and figured out over time to help the client engage in more “toward moves.”

The Dysfunction

ACT views any dysfunction or maladaptive behaviors as acting opposite to these core components. So instead of defusion, we are fused to our thoughts. Instead of acceptance, we resist. Instead of being present, we avoid. Instead of zooming out and viewing ourselves as the context, we overidentify with what we are experiencing. Rather than acting in line with our values, we act based on others’ expectations or struggle with confusion about what our values are. And lastly, rather than committed action, we avoid the discomfort of change, procrastinate, or justify our inaction.

The Outro

To sum it all up, ACT aims to increase psychological flexibility, helping people “be present, open up, and do what matters.” This is done through the 6 core components: contact with the present moment, defusion, acceptance, self-as-context, values, and committed action. This is just the tip of the iceberg, the introduction to a larger, vast, and more complex modality. It requires a level of metacognition, an ability to think about your thinking. ACT can be applied to individual counseling, couples, or families. If you find you are having a difficult time adjusting your sails to adapt to the direction of the storms you are facing, give ACT a try and see what embracing acceptance and commitment can do for you.

Harris, R. (2019). Act made simple: An easy-to-read primer on acceptance and commitment therapy (2nd ed.). New Harbinger Publications.