Acceptance and commitment therapy (ACT) is an action-oriented approach to psychotherapy that stems from traditional behavior therapy and cognitive behavioral therapy. Clients learn to stop avoiding, denying, and struggling with their inner emotions and, instead, accept that these deeper feelings are appropriate responses to certain situations that should not prevent them from moving forward in their lives. With this understanding, clients begin to accept their issues and hardships and commit to making necessary changes in their behavior, regardless of what is going on in their lives, and how they feel about it.

When It’s Used

ACT has been used effectively to help treat workplace stress, test anxiety, social anxiety disorder, depression, obsessive-compulsive disorder, and psychosis. It has also been used to help treat medical conditions such as chronic pain, substance abuse, and diabetes.

What to Expect

Working with a therapist, you will learn to listen to your own self-talk or the way you talk to yourself specifically about traumatic events, problematic relationships, physical limitations, or other issues. You can then decide if an issue requires immediate action and change or if it can—or must—be accepted for what it is while you learn to make behavioral changes that can affect the situation. You may look at what hasn’t worked for you in the past so that the therapist can help you stop repeating thought patterns and behaviors that are causing you more problems in the long run. Once you have faced and accepted your current issues, you make a commitment to stop fighting your past and your emotions and, instead, start practicing more confident and optimistic behavior, based on your personal values and goals.

How It Works

The theory behind ACT is that it is not only ineffective but often counterproductive, to try to control painful emotions or psychological experiences, because suppression of these feelings ultimately leads to more distress. ACT adopts the view that there are valid alternatives to trying to change the way you think, and these include mindful behavior, attention to personal values, and commitment to action. By taking steps to change their behavior while, at the same time, learning to accept their psychological experiences, clients can eventually change their attitude and emotional state.