Acceptance and Commitment Therapy

What ACT is

Acceptance and commitment therapy (pronounced as one word, ACT, in its abbreviated form) is a branch of CBT. It does follows the general ideas of CBT. However, it stands out in a few ways. 

In a nutshell, ACT attempts to build acceptance of uncomfortable experiences in order to have the connected bliss that accompanies them, and commitment toward valued living instead of rule based or autopilot living. 

This therapy also separates the idea of human pain from human suffering. Pain, it says, is a natural aspect of living. Suffering, on the other hand, is all the unnecessarily added awfulness that we add to our pain. For instance, losing someone is natural aspect of human life that creates a sense of pain. Yet, shaming ourselves for not doing something differently in the situation causes needless suffering. 

ACT contends that human suffering stems from psychological rigidity, or being too inflexible in how we see ourselves, others, and the world. There are six factors that ACT believes leads to psychological inflexibility, and six opposing domains that promote vitality and flexibility. 

Six Domains of ACT

Present Moment

One of these factors is being overly focused on a feared future or a haunting past. ACT believes that when we are stuck in the past or rushing into the future, we are not grounded in the present moment. Being more focused on the present moment is key to being more connected to your life, yourself, and others. 

Acceptance / Willingness to Experience

Another element that leads to suffering is avoiding experiences that seem too difficult or seem to cause too much discomfort. When we avoid or numb ourselves from feeling the hard things, we also tend to miss out on the joyous bits of living too. And when we fight with our experiences, we tend to worsen them. ACT believes that opening ourselves up and being willing to experience all facets of life allows us to be fully embodied and also struggle less with discomfort overall.  

Defusion from Unhelpful Thoughts

A third domain involves how fused we are with the thoughts that pop into our heads. Our minds chatter all day long, regardless of how aware we are of what they are saying. When we believe everything our minds tell us without ever considering these are just ideas that interject themselves into our brain space, we tend to create more suffering for ourselves. Usually, because our minds say it, it feels real and true. The more we are fused to our unhelpful thoughts, the more suffering we are likely to experience. On the other hand, the more we can accept thoughts as just thoughts, and not readily believe everything they say, the more we are defused from them, and will likely decrease our chances of suffering. 

Flexible Self View

A fourth component involved in increasing suffering is a fixed sense of self. ACT acknowledges that when we are not able to see ourselves as ever-changing and adaptable, it often leads to feeling trapped or maintaining some immobility. Creating a more flexible view of ourselves promotes a more helpful and workable relationship with ourselves.  

Connection to Personal Values

A fifth factor is being disconnected from our personal values, or what really matters to us. It is easy to get swept up in societal or familial ‘shoulds’ of how to live our lives or what to strive for. Because of this, it is also easy to not fully recognize what our own personal values even are. The better we can clarify our personal values, and the more we can live in connection with them, the more we are likely to experience those joyous and desired moments in life. 

Committed Action toward Values and Goals

The last element of psychological inflexibility is being stuck in inaction, or not moving toward anything important to us. When we take committed action toward our personal goals and values, it is easy to see how we can increase the vitality in our lives.

Length of ACT

While some significant changes can be seen within a few weeks, it can be difficult to guarantee this timeframe due to several human factors in our growingly chaotic lives. This center has successfully graduated clients within a few months and up to a few years. 

The length of time your therapy will take depends on several different factors, including 

  • the number of goals you have, and how complex and/or deeply rooted the issues are,
  • how motivated you are to change,
  • how well you follow through with practice between sessions, and
  • the frequency and duration of your sessions.
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How Therapy Progresses

Because acceptance and commitment therapy is a subset of CBT, it also has three main phases.

Phase 1: Assessment and Psychoeducation

Your therapy will begin with a thorough assessment of the presenting issues, diagnosing (if necessary), and goal setting. In order to fully and correctly address the problem(s), your therapist will need to take time to understand how they show up for you, personally. During this time, your therapist will also provide ample psychoeducation about your presenting problems, ACT, the human mind, and human behavior. The length of this phase is typically 1 to 3 sessions. However, it can take up to several weeks if the presenting issues are very complex or undefined, your goals are uncertain, and/or you prefer your sessions to be less structured.

Phase 2: Active Phase of Therapy

During this phase of therapy, you and your therapist will collaboratively create a treatment plan based on your presenting issues, desired goals, and personal values. You will be invited to experiment with and try various types of new behaviors, ways of talking to yourself, and techniques for better understanding yourself and your circumstances. You will also be expected to practice these new skills on your own between sessions in order to better reinforce the learning. This phase takes up the bulk of your therapy, and can take several weeks or several months.

Phase 3: Relapse Prevention and Termination

This phase of therapy focuses on consolidating all the learning done throughout your journey. Your therapist will discuss with you how to prevent backsliding, and what to do if you begin to struggle with using your tools on your own. Termination, or ending therapy, can occur whenever you want. However, it is best done when you have reached your therapeutic goals, are living more in line with your values, and feel confident in your ability to manage difficult situations on your own.

When Therapy Ends

While you may end your therapeutic journey at any time you choose, your therapist will look for certain markers to help determine when you may be most ready to end therapy.

  • The symptoms and distress that were present at the start of therapy are no longer significantly interfering with or controlling your life.
  • You are feeling more confident in your ability to manage difficult situations and have demonstrated an ability to recover well after distress.
  • Your therapy goals have been met.
  • You are making decisions that are more in line with your values.