Acceptance and Commitment Therapy (ACT) gets it name from one of its core messages: accept what is out of your personal control, and commit to action that improves and enriches your life. The aim of ACT is to maximise human potential for a rich, full and meaningful life. ACT (which is pronounced as the word ‘act’, not as the initials) does this by:
a) teaching you skills to handle your thoughts and feelings more effectively – in such a way that they have much less impact and influence over you. (These are known as mindfulness skills).
b) helping you to clarify your values – what sort of person you want to be, what you want to stand for in life, how you want to treat yourself and others and the world around you – and translate them into actions to enrich and enhance your life.
Mindfulness is a “hot topic” in Western psychology right now – increasingly recognised as a powerful therapeutic intervention for everything from work stress to depression – and also as an effective tool for increasing emotional intelligence. Acceptance and Commitment Therapy is a powerful mindfulness-based therapy (and coaching model) which currently leads the field in terms of research, application and results.
Mindfulness is a mental state of awareness, focus and openness – which allows you to engage fully in what you are doing at any moment. In a state of mindfulness, difficult thoughts and feelings have much less impact and influence over you – so it is hugely useful for everything from full-blown psychiatric illness to enhancing athletic or business performance.
In many models of coaching and therapy, mindfulness is taught primarily via meditation. However, in ACT, meditation is seen as only one way amongst hundreds of learning these skills – and this is a good thing, because most people do not like meditating! ACT gives you a vast range of tools to learn mindfulness skills – many of which require only a few minutes to master.
Distancing from, and letting go of, unhelpful thoughts, beliefs and memories.
Making room for painful feelings, urges and sensations, and allowing them to come and go without a struggle.
Engaging fully with your here-and-now experience, with an attitude of openness and curiosity.
These 3 skills require you to use an aspect of yourself for which no word exists in common everyday language. It is the part of you that is capable of awareness and attention. In ACT, we often call it the ‘observing self’.
We can talk about ‘self’ in many ways, but in common everyday language we talk mainly about the ‘physical self’ – your body – and the ‘thinking self’ – your mind. The ‘observing self’ is the part of you that is able to observe both your physical self and your thinking self.
It is the ‘part’ or ‘aspect’ of you that is aware of everything else: aware of every thought, every feeling, everything you see, hear, touch, taste, smell, and do.
Acceptance and Commitment Therapy (ACT) is a unique and creative approach to a change in behaviour which alters the very ground rules of most Western psychotherapy. It is a mindfulness-based, values-oriented behavioural therapy, that has many parallels to Buddhism, yet is not religious in any way; it is a modern scientific approach, firmly based on cutting-edge research into human behavioural psychology.
ACT can be delivered in many different ways:
a) long-term therapy – for example, the Spectrum protocol for ACT with borderline personality disorder: forty 2-hour sessions.
b) medium-term therapy – for example, JoAnne Dahl’s protocol for ACT with chronic pain: eight hours in total
c) brief therapy – for example, Patty Bach’s protocol on ACT with schizophrenia: only four 1-hour sessions
d) ultra-brief therapy – for example, Kirk Strosahl’s work in primary care medical settings, where ACT can be highly effective even in one or two twenty to thirty-minute sessions.
My own personal style for both coaching and therapy is what I call ‘ACT Made Simple’
– it is a distilled, simplified version of ACT, influenced very strongly by three factors:
However, some of these are unnecessarily complex or longwinded. I have made it my personal mission to modify, adapt or reinvent tools, techniques, and training methods wherever possible, in order to make ACT readily accessible to everyone and anyone – whether they are a health professional, therapist, coach, student, client, patient – or simply an interested member of the general public.
My personal preference in ACT is to work quickly and effectively, and as a result, the vast majority of my work would fall under categories b), c), and d) above. However, I do have a few long-term clients with multiple severe problems, that I have been seeing for several years. And this is one of the many things I love about the ACT model: its flexibility. I love the way it can so readily be adapted, and made as short or long as it needs to be, to suit the individual needs of the client, group, or organisation.
To download a simple, non-technical article which gives a basic overview of ACT, click here.
Contacting The Present Moment means being psychologically present: consciously connecting with whatever is happening right here, right now.
Defusion means learning to separate, step back, detach or ‘unhook’ yourself from thoughts and feelings. Instead of getting ‘caught up’, ‘entangled’, ‘hooked’, ‘dominated’, or ‘pushed around’ by them, you learn how to let them ‘flow through you’; to let them come and stay and go – as if they were leaves floating down a stream, or cars driving past outside your house. You learn how to step back and observe your thoughts and feelings, so you can respond effectively – instead of getting ‘tangled up’ or ‘lost in them’.
Acceptance means opening up and making room for painful thoughts, feelings and sensations. You learn how to drop the struggle with them, give them some breathing space, and let them be present without getting overwhelmed by them; the more you can open up, and give them room to move, the easier it is for your thoughts and feelings to freely ‘flow through you’; to come and stay and go without draining you or holding you back.
The Observing Self is the ‘part’ or ‘aspect’ of you that is able to notice whatever you are thinking or feeling or doing at any moment. The technical term for this, in ACT, is ‘self-as-context’. We don’t have a word for it in common everyday language – we normally just talk about ‘the mind’. But we can talk about ‘two parts’ to the mind. We can talk about the thinking self – i.e. the part that is always thinking; the part that is responsible for all your thoughts, beliefs, memories, judgments, fantasies etc. And we can talk about the ‘observing self’: the part of your mind that notices everything that you think and feel and see, hear, touch, taste, and smell.
Values are what you want your life to be about, deep in your heart. What do you want to stand for in life? What you want to do with your time on this planet? What kind of person do you want to be? How do you want to treat yourself and others?. What strengths and qualities would you like to be remembered for by the people you love?
Committed Action means taking action guided by your values – doing what matters – even if it’s difficult or uncomfortable.
When you put all these things together, you develop ‘psychological’ flexibility. This is the ability to be in the present moment, with awareness and openness, and take action, guided by your values.
In other words, it’s the ability to be present, open up, and do what matters. The greater your ability to be present, open up and do what matters, the greater your quality of life; the greater your sense of vitality, well being and fulfillment.
ACT (which is pronounced as the word ‘act’) uses a wide range of experiential exercises to undermine the power of destructive cognitive, emotive, and behavioural processes. It helps clients to fundamentally change their relationship with painful thoughts and feelings, to develop a transcendent sense of self, to live in the present, and to take action, guided by their deepest values, to create a rich and meaningful life.
David Barlow, famous not only for his work on CBT with anxiety disorders, but also for his development of the scientist-practitioner model, writes of ACT:
“Once in a while, there is a unique contribution to psychotherapy. Even more rare is the grounding of that contribution in sound philosophy, on the one hand, and firm data on the other. Acceptance and Commitment Therapy represents such an effort. In a truly creative leap forward, the authors present a new approach to behaviour change that is “must” for everyone in the field of psychotherapy”.. Challenging the assumptions and methods of cognitive therapy, this is amongst the most significant new approaches to behaviour change of the past three decades.”
ACT takes the view that most psychological suffering is caused by ‘experiential avoidance’, i.e. by attempting to avoid or get rid of unwanted private experiences (such as unpleasant thoughts, feelings, sensations, urges & memories). Clients’ efforts at experiential avoidance might work in the short term, but in the long term they often fail, and in the process, they often create significant psychological suffering. (For example, think of any serious addiction: in the short term it makes you feel good and helps you get rid of unpleasant thoughts and feelings – but in the long term, it destroys your health and vitality).
In ACT, clients develop mindfulness skills (both traditional techniques, and many modern, innovative ones) which enable them to fundamentally change their relationship with painful thoughts and feelings. When clients practice these skills in everyday life, painful feelings and unhelpful thoughts have much less impact and influence over them. Therefore, instead of wasting their time and energy in a fruitless battle with their inner experiences, they can invest their energy in taking action to change their life for the better – guided by their deepest values.
A growing body of empirical data confirms that cultivating acceptance, mindfulness, and openness to experience is highly effective for the treatment of depression, anxiety disorders, substance abuse, chronic pain, PTSD, anorexia, and even schizophrenia. ACT is also a very effective model for life coaching and executive coaching.
ACT is one of the ‘third wave’ of behaviour therapies, along with Dialectical Behaviour Therapy, Mindfulness-Based Cognitive Therapy, and several others. These therapies comprise a movement in psychology that regard mindfulness and acceptance as important additions to change-oriented treatment strategies.
ACT was the first of the ‘third wave’ therapies, and has the largest body of empirical data to support its effectiveness. And it is very effective. For example, one published study showed hospital re-admission rates for psychotic patients were cut by 50% with only 4 hours of ACT (primarily using values-guided behavioural interventions, and cognitive defusion techniques to reduce believability in delusions & hallucinations).
To download this paper, by Bach and Hayes, click here.
ACT is based on a theory of human language and cognition known as Relational Frame Theory (RFT). You can be an excellent ACT therapist without knowing RFT, in the same way that you can be an excellent driver without knowing how your car engine works. However, a working knowledge of RFT can certainly enrich your practice, and give you a greater understanding of how ACT works and why it is so effective.
ACT and RFT Websites