ACT: Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a form of cognitive behavioral therapy that is used to treat people with anxiety, depression, stress-related medical problems or chronic pain. It was developed by Steven Hayes in the late 1980s when he began working at the University of Nevada’s Psychology Department.

This therapy teaches clients how to face their fears without avoiding them through mindfulness exercises. ACT has been shown to be effective for reducing symptoms in people who have had trouble with traditional forms of psychotherapy in the past. 

What Is Acceptance and Commitment Therapy?

Acceptance and commitment therapy is a type of clinical behavioral analysis used in psychotherapy. Stability is a series of evidence-based therapeutic coping approaches that incorporate acceptance and understanding techniques in a number of ways that provide psychological versatility to behavioral improvement strategies.

Acceptance and Commitment Therapy, which is the leading model of Cognitive-Behavioral Psychotherapy approaches called “Third Wave” or “Third Generation”, is a psychotherapy method that follows the behavioral tradition.

acceptance and commitment therapy (act)

While the classical behavioral approach counts only the observable actions as behavior and does not give distinct importance to what happens in the human mind, radical behaviorism proposed by Skinner defines all the internal experiences of the organism such as thought, emotion, and memory as behavior.

Behavioral scientists have benefited from these ideas to study mental processes like language and thought using behavioral theories. Researchers in the behavioral school of thought have utilized it to tackle psychological phenomena such as language and thought, and Relational Frame Theory (RFT) was created as a result.

Developed by Hayes, Strosahl, and Wilson with the interaction of both clinical practices and RFT studies in the 1980s, ACT is a psychotherapy method with a high scientific evidence level. From the first years of its development to November 2018, 256 Randomized Controlled Trials (RCTs) on the ACT have shown that its effectiveness has been proven in a wide range of areas such as depression, anxiety, psychosis, obsessive-compulsive disorder, substance use, eating disorders, chronic pain, stress, borderline personality disorder, cancer, epilepsy, diabetes tinnitus, procrastination, parenting, quality of life, sports performance, stigmatization.

What Kind of Therapy Is ACT?


On the philosophical basis of Acceptance and Commitment Therapy, there is a thought called “functional contextualism.” From this point of view, Acceptance and Commitment Therapy does not define any behavioral element belonging to the organism as “good” or “bad”. It says that they should be evaluated according to the context in which the behavior is in and examines the behavior’s function.

The mechanistic approach, which defends health and happiness, is a natural homeostatic state and suggests that the ‘abnormal’ situations encountered can be corrected by detecting and repairing hypothetically defective parts or parts. However, it has achieved quite successful and consistent data in other medical areas. It cannot show the same success in behavioral problems.

The fallacy of the assumption that humans’ natural and normal state is happiness will be understood when looking at the statistics of psychological problems around the world. As long as we live, pain is inevitable. Trying to eliminate, reduce, or control pain will only lead to that pain to visit us more with new suffering. Acceptance and Commitment Therapy claims that the functioning of a normal mind can cause pain.

While escaping from outside danger and trying to destroy it is often a useful strategy, it will become useless when the same strategy is used for our negative inner lives (emotions, thoughts, memories, and feelings). In other words, when it comes to our negative internal experiences, the main problem is not those experiences, but our efforts to control them.

From this point of view, Acceptance and Commitment Therapy does not correct or repair negative internal experiences; It emphasizes sincere contact with them and makes room for them in our lives with the discomfort they cause.

ACT’s Psychopathology Approach

The purpose of Acceptance and Commitment Therapy is to increase psychological flexibility in humans. Psychological flexibility is defined as the determination to approach our inner lives with attention and openness, touching the moment, and acting in line with our values. In other words, it means realizing our feelings, thoughts, memories and feelings that stand before us as an obstacle for a meaningful and full life.

The main goal is to weaken their dominance over our behavior without trying to change, control them, or reduce their intensity or frequency, so we can persevere in our behavior in areas we value.

The opposite of the psychological flexibility (Figure 1) model is defined as psychological rigidity and defines the ACT’s approach to psychopathology (Figure 2). Both models consist of six different dimensions that interact with each other.


1) Living in the present: ACT promotes ongoing non-judgmental contact with psychological and environmental events as they occur. The goal is to have clients experience the world more directly so that their behavior is more flexible and thus, their actions are more consistent with the values they hold. This is accomplished by allowing workability to exert more control over behavior; and using language more as a tool to note and describe events, not simply to predict and judge them.

2) Acceptance: Acceptance is taught as an alternative to experiential avoidance. Acceptance involves the active and aware embrace of those private events occasioned by one’s history without unnecessary attempts to change their frequency or form, especially when doing so would cause psychological harm. For example, anxiety patients are taught to feel anxiety, as a feeling, fully and without defense. Pain patients are given methods that encourage them to let go of a struggle with pain, and so on.

3) Cognitive Defusion: Cognitive defusion techniques attempt to alter the undesirable functions of thoughts and other private events, rather than trying to alter their form, frequency or situational sensitivity. Said another way, ACT attempts to change how one interacts with or relates to thoughts by creating contexts in which their unhelpful functions are diminished. There are scores of such techniques that have been developed for a wide variety of clinical presentations.

For example, a negative thought could be watched dispassionately, repeated aloud until only its sound remains, or treated as an externally observed event by giving it a shape, size, color, speed, or form. A person could thank their mind for such an interesting thought, label the process of thinking (“I am having the thought that I am no good”), or examine the historical thoughts, feelings, and memories that occur while they experience that thought.

Such procedures attempt to reduce the literal quality of the thought, weakening the tendency to treat the thought as what it refers to (“I am no good”) rather than what it is directly experienced to be (e.g., the thought “I am no good”). The result of defusion is usually a decrease in believability of, or attachment to, private events rather than an immediate change in their frequency

4) Self as Context: As a result of relational frames such as I versus You, Now versus Then, and Here versus There, human language leads to a sense of self as a locus or perspective and provides a transcendent, spiritual side to normal verbal humans. This idea was one of the seeds from which both Acceptance and Commitment Therapy and RFT grew and there is now growing evidence of its importance to language functions such as empathy, the theory of mind, sense of self, and the like. In brief, the idea is that “I” emerges over large sets of exemplars of perspective-taking relations (what are termed in RFT “deictic relations”).

Still, since this sense of self is a context for verbal knowing, not the content of that knowing, its limits cannot be consciously known. Self as the context is important in part because from this standpoint one can be aware of one’s own flow of experiences without attachment to them or an investment in which particular experiences occur, thus defusion and acceptance are fostered. Self as the context is fostered in Acceptance and Commitment by mindfulness exercises, metaphors, and experiential processes.

5) Values: Values are chosen qualities of purposive action that can never be obtained as an object but can be instantiated moment by moment. ACT uses a variety of exercises to help a client choose life directions in various domains (e.g. family, career, spirituality) while undermining verbal processes that might lead to choices based on avoidance, social compliance, or fusion (e.g. “I should value X” or “A good person would value Y” or “My mother wants me to value Z”). In ACT, acceptance, defusion, being present, and so on are not end in themselves. Rather, they clear the path for a more vital, values-consistent life.

6) Committed Action: Finally, ACT encourages the development of larger and larger patterns of effective action linked to chosen values. In this regard, ACT looks very much like traditional behavior therapy, and almost any behaviorally coherent behavior change method can be fitted into an ACT protocol, including exposure, skills acquisition, shaping methods, goal setting, and the like.

Unlike values, which are constantly instantiated but never achieved as an object, concrete goals that are values consistent can be achieved and ACT protocols almost always involve therapy work and homework linked to short, medium, and long-term behavior change goals. Behavior change efforts lead to contact with psychological barriers that are addressed through other ACT processes (acceptance, defusion, and so on).


1. Learning ACT Easy; Russ Harris; Litera Publications-2015

2. Learning ACT; Jason B. Luoma, Steven C. Hayes, Robyn D. Walser; Context Press-2007

3. Acceptance and Commitment Therapy, The Process and Practice of Mindful Change; Steven C. Hayes, Kirk D. Strosahl, Kelly G, Wilson; Guilford- 2nd edition-2006

4. The Happiness Trap; Russ Harris; Litera Publications-2018

Last Updated on December 10, 2022 by Lucas Berg


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