Founder, Description, Philosophy
Acceptance and commitment therapy (ACT) is a newer form of cognitive behavioural therapy that focuses on contextual and experiential change strategies and the influence of language and “thinking” on behaviour. It was developed by Dr. Steven C. Hayes in 1982 to integrate both cognitive therapy and behavioural therapy. We live in a culture that generally focuses on “feeling good” and avoiding pain based on this concept, the basic premise of ACT is that trying to control painful emotions or psychological experiences is counterproductive and ineffective because attempting to suppress these experiences often leads to more distress. Acceptance and commitment therapy uses alternatives to trying to change the way you think including mindful behaviour, paying attention to personal values, and making a commitment to action. Acceptance and commitment therapy is different from CBT in that it attempts to promote psychological flexibility, i.e., being open, aware, and in contact with the present moment. It also promotes flexibility engaging in behaviours which help life goals. Clients can change their attitude and emotional states by taking the steps to change behaviour and learn to accept their personal experiences.
What type of problems is this approach used to treat and what populations can it serve?
Acceptance and commitment therapy has been used to treat a number of problems including stress in the workplace, test anxiety, social anxiety disorder, stress produced by end-stage cancer, depression, obsessive-compulsive disorder, and psychosis. Some medical conditions have also been treated with ACT including chronic pain, substance abuse, and diabetes. This form of therapy can be used within multiple contexts where psychological factors play a major role in quality of life and mood (ex. Illness perceptions, coping strategies, self-efficacy, psychological flexibility, and emotion regulation).
What does this approach look like in practice? What are some types of interventions?
The interventions in ACT attempt to change the function of negative events and the person’s relationship to those events using different strategies like mindfulness and acceptance. The focus of ACT is listening to one’s own self-talk about traumatic experiences, problematic relationships, physical limitations, and other issues of importance to the client. Clients will learn to decide whether a problem requires immediate action and change or whether it must be accepted for what it is while learning to make behavioural changes that affect the situation. The therapist may guide the client to look at what they’ve done in the past that hasn’t worked so that the client can be helped to stop repeating thought patterns or behaviours that are causing more problems. Once the client faces and accepts their issues for what they are a commitment is made to stop fighting the past and the emotions and instead, start practicing more adaptive behaviours based on their personal values and goals.
Hayes, S.C., Luoma, J.G., Bond, F.W., Masuda, A., Lillis, J. (2006). Acceptance and commitment therapy processes and outcomes. Behavior research and therapy, 44, 1-25.
Graham, C.D., Gouick, J., Krahé, C., Gillanders, D. (2016). A systematic review of acceptance and commitment therapy (ACT) in chronic disease and long-term conditions. Clinical psychology review, 46, 46-58.