Acceptance and Commitment Therapy (ACT)

What is Acceptance and Commitment Therapy (ACT)?

Acceptance and Commitment Therapy (ACT) is form of psychotherapy geared toward helping you take positive action in your life. ACT involves elements of mindfulness practices and cognitive behavioral therapy.

This kind of therapy involves learning to accept unpleasant thoughts, emotions, or experiences without viewing them as problems. Instead, the goal is to define your own personal values and identify ways you can take action that you believe in, even without changing the negative parts of your experience. Language is very important in ACT as well. It theorizes that changing the way you describe a problem can actually change your experience of it as well.

ACT is usually short-term, meaning that it is designed to be used over the course of only a few sessions with a therapist.


What can Acceptance and Commitment Therapy (ACT) help with?

ACT can be helpful for a broad range mental health concerns, including:

Additionally, it can also be helpful for physiological symptoms that may have a psychological root, such as chronic pain.

Does Acceptance and Commitment Therapy (ACT) work?

Yes, research has found empirical evidence that ACT is likely to be helpful in treating several different mental health conditions. For example, one review found that according to many different studies, ACT helped reduce symptoms for people dealing with anxiety and depression. A similar review also reported that there is significant evidence that ACT is an effective treatment for people suffering from chronic pain.

How does Acceptance and Commitment Therapy (ACT) work?

ACT is thought to work by decreasing the power of a person’s painful thoughts, memories, and experiences. Though this pain may still exist, ACT holds that accepting it rather than trying to avoid it will neutralize its power. This process is based on the idea that language--often in the form of thoughts--can make problems seem more painful than they actually are. By accepting the problem and using different language to describe it, people using ACT therapy can make even difficult situations less distressing.

Frequency of Acceptance and Commitment Therapy (ACT) sessions

ACT sessions are generally held on a weekly basis. However, some therapists may recommend more or less frequent sessions, based on your symptoms and treatment goals.

Length of Acceptance and Commitment Therapy (ACT) treatment

Although there is no set endpoint for ACT therapy, it is generally short-term. This means that treatment usually takes place over the course of a few weeks or a few months.

As with any therapy, you and your therapist will agree on treatment goals early on in the therapeutic process. This discussion should also include ways to measure progress based on your individual goals, as well as how you’ll know when it’s time to end treatment.

Structure of Acceptance and Commitment Therapy (ACT) sessions

Unlike some kinds of therapy, there is no set structure for ACT sessions. However, most ACT treatment will guide you through particular phases across your sessions. These phases include:

  1. Talking through the issues that brought you to therapy. Your first session or two may focus mostly on building rapport with your therapist and developing a shared understanding of your past and present experiences with mental health. You’ll also discuss strategies you’ve used before that may not have worked well.
  2. Focusing on your own self-talk and ideas about your life. A big part of ACT is learning to be mindfully aware of your own thoughts and emotions. You might work with your therapist to spots patterns or gain insight into how you normally think and talk about your life and your perceived problems.
  3. Accepting realities, especially painful ones. In ACT, your therapist will encourage you to accept certain aspects of your life without judgment. For example, you may wish to avoid thinking about a painful event from your past, even though there’s nothing to be done about it now. In that case, you would learn to accept the painful memory without trying to avoid it. The idea is to gain some detachment from the pain without trying to hide from it or pretend that it’s not there.
  4. Identifying your core values. Another key part of ACT is gaining clarity about what you really value in life. What is meaningful to you, and how do you want to define yourself and your life?
  5. Choosing actions. Once you have some more awareness of your thought patterns and a clearer sense of the values you want to prioritize, your sessions may move on to identifying ways you’d like to create change. In this phase of treatment, your therapist will help you find ways that you can take positive action that aligns with your values. The idea is to balance acceptance of what you can’t change with action around the things you can change.
  6. Commitment to self-compassion and meaningful action. It’s also important to commit to the principles of acceptance and action going forward. As you work toward ending treatment, your therapist will work with you to create this commitment.

What happens in a typical Acceptance and Commitment Therapy (ACT) session?

ACT can involve a wide range of techniques geared toward the above phases of treatment. A few common activities you might encounter in sessions include:

  • Observing your thoughts: Your therapist will help you learn to listen to your existing self-talk and observe how it might be interfering with acceptance.
  • Meditation and other mindfulness practices: ACT is very closely linked to mindfulness. You may use meditation, breathing exercises, or mindful movement to gain more awareness of yourself and your thoughts in the moment.
  • Defusion strategies: In ACT, defusion strategies are used to reduce the emotional charge around a painful thought or memory. This might mean learning to notice how a thought makes you feel physically and emotionally, then experimenting with different thoughts that might feel more positive.
  • Activities to identify values and goals: Your therapist will likely give you tools to help you define personal values and goals that can guide your choices going forward.
  • Self as context: In ACT, self as context is the idea that you are not the same as your experiences. Rather, you exist separately from the events of your life. Learning to realize this can make it easier to detach from the pain of difficult experiences.
  • Exercises for self-compassion: Your therapist may guide you through activities to help you emphasize your strengths, accept your weaknesses, and allow yourself to be imperfect.

What to look for in an Acceptance and Commitment Therapy (ACT) therapist?

Therapists for ACT may be social workers, psychologists, psychiatrists, or another kind of mental health professional. No matter what kind of therapist you choose to work with, make sure that they meet the following criteria:

  • An advanced degree in a mental health field;
  • Licensure to practice in the state where you live;
  • Additional experience and/or training using ACT;
  • If applicable, experience working with people who share your specific concerns (if you’re dealing with a certain mental health condition) or identity (if you feel that any aspect of your identity may be relevant to treatment).

The Association for Contextual Behavioral Science also provides a directory of ACT therapists.

New to therapy? Learn about how to find a therapist here.