Q. What is Acceptance and Commitment Therapy?
A. Acceptance and Commitment Therapy or ACT (pronounced ‘act’) is a modern form of Cognitive Behaviour Therapy (CBT) that is widely recognised as an effective treatment for a range of difficulties.
Q. How does ACT work?
A. ACT aims to help people live rich, vital and meaningful lives. Therapy involves teaching people skills to:
- deal more effectively with distressing and painful thoughts and emotions;
- clarify what really matters to them and what they want their life to be about; and
- engage in behaviours that are guided by their values.
Q. Who benefits from ACT?
ACT has been researched extensively and found to be effective for people with a wide range of problems including:
- anxiety disorders;
- depression;
- obsessive-compulsive disorder;
- workplace stress;
- chronic pain;
- diabetes management;
- adjustment to cancer;
- smoking cessation; and
- borderline personality disorder;
ACT is also useful for people struggling with issues related to parenting, relationships, sleep, and performance anxiety.
Because ACT targets processes common to a range of problems of daily living, it is especially helpful for people with co-morbid conditions. Its heavy use of metaphor and “hands on” learning also make ACT ideally suited to low literacy populations.
Q. Is ACT the same as mindfulness?
Mindfulness is a mental state of active, open, attention to the present moment. Mindfulness skills are taught in ACT to help people deal with difficult thoughts and emotions. However, mindfulness is just one element of ACT, which also teaches ways to help people move towards living by their values.
Q. How is ACT different from traditional CBT?
ACT is an adaptation of traditional CBT. The table below shows the main points of differentiation between the two therapies using anxiety as an example.
| Traditional CBT | ACT | |
| Therapy goal | Reduction in symptoms of anxiety. | Improved quality of life. Accepting anxious thoughts and feelings rather than struggling with so that anxiety has less impact and influence on behaviour when it shows up. |
| Treatment of anxious thoughts |
Cognitive restructuring skills are taught to examine and change difficult ‘threat-related’ thoughts. |
Cognitive “defusion” skills are taught used to disentangle or distance from ‘threat-related’ thoughts. |
| Treatment of anxious feelings/sensations |
Control of symptoms is emphasised; e.g., symptom-monitoring, relaxation training and cognitive restructuring |
Acceptance of anxious feelings, sensations and emotions (and control of behaviour) is emphasised; e.g., mindfulness, values guided action |
Q. Where can I learn more about ACT?
If you would like to learn more about ACT, see this article in AFP (2012) https://www.racgp.org.au/afp/2012/September/acceptance-and-commitment-therapy