Acceptance and Commitment Therapy

According to the Association for Contextual Behavioral Science (ACBS), ACT is:

“a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility.”

 

The ACBS views ACT as a therapy based on the concept that suffering is a natural and inevitable condition for humans. We have an instinct to control our experiences, but this instinct does not always serve us. The founder of ACT has also offered a definition of ACT in terms familiar to the psychology field:

“a psychological intervention based on modern behavioral psychology, including Relational Frame Theory, that applies mindfulness and acceptance processes, and commitment and behavior change processes, to the creation of psychological flexibility”

 

(Hayes, “The Six Core Processes of ACT”)

To put it in less clinical terms, Dr. Russell Harris (2011) has defined ACT as “a mindfulness-based behavioral therapy that challenges the ground rules of most Western psychology.” Its unique goal is to help patients create a rich and meaningful life and develop mindfulness skills alongside the existence of pain and suffering.

Core Processes

Six core processes of ACT guide patients through therapy and provide a framework for developing psychological flexibility (Harris, 2011). These six core processes of ACT include the following:

• Acceptance

• Cognitive Defusion

• Being Present

• Self as Context

• Values

• Committed Action

Acceptance is an alternative to our instinct to avoid thinking about negative-or potentially negative-experiences. It is the active choice to allow unpleasant experiences to exist, without trying to deny or change them. Acceptance is not a goal of ACT, but a method of encouraging action that will lead to positive results.

Cognitive Defusion refers to the techniques intended to change how an individual reacts to their thoughts and feelings. Acceptance and Commitment Therapy does not intend to limit our exposure to negative experiences, but rather to face them and come out the other side with a decreased fixation on these experiences.

Being Present can be understood as the practice of being aware of the present moment, without judging the experience. In other words, it involves experiencing what is happening without trying to predict or change the experience.

Self as Context is the idea that an individual is not simply the sum of their experiences, thoughts, or emotions. The “self as context” process offers the alternative concept that there is a self outside of the current experience. We are not only what happens to us. We are the ones experiencing what happens to us.

Values in this context are the qualities we choose to work towards in any given moment. We all hold values, consciously or unconsciously, that direct our steps. In ACT, we use tools that help us live our lives in accordance with the values that we hold dear.

Finally, ACT aims to help patients commit to actions that will assist in their long-term goals and live a life consistent with their values. Positive behavior changes cannot occur without awareness of how a given behavior affects us.

ACT is not all that different from other behavioral-based therapies; it just emphasizes acceptance instead of avoidance, and in that way, differs from many other forms of therapy. This departure from most mainstream treatment can be traced back to the background of ACT’s founder, Stephen C. Hayes.

 

Steven C. Hayes and ACT

Steven C. Hayes, a psychology professor at the University of Nevada, developed ACT in 1986 (Harris, 2011). His work began with how language and thought influence our internal experiences and laid the foundation for ACT. Hayes disagreed that suffering and pain are to be avoided and buffered whenever possible. He saw suffering as an inevitable and essential part of being human, as well as a source of fulfillment when we do not flee from what scares us. Steven Hayes makes a compelling case for acceptance and self-compassion based on his own experiences with pain. His TED Talk on psychological flexibility explains the foundation for his psychological exploration of ACT.