What if your clients could learn to embrace life’s challenges instead of constantly battling them? Acceptance and Commitment Therapy, or ACT, aims to help people accept uncomfortable emotions so they can more easily take actions aligned with their values. Mental health professionals can integrate ACT into their practices by familiarizing themselves with key concepts and techniques. Read on to learn more about ACT and how counselors at The FL Wolters Group, PLLC use this approach to promote healing and personal growth.
What is ACT?
ACT is defined as a third-wave approach to therapy, initially developed in the 1980s by psychologist Steven Hayes and his colleagues. Research suggests that ACT offers a more comprehensive treatment method than traditional behavioral modalities, as ACT places a higher emphasis on emotional experiences. Six core principles of ACT work together to achieve the overall objective of enhancing psychological flexibility and emotional wellness.
Acceptance promotes embracing difficult thoughts and feelings instead of avoiding them.
Cognitive defusion involves distancing yourself from disruptive thoughts.
Being present means focusing on the present moment without judgment.
Self-as-context refers to the objective observation of thoughts and feelings.
Values clarification focuses on helping people identify what truly matters to them.
Committed action involves taking steps that align with personal values.
Alex Smith, who worked as a clinical intern at our practice over the last year, began incorporating ACT into therapy sessions as well as their everyday life. As a primarily person-centered therapist, Alex believes that ACT concepts brought about a powerful shift in how they approached clients and presenting problems. This technique does not push for immediate change, but rather guides individuals towards full acceptance of themselves and their challenges in order to plan and commit to values-based action.
What’s Different About ACT?
It is important to understand how ACT differs from other modalities in handling thoughts, feelings, and behaviors, which can help therapists and clients determine whether this treatment intervention is a good fit. As a therapist, you might ask yourself the following questions about your work with a particular client:
Does the client have trouble using Cognitive Behavioral Therapy (CBT) techniques to change negative thoughts? ACT can help individuals learn how to observe and accept distressing thoughts and feelings, instead of trying to avoid or suppress them.
Are you looking to build long-term psychological flexibility, or do you prefer more short-term, solution-focused methods? While ACT does not typically offer simple solutions to specific problems, this approach can teach people to confront and accept uncomfortable thoughts and emotions over time.
Would the client prefer to respond to intense emotions by trying to develop new skills, or by engaging in valued actions despite uncomfortable circumstances? While ACT is not the only approach that prioritizes accepting difficult emotions, it puts more emphasis on working around ongoing discomfort rather than more skills-based approaches like Dialectical Behavior Therapy (DBT).
There are pros and cons to all types of therapies and interventions, even before accounting for the various identities, goals, and values of each individual therapy client. When asked how ACT compares to other therapeutic approaches, Alex Smith reported that some clients appeared to prefer its emphasis on acceptance and defusion, finding the approach more flexible than modalities like CBT. However, other individuals shared preference for techniques like cognitive restructuring, leading Alex to the conclusion that the usefulness of ACT “really depends on the person.”
Who Benefits From ACT?
ACT has gained recognition in the mental health field as a helpful and reliable approach to treatment for multiple presenting problems. Studies demonstrate its usefulness when working with the following conditions:
Anxiety: ACT encourages the acceptance of anxious feelings rather than avoiding them.
Depression: ACT promotes values-driven living, which can improve mood and serve as a motivator for change.
Chronic Pain: ACT techniques like cognitive defusion can help with managing the psychological aspects of pain.
Trauma: ACT can help reduce the impact of difficult memories by using tools like acceptance and observation.
Research is ongoing, but it suggests that ACT may also help with a variety of other issues commonly addressed in therapy, such as stress, insomnia, substance misuse, and eating disorders. As a single treatment intervention, its greatest strengths are improving psychological flexibility and reducing distress. If therapists are looking to use a more comprehensive treatment strategy, research shows that combining ACT with other therapeutic techniques – such as CBT or Motivational Interviewing – can increase its effectiveness.
What Are ACT’s Ethical Implications?
Although evidence supports the efficacy of ACT, there are still the following limitations and challenges to consider before choosing this approach.
Ethical guidelines require mental health professionals to provide clients with relevant details of ACT so they can give informed consent for its use. Some concepts of ACT are abstract and can be difficult to understand, particularly for individuals with lower levels of health literacy or cognitive functioning.
ACT offers benefits like flexibility and personalization, but these advantages can also make it harder to consistently evaluate outcomes compared to more structured therapies.
The success of ACT relies heavily on a strong therapeutic relationship and supportive environment, where clients feel safe exploring their discomfort.
ACT emphasizes personal values and psychological flexibility, which may not resonate with the cultural perspectives or experiences of all clients.
More long-term research is needed to determine if the positive effects of ACT are maintained over time.
Therapists must be transparent and tailor their communication to ensure that clients understand the relevant concepts and processes of therapy. By breaking down therapeutic approaches like ACT into simple terms, our practice hopes to enhance client engagement and make interventions more accessible, creating better chances for overall treatment success.
Please share any feedback or questions in the comments below, or contact us directly for more information!
Sources
Buttars, E. M., Taylor, J. M., & Neimeyer, G. J. (2021). Continuing education in professional psychology: Exploring the translation of learning into practice. Professional Psychology: Research and Practice, 52(6), 627-634.
Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 21, 181-192.
Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40(7), 976-1002.
Hughes, L. S., Clark, J., Colclough, J. A., Dale, E., & McMillan, D. (2017). Acceptance and commitment therapy (ACT) for chronic pain: A systematic review and meta-analyses. The Clinical Journal of Pain, 33(6), 552-568.
Larmar, S., Wiatrowski, S., & Lewis-Driver, S. (2014). Acceptance & commitment therapy: An overview of techniques and applications. Journal of Service Science and Management, 7, 216-221.
Li, Z., Shang, W., Wang, C., Yang, K., & Guo, J. (2022). Characteristics and trends in acceptance and commitment therapy research: A bibliometric analysis. Frontiers in Psychology, 13, 1-17.
Salari, N., Khazaie, H., Hosseinian-Far, A., Khaledi-Paveh, B., Ghasemi, H., Mohammadi, M., & Shohaimi, S. (2020). The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review. BMC Neurology, 20, 1-18.
Samaan, M., Diefenbacher, A., Schade, C., Dambacher, C., Pontow, I., Pakenham, K., & Fydrich, T. (2021). A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders. Psychotherapy Research, 31(3), 372-385.
Comments