Treatment Modalities

Acceptance Commitment Therapy or ACT

Acceptance and commitment therapy

Flexible adaptation to challenges


Acceptance and commitment therapy (ACT) rests on the fundamental premise that pain, grief, disappointment, illness, and anxiety are inevitable features of human life, with the therapeutic goal of helping individuals productively adapt to these types of challenges by developing greater psychological flexibility rather than engaging in counterproductive attempts to eliminate or suppress undesirable experiences.
ACT is an empirically supported psychotherapy that offers promise for patients suffering from a wide range of mental and physical conditions. This is achieved through committed pursuit of valued life areas and directions, even in the face of the natural desire to escape or avoid painful and troubling experiences, emotions, and thoughts. ACT is transdiagnostic (applies to more than one condition), process-focused, and flexibly delivered. In a relatively short period of time, ACT has been effectively implemented across a broad range of therapeutic settings, including mental health, primary care, and specialty medical clinics. Increased engagement in meaningful life activities, even while experiencing negative thoughts and emotions or other difficulties, is accomplished in ACT by cultivating psychological flexibility.
Psychological flexibility is cultivated in ACT by strengthening the following six core skills:
  1. flexibly and purposefully remaining in the present moment by being mindful of thoughts, feelings, bodily sensations, and action potentials, including during distressing experiences (vs losing contact with the present)
  2. keeping balanced and broad perspective on thinking and feeling, such that painful or distressing thoughts and feelings do not automatically trigger maladaptive avoidance behaviors (vs poor perspective-taking skills)
  3. clarifying fundamental hopes, values, and goals such as being there for one’s family, pursuing meaningful work, and so on (vs being disconnected from the things and people that matter most)
  4. cultivating commitment to doing things in line with identified hopes, values, and goals (vs failing to take needed behavioral steps in accord with core values)
  5. willingly accepting the unwanted feelings inevitably elicited by taking difficult actions, particularly those consistent with patients’ hopes, values, and goals (vs making efforts to control or eliminate difficult internal experiences)
  6. diffusion, or stepping back from thoughts that interfere with valued actions and seeing them for what they are (vs seeing thoughts as literal truths).
Dindo, L., Van Liew, J. R., & Arch, J. J. (2017). Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics, 14(3), 546–553.
https://doi.org/10.1007/s13311-017-0521-3
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