Acceptance and commitment therapy

Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that uses mindfulness strategies mixed with commitment and behavior-change strategies to increase psychological flexibility. The approach was developed in the late 1980s by Steven C. Hayes, a psychology professor at the University of Nevada, Reno. ACT is rooted in behavioral psychology and is a branch of cognitive behavioral therapy (CBT), but it differs from traditional CBT in its use of acceptance and mindfulness strategies. ACT is applied to a wide range of psychological disorders, including anxiety, depression, substance abuse, and stress.

Principles

ACT is based on the Relational Frame Theory (RFT), a theory of language and cognition that suggests that the ability to relate events mutually and in combination is the foundation of human higher cognition. ACT teaches that psychological suffering is often due to experiential avoidance, cognitive entanglement, and an inability to take action consistent with deeply held values. The core conception of ACT is that fighting against unwanted thoughts, feelings, and bodily sensations counterproductively increases distress. ACT aims to help individuals accept their reactions and be present with what life brings them without unnecessary defense.

Core Processes

ACT involves six core processes that are interrelated and reflect ACT's model of psychological flexibility:

1. Cognitive Defusion: Learning methods to reduce the tendency to reify thoughts, images, emotions, and memories. 2. Acceptance: Allowing thoughts to come and go without struggling with them. 3. Contact with the Present Moment: Being aware of the here and now, experienced with openness, interest, and receptiveness. 4. Observing the Self: Accessing a sense of continuity in consciousness that is unchanging. 5. Values: Discovering what is most important to one's true self. 6. Committed Action: Setting goals according to values and carrying them out responsibly.

Applications

ACT has been applied to a variety of psychological disorders. Its versatility is also seen in its application to improve workplace performance, increase psychological well-being, and support physical health conditions like chronic pain. The therapy's effectiveness is supported by empirical research, and it is considered an evidence-based practice for several conditions.

Training and Dissemination

Training in ACT is available for mental health professionals through workshops, books, and online courses. The Association for Contextual Behavioral Science (ACBS) is a primary resource for those interested in learning more about ACT and RFT.

Criticism and Support

While ACT has garnered support within the psychological community for its innovative approach and empirical backing, it has also faced criticism. Some argue that its distinctiveness from traditional CBT is overstated, and others question the empirical basis of some of its components, like RFT. Despite these criticisms, ACT continues to grow in popularity and application across various domains of mental health.