Acceptance and Commitment Therapy: Techniques, Benefits & Uses

While many mental health and addiction recovery approaches prioritize changing negative thoughts, acceptance and commitment therapy (ACT) focuses on first learning to understand your thoughts and feelings. Once you do so, you can more effectively commit to making changes and reaching goals.

What Is Acceptance and Commitment Therapy?

Acceptance and commitment therapy is a type of cognitive behavioral therapy (CBT), but it is not like traditional psychotherapies. It doesn’t require you to make immediate changes to your situation. Instead, ACT can help you process and recover from adverse experiences and unresolved traumas as a first step toward achieving real and lasting change in your behavior.

ACT can help you address issues such as

Anxiety
Depression
Daily stressors
Chronic pain
Eating disorders
Obsessive-compulsive disorders
Post-traumatic stress
Substance use disorders

ACT helps you be in the present moment, recognize and accept your thoughts and feelings, and commit to handling life’s challenges in the best possible way. Ultimately, this results in positive change.

Core Principles of ACT Therapy

ACT has certain core principles that make the treatment method effective for many. Each principle plays a role in helping you understand a situation, broadening how you think about it, and eventually improving it.

The principles of ACT support your psychological flexibility by helping you

Accept your experiences and your feelings
Reframe negative experiences, thoughts, and feelings
Determine what you want and what you value
Behave in ways that align with your values
Stay present in the moment
Understand yourself in your situational and emotional context

In ACT, these principles are actualized through six core processes: acceptance, cognitive defusion, being present, self as context, values clarification, and commitment to action.

It takes discipline and practice to enact these principles and processes but they can become a natural process over time.

The Hexaflex Model for ACT

Therapists using ACT may use a cognitive tool called the hexaflex to help you become more flexible in your thoughts, feelings, and actions. They will start by drawing a diagram of the six core processes.

Each ACT process represents a point on the hexaflex diagram. Using the hexaflex to work through the six core processes enables you to develop the resilience and agility you need to heal from past trauma and enjoy a healthy, self-determined life.

Your therapist may start with any point or process on the hexaflex, each teaching a separate skill. They will list four on the right and four on the left. Points on the right are commitment and behavior-related and the left is mindfulness and acceptance-related.

Acceptance

In the hexaflex model, exercises in acceptance will help you access your emotions, senses, memories, and internal experiences. Your therapist may label these as “private events” which must be explored, acknowledged, and embraced in healthy ways before meaningful change can occur.

As you work on acceptance, your therapist may also have you engage in mindfulness practices, self-care, or exposure therapy to reduce the power of negative emotions.

Cognitive defusion

The hexaflex interventions for cognitive defusion will help you assess negative thoughts and feelings. This helps you avoid putting too much importance on unrealistic, negative thoughts.

Mindfulness and guided imagery for cognitive distancing can help you view thoughts and emotions as temporary. This way, you can re-center yourself in the present even as you visualize those defused thoughts filtering out of your mind through cognitive distancing.

Being present

To be more present, you must learn to become comfortable with your internal and external surroundings in the current moment. Your therapist may use interventions to help you recognize and feel comfortable with your situation.

Focused breathing exercises and mindful meditation can help you calm your racing mind and direct your focus inward. You’ll learn how to be present in the moment and stop ruminating over the past or worrying about the future.

ACT therapists know that we can only act in the present moment. We cannot change the past or alter the future but we can honor the values we’re committed to and advance toward the goals we’ve set.

Self as context

Interventions for this principle in acceptance and commitment can help you learn more about yourself and release the negative thoughts that have influenced both your emotions and your behaviors.

The self as context intervention teaches you to recognize how your experiences have shaped your thoughts and how these, in turn, have influenced how you’ve defined yourself. For example, if you’ve gone through a series of job losses, you might believe that you’re not meant for career success. This thought might keep you from trying for that promotion or applying for the dream job.

The self as context intervention helps you separate your current thoughts and actions from past experiences and the thoughts they engender. Reflection, introspection, and mindfulness help you develop a healthy perspective about yourself.

Values

Once you discover your actual values, you must learn to set goals accordingly. Interventions for this principle will help you put your life on track based on what you’ve learned about yourself and your values. Journaling and self-reflection activities help you determine your values.

Committed action

Commitment to action consists of being OK with the ups and downs of life but not giving up on your goals or abandoning your values. Above all, committed action means behaving in a way that aligns with those values and moves you toward your goals.

Interventions help you work through obstacles or barriers ranging from negative self-talk to fears and self-doubt. These interventions also help you overcome more tangible barriers, such as financial challenges. You’ll learn actionable strategies to overcome them, such as developing a budget.

The acceptance and commitment therapy hexaflex model promotes psychological flexibility by helping you be present and aware while working toward your goals.

ACT vs. CBT

Both ACT and cognitive behavioral therapy (CBT) are effective psychotherapies that help you make positive changes in your life. ACT helps you to accept your thoughts and feelings as normal, whereas CBT teaches you to identify and reframe or eliminate negative thoughts and feelings.

ACT is a practical tool that you will utilize for the rest of your life. Some CBT tools are meant for short-term use.

One goal of CBT is to reduce painful or adverse symptoms. You work toward that goal with help from your therapist. ACT doesn’t focus on relieving symptoms. Instead, the ACT model holds that symptom relief will naturally occur when you focus on its six core principles.

Learn more about CBT therapy.

Conditions Treated by ACT

Acceptance and commitment therapy is a beneficial treatment for a wide range of mental health and substance abuse disorders. It can also help many physical ailments, like chronic pain. There is robust statistical evidence showing ACT improves various psychological and physical symptoms.

Anxiety

Acceptance and commitment therapy for anxiety reduces avoidance and builds emotional resilience by teaching you how to detach from unhealthy thoughts and feelings. Worrying thoughts linger in the mind, increasing symptoms that interfere with concentration, self-esteem, and daily functioning. ACT helps you accept sensations and thoughts and place less importance on them.

Learn more about treatment for anxiety.

Trauma

Acceptance and commitment therapy for trauma helps individuals process and accept difficult emotions by developing flexible thinking. When you become present and aware of your feelings, you accept them while also learning to detach from the ones that are unrealistic or are affecting how you function. You don’t get stuck in repetitive thoughts about the trauma. Instead, you accept that it happened and reduce its power over you so you can make positive changes.

Chronic pain

Chronic pain can induce physical and psychological effects that make it hard to function at work, home, school, and social situations. Acceptance and commitment therapy for chronic pain improves your quality of life in the following ways:

Reduces mental health symptoms like anxiety and depression
Helps you accept pain conditions and their impacts
Reduces catastrophizing
Improves mindfulness, stress management, and relaxation

Implementing new skills taught through ACT can improve your overall functioning because mental and physical health are directly connected. ACT proves that improving one can enhance the other.

OCD

OCD-focused acceptance and commitment therapy helps individuals manage obsessive thoughts and compulsions in two different ways. ACT teaches you how to accept that your obsessive thoughts exist and then decide how you want to deal with them. You learn that while you may not always be able to control your obsessive thoughts you can control how you respond to them.

Compulsions are ritualistic and repetitive behaviors that people use to reduce the anxiety caused by their obsessive thoughts. Obsessive compulsive disorder can make people believe they can only react in one specific way to ease the angst of their obsessive thoughts.

ACT teaches you to explore more than one way to deal with your thoughts, including the obsessive thoughts of OCD. You’ll learn to break patterns of thoughts and behaviors and sever the tie between your thoughts and compulsive actions.

ACT Therapy Techniques

When thoughts become barriers and obstacles to functioning, it’s crucial to engage in therapies that can help you overcome them. Acceptance and commitment therapy techniques are highly effective in ensuring that negative thoughts no longer interfere with your wellbeing or your ability to function.

Reframing and neutralizing thoughts

Thoughts must be accepted and responded to as thoughts, not always as facts. Whether a harmful thought is true or false, ACT teaches you to weaken its importance in your daily life because these negative thoughts shape how you think and feel about yourself and the world and how you behave in the world.

If you can’t tell the difference between true and false or harmful and helpful thoughts, you are more likely to believe negative or unrealistic thoughts and react emotionally.

Cognitive defusion helps you release thoughts that may be harmful. Techniques to help with this include

“I have a thought that” or “naming your thoughts,” where you identify a distressing thought, label it, and avoid reacting. Instead, you just let the thoughts arrive and leave.

“Word repetition,” where you identify a distressing thought, label it with one word, repeat it quickly and in different ways, and notice a reduced power.

“Metaphor creation,” where you imagine placing distressing thoughts in a container and then watching the container float, fly, or crumble away.

Numerous other cognitive defusion techniques exist. You and your therapist will utilize the ones that best fit your needs.

Focusing on today

Mindfulness embodies the concept of ACT because it requires you to be present in the moment while also incorporating self-care and compassion. It teaches you how to pay attention to your thoughts, feelings, and needs whether psychologically, emotionally, spiritually, or physically. Mindfulness techniques include

Visualization
Meditation
Yoga
Tai Chi
Deep breathing

You can turn every action into a mindful practice. Mindful eating, moving, and journaling are ways to become more self-aware. External mindfulness focuses on gratitude, sharing, the environment, and more.

Living and behaving your beliefs

Value-based actions refer to the goals you set and the steps you will take to achieve those goals. Your values help you make the necessary changes when practicing the core principles of ACT.

Being honest, showing respect, volunteering, generosity, and showing yourself compassion are examples of value-based actions. They are the things you commit to doing to continue the benefits of flexible psychology.

You can apply acceptance and commitment therapy techniques in daily life by taking time each day just for self-care. Make your physical and psychological health a priority. Engage in activities that promote healing and wellness. Continue working on the core principles and, if necessary, seek help from a counselor or support group.

Acceptance and Commitment Therapy: A Practical Guide