ACT

What is Acceptance and Commitment Therapy (ACT)?

Acceptance and Commitment Therapy (ACT) is an evidence-based approach that combines traditional Western psychological methods with Eastern philosophies. It integrates mindfulness and acceptance strategies with the behavioural techniques commonly used in Cognitive Behavioural Therapy (CBT).

ACT primarily focuses on developing psychological flexibility, helping individuals notice and accept life’s inevitable discomforts rather than trying to avoid them. It is a talking therapy that supports clients in learning new skills to respond differently to thoughts, feelings, and sensations that are usually avoided or feared.

Unlike CBT, which focuses on changing thoughts and behaviours to reduce distress, ACT emphasizes changing the relationship with thoughts and feelings. It combines mindfulness, acceptance, and values-based strategies to promote a more open and meaningful way of living. The goal is not to eliminate discomfort but to help individuals live fully and purposefully despite it.
Through ACT, people learn to relate differently to internal experiences such as distressing thoughts, emotions, and physical sensations. The therapy provides practical tools to reduce the influence of these experiences while supporting a commitment to live a life guided by personal values. ACT encourages individuals to:

  • Accept what is beyond their control
  • Commit to actions that improve and enrich their lives
  • Do more of what matters, creating a fulfilling life despite challenges

ACT also teaches mindfulness skills that reduce the impact of painful thoughts and feelings while clarifying values to guide meaningful behaviour.

Theoretical Framework

ACT is grounded in a coherent theoretical and philosophical framework and is supported by extensive empirical research. It combines mindfulness and acceptance strategies with commitment and behavioural change techniques to enhance psychological flexibility and the ability to engage fully in the present moment and, depending on the situation, to adjust or persist in behaviour in service of one’s chosen values.

Based on Relational Frame Theory (RFT), ACT explains how language and thought patterns can trap individuals in unhelpful attempts to control or avoid inner experiences. Through experiential exercises, metaphors, and paradoxes, clients learn to:

  • Engage with thoughts, feelings, memories, and sensations they may have feared or avoided
  • Reframe and accept these internal experiences
  • Gain clarity about their personal values
  • Commit to meaningful behaviour change

The Six Core Processes of ACT (Hexaflex)

1. Acceptance
Acceptance involves embracing thoughts, feelings, and sensations that would typically be avoided. It does not mean liking them but rather allowing them to exist without struggle. This willingness to experience discomfort supports all other ACT processes.

2. Cognitive Defusion
Defusion teaches detachment from thoughts, memories, and feelings. Thoughts are seen as passing events rather than absolute truths. For example, instead of thinking “I am no good,” you might reframe it as “I am having the thought that I am no good.” This creates distance and reduces the power of thoughts over behaviour.

3. Being Present
Being present refers to engaging fully with the current moment, with openness and curiosity rather than judgment. This mindfulness-based awareness helps reduce autopilot behaviour and encourages more flexible, value-driven action.

4. Values
Values are personal guiding principles that define what matters most. They provide direction and purpose, even in times of uncertainty. Asking questions such as “Who do I want to be?” or “What do I want my life to stand for?” helps clarify these values.

5. Self as Context (Observing Self)
The observing self notices thoughts and feelings without being overwhelmed by them. It represents a stable sense of awareness that allows us to accept and observe our internal experiences from a broader perspective.

6. Committed Action
Committed action involves taking purposeful steps guided by your values, even when faced with challenges or discomfort. This can include setting short-, medium, or long-term goals and developing skills such as assertiveness, problem-solving, or self-soothing.

These six processes are interconnected and work together to help individuals navigate stressors, overcome obstacles, and maintain meaningful progress. ACT emphasizes that each person’s journey is unique, so approaches are tailored to individual needs. The therapy’s name itself highlights its two central principles: acceptance of what is beyond personal control and commitment to actions that enrich life.

How ACT works

ACT helps individuals unlock their potential to live a meaningful and fulfilling life. Mindfulness skills are used to reduce the influence of distressing thoughts and feelings while promoting engagement with the present moment.

ACT breaks mindfulness into three main components:

  • Defusion: distancing from unhelpful thoughts, beliefs, and memories
  • Acceptance: allowing painful feelings and sensations to come and go without struggle
  • Contact with the present moment: engaging fully with current experiences with openness and curiosity

The therapy also clarifies values that guide and motivate behavioural change, helping clients move toward a life that feels authentic and purposeful.

Applications of ACT

ACT has been shown to be effective for a wide range of emotional and behavioural challenges, including:

  • Anxiety disorders (including social anxiety)
  • Depression
  • Chronic pain
  • Stress management
  • Trauma and PTSD
  • Eating disorders
  • Substance abuse and addiction
  • Relationship challenges
  • Workplace stress and burnout

How I might use ACT in my work

In my work, I might use ACT to support individuals who struggle with psychological inflexibility particularly those who find themselves caught in patterns of avoidance, control, or self-criticism. Many people attempt to suppress or fight against distressing thoughts and emotions, which can actually intensify their suffering. ACT provides a framework for helping clients develop a more compassionate and accepting relationship with their internal experiences.

I would use ACT techniques to help clients learn how to tolerate and make space for difficult emotions rather than trying to suppress or escape them. This might involve teaching mindfulness skills to help them observe thoughts without becoming entangled in them, or using metaphors and experiential exercises to promote acceptance and defusion.

For clients who feel stuck or disconnected from what truly matters, I would integrate values clarification work to help them identify what gives their life meaning and purpose. From there, I would support them in taking committed, values-based actions, even when uncomfortable feelings or fears arise.

ACT would be particularly useful for individuals experiencing anxiety, trauma, or low mood, as well as those struggling with self-criticism or perfectionism. By encouraging flexibility and acceptance, I could help clients move from a stance of resistance to one of openness and learning that suffering can coexist with growth, and that meaningful living does not depend on the absence of pain but on the willingness to engage with life fully.