Acceptance and Commitment Therapy (ACT)

“What we need to learn to do is to look at thought, rather than from thought.” 
Steven C. Hayes.

Clients and other therapists who know me know that I consider myself an “eclectic” therapist, i.e., one who utilizes a variety of therapeutic modalities, rather than just one form of therapy.

As such, I have used Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Family Systems Therapy, Eye Movement Desensitization and Reprocessing (EMDR), and, now, finally, I have started the process to become certified in Acceptance and Commitment Therapy (ACT). This all began as a response to my work with people suffering from posttraumatic stress disorder (PTSD), which is what led me to EMDR. However, when I began working exclusively through telemedicine, I no longer felt I could use EMDR with my clients who have PTSD, as I feel it is contraindicated for these clients, as they can experience dissociation, and I cannot, in good faith, conduct a therapy session with a client who might dissociate while I cannot reach them, leading them to, potentially, becoming unsafe. As such, I felt I had to find another treatment option for these clients, so I found my way to Acceptance and Commitment Therapy (ACT).

Acceptance and Commitment Therapy (ACT) came into “being” in 1982, when Steven C. Hayes identified a “new” way of working with patients, with a framework that has some things in common with Cognitive Behavioral Therapy (CBT). 

ACT focuses on helping people feel and express, indeed, accept, unpleasant feelings, and to learn how to deal with them and to NOT overreact to them, or try to avoid them.

ACT differs from CBT primarily in working helping people better “manage” their thoughts, feelings, sensations, memories by just “noticing, accepting and embracing” those states/events, rather than trying to change or reject them. This is a goal with ACT even in the case of unwanted states/events.

6 Core Psychological Flexibility Processes

Stage 1 – Acceptance, to allow unwanted states/events/experiences to come and go without fighting them.

Stage 2 – Defusion, to stop trying to make these states/events/experiences “concrete,” but, instead understanding that they are abstracts.

Stage 3 – Present Moment, to be aware of the “here and the now.”

Stage 4 – Contextualized Self, to become intimate with the authentic self, the “real” self, as it is consistent and constant in life.

Stage 5 – Values, to identify what is most important to you.

Stage 6 – Committed Action, to identify and set goals based on one’s own values, and carrying them out responsibly, to lead to a meaningful, fulfilled life.

Stay tuned for the next Mental Health Musings, which will explore Stage 1 – Acceptance.