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Author: Dr Christine CullClinical Psychologist

With Acceptance and Commitment therapy, clients learn to stop avoiding, denying, and struggling with their inner emotions and, instead, accept that these deeper feelings are appropriate responses to certain situations.

The aim of ACT is to help people be able to move on with their lives.


What is ACT (Acceptance and Commitment Therapy)?

Acceptance and commitment therapy is based around clients beginning to accept their issues and the things that have happened to them in the past. They are encouraged to commit to making changes in their behaviour, regardless of what is going on in their lives, and how they feel about it.

Acceptance and commitment therapy differs from CBT; instead of challenging distressing thoughts by looking for evidence and coming up with a more rational response (CBT), in ACT, the thought is accepted as just a thought and not necessarily based on fact or truth.

ACT explores ways in which our interactions with thoughts/feelings can be modified, using a variety of techniques, which may include mindfulness, metaphors and language.

ACT is: “a psychological intervention based on modern behavioral psychology, that applies mindfulness, acceptance processes, and commitment and behavior change processes, to the creation of psychological flexibility”


What should I expect from ACT?

Acceptance and commitment therapy promotes psychological flexibility based on six core processes, using, among other things, approaches including:

  • mindfulness and being present in the moment
  • acceptance of what is out of our control
  • commitment to living a life that is in accordance with your values

All of these will be explained to you by your ACT therapist - the aim is that you are able to take these new skills forward and apply them as and when situations arise in your life.

Using these core processes, ACT will help you:

  1. Learn to listen to yourself - working with a therapist or psychologist, you will learn to listen to your own ‘self-talk’, or the way you talk to yourself - specifically about traumatic events, problematic relationships, physical limitations, or other issues.
  2. Accept or change? - by listening to your ‘self-talk’ you can then decide if an issue requires immediate action and change or if it can (or must) be accepted for what it is.
  3. Make changes - you will work with your therapist to learn how to make behavioural changes that can affect the situation for the better.
  4. Stop repeating unhelpful patterns - With ACT therapy you will look at what hasn’t worked for you in the past, so that the therapist can help you stop repeating thought patterns and behaviours that are causing you more problems in the long run.
  5. Commit to yourself - Once you have faced and accepted your current issues, you make a commitment to stop fighting your past and your emotions and, instead, start practicing more confident and optimistic behaviour, based on your personal values and goals.

What is ACT used to treat?

Acceptance and commitment therapy can be used to treat a wide range of issues including:

I have been able to make a lot of changes in the last year and am really proud of how well I manage with things now – it’s been transformative – I only wish I had done this earlier.

Ali, Cambridge


Is ACT right for me?

It can be really hard to know which therapy is the right one for your current circumstances. It’s normal for people to find one type of therapy works at a particular time in their lives, but then change to another type later on.

The key indicators that Acceptance and commitment therapy might be a good choice for you are:

  1. You are looking for something relatively short term. The concepts of ACT can be applied to a range of mental and physical illnesses, but normally around 12 sessions is offered to start with.
  2. You don’t want to work through past events in huge depth. Whilst ACT will look at the circumstances that have caused your current difficulties, it won’t go over them in the same depth that therapies such as psychodynamic or humanistic will. If you have suffered prolonged trauma or abuse it may be that ACT is not the best choice for you. Our triage team of highly trained experts can help you decide.
  3. You are happy to complete ‘homework’ between sessions. People who are depressed or living in chaotic circumstance can find it hard to find the energy or time to do this. The use of practical workbooks and exercises can make it easy for someone to understand and implement the techniques they are learning in their therapy and will suit those who like to be action driven.
  4. You are interested in adopting different strategies to manage the difficulties in your life. This may sound obvious but in order for acceptance and commitment therapy to be effective you have to be willing to change the way you think and approach certain areas of your life.

Why might ACT be the wrong therapy for me?

Before deciding to have Acceptance and commitment therapy, it might be helpful to think about the following:

  • Is short-term therapy right for me? If you have severe or complex problems, you may find a short-term therapy like ACT is less helpful. Sometimes, therapy may need to go on for longer to cover fully the number of problems you have, and the length of time they've been around.
  • Am I comfortable thinking about my feelings? ACT can involve becoming aware of your anxieties and emotions. Initially, you may find this process uncomfortable or distressing.
  • Would I prefer a more personalised approach? ACT is highly structured. It calls for a radical acceptance of the concepts and ideas in order to put them into action. Your therapist will support you in learning about these new concepts and how they apply to your circumstances.
  • How much time do I want to spend? ACT can involve exercises for you to do outside of your sessions with a therapist. You may find this means you need to commit your own time to complete the work over the course of treatment, and afterwards.

For many people, the change in focus from challenging, changing and reducing unhelpful thoughts and feelings, to living well despite them can take time to get used to, but is well worth the effort in the long term.
CPsychol, AFBPsS

Clinical Psychologist
Cambridge

Having left the NHS in 2017, Dr Cull continues to undertake clinical work in the independent sector, across a range of specialties. 

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