Acceptance & Commitment Therapy

Acceptance and Commitment Therapy (ACT) is described as a 'contextual CBT' which uses mindfulness and behavioural activation to increase clients' psychological flexibility (the ability to engage in value-based, positive behaviours while experiencing difficult thoughts, emotions, or sensations). The assumption of ACT is that psychological problems and suffering are often caused by experiential avoidance, cognitive entanglement, and psychological rigidity (fixation in painful experiences) which lead to a failure to take needed behavioural steps in accordance to one's core values

ACT believes that many psychological problems are underpinned by the concepts represented in the acronym, FEAR:

• Fusion with your thoughts on painful event(s)
  
• Excessive E valuation of experience
  
• Avoidance of repeat experience
  
• Reason-giving for your unhelpful behaviour
  

In order to deal with the psychological problems,  ACT helps you to :

1. Accept your past thoughts, feelings and behaviours and be present
   
2. Choose a valued direction
   
3. Take action
   

ACT has been shown to:

• increase effective action;
• reduce dysfunctional thoughts, feelings, and behaviours;
• alleviate psychological distress for individuals with a broad range of mental health issues (e.g. coping with chronic illness, and workplace stress). 

ACT establishes psychological flexibility by focusing on six core processes:

1. Cognitive de-fusion (emotional separation/distancing): Observing your own uncomfortable thoughts , images, emotions and memories without automatically taking them literally, attaching any particular value to them or becoming one with them. 
   
2. Acceptance: Allowing thoughts to come and go without struggling with them.
   
3. Contact with the present moment:  Being able to direct attention flexibly and voluntarily to present external and internal events rather than automatically focusing on the past or future. Awareness of the here and now.
   
4. Observing the self: Accessing a transcendent sense of self, a continuity of consciousness which is unchanging. Being in touch with a sense of ongoing awareness
   
5. Values: Discovering what is most important to you.
   
6. Committed action: Setting goals according to the personal values you identified and carrying them out responsibly.

When It's Used

ACT is particularly effective in helping people:

• live in the present moment in a conscious way and 
• able to make choices and decisions on what the situation affords, 
• change or persist in behaviour in the service of their values.

ACT is effective in the management of 

• depression and anxiety disorders,
•  substance misuse, 
• abuse (sexual, emotional, physical etc), 
• chronic pain and
• Anorexia. 

The goal of ACT is to:

• help you accept what is out of your personal control while committing to action that will improve the quality of your life . 

• help you live a meaningful life while handling the pain and stress that is an inevitable part of life. 

• teach you psychological skills to deal with painful thoughts and feelings effectively and helps you understand what is truly important and meaningful to you. 

Mindfulness skills are central to ACT and are taught in order to facilitate the development of an ‘observing self’ that can help you notice both your physical experiences and your thinking processes.

What to Expect

You and your therapist will look into the main areas of your life such as relationships, career and education, leisure, family, spirituality and develop a shared understanding of your values and goals. You will develop skills and strategies that help you work towards achieving your goals and living your life in a way that is consistent with your values. You will be asked to do homework tasks between sessions. You will work towards taking effective action in order to create a rich and meaningful life. Your therapist will be a coach that is trying to help you stay focused on developing resilience so that you can live the life that you want rather than be constrained by the impact of negative thoughts and feelings about your past or ongoing experiences.