Acceptance and commitment therapy, or ACT, is a relatively new form of psychotherapy. ACT is a type of cognitive-behavior psychotherapy, or a therapy in which thoughts and actions are addressed to alleviate anxiety and distress. The ACT approach uses acceptance, mindfulness, commitment and behavior strategies to improve psychological functioning, according to Dr. Steven Hayes, co-author of the book, "Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change."
Foundation
Acceptance and Commitment Therapy, or ACT, aims to change how people view their thoughts, feelings, memories and physical sensations, especially those that are typically avoided or feared. Individuals learn to notice or accept their thoughts, feelings, memories and physical sensations. People are taught to accept reactions to experiences and to stay in the present. Personal values are also clarified and people learn to take action on these values. As a result, people who undergo ACT have increased psychological flexibility, which has been defined by Dr. Hayes as improving the ability to experience events in the present and to act in ways that are consistent with a person's values.
Core Principles
ACT has six core principles to help people develop psychological flexibility, according to Dr. Hayes. Cognitive diffusion is learning to distance oneself from the literal meaning of language to help people see thoughts, feelings and memories in a more realistic way. Acceptance is another principle in which people learn to allow thoughts, feelings and memories to come and go without struggle. The principle of being in contact with the present moment helps individuals to experience the here and now. Observing oneself in situations is another principle. A fifth principle is discovering what values are most important. The last principle is committed action, or carrying out goals that are congruent with values.
Differences with Traditional CBT
Traditional cognitive behavior therapy, or CBT, focuses on identifying errors in thinking when experiencing depression or anxiety. These thinking errors are evaluated for the degree of truth they hold. An error in thinking is then replaced with a more realistic thought. For example, a person may think, "I'm stupid" after getting a poor grade on an exam. After evaluating the statement for accuracy, the person can change the statement and say, "I did not do so well on that test, but I'll try harder next time." ACT differs from CBT in that the person learns to accept the thinking errors. For example, when a person thinks, "I'm stupid," the statement may be viewed as, "I am having the thought that I'm stupid." This indifferent observation of the thought is typically repeated until the thought is diffused.
Similarities with Other New CBT Approaches
ACT is sometimes compared with other new CBT approaches--namely dialectical behavior therapy, or DBT, and mindfulness-based cognitive therapy. These new approaches to psychotherapy are similar in that they emphasize being in the present and changing perception of the environment and experiences. ACT and DBT are similar in their emphasis of acceptance.
Effectiveness
The effectiveness of ACT is being evaluated. A review of research by in the March 2008 issue of "Behaviour Research and Therapy" found that ACT could not be considered an empirically supported treatment at the time of the publication. The studies supporting the effectiveness of ACT had methodological flaws, whereas the few studies with solid research methodologies found ACT to be ineffective. The article concluded that more research is needed to determine the effectiveness of ACT.
References
- "Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change"; Steven Hayes, PhD, Kirk Strosahl, PhD, and Kelly Wilson; 2003.
- "Behaviour Research and Therapy: Efficacy of the Third Wave of Behavioral Therapies: A Systematic Review and Meta-Analysis"; Lars-Goran Ost; 2008.
