Acceptance and Commitment Therapy (ACT): An Introduction

Helping a client end suffering and move forward with a healthy and meaningful life is an important part of being a behavioral health provider. Empirically based, Acceptance and Commitment Therapy (ACT) may be the modality that makes a difference for providers and their clients. The research base supports its effectiveness in treating a multitude of conditions, including depression, chronic pain, anxiety, PTSD, drug abuse, and stress. Based on the core concept that the cause of human suffering lies in difficulties in the interface between language and cognitions that controls behavior, ACT helps clients to control their actions by becoming more psychologically flexible. The mindfulness and other exercises and skills learned by clients help them to think in more meaningful ways that assist them in choosing behaviors that align with their own values (Hayes, 2021). To learn just how important psychological flexibility is in this process of ending suffering, watch the talk that Steven Hayes gave at  TEDx Talks: Psychological flexibility: How love turns pain into purpose at the University of Nevada, Reno on February 22, 2016. In the video available on YouTube, he relates how his own experience with panic disorder let to the development of ACT.

How Does ACT Work?

ACT makes use of the broad base of traditional cognitive therapy techniques in its methods rather than a new set of techniques specifically developed for ACT. ACT also uses mindfulness techniques to achieve a mental state where one is aware and in the present moment, and accepting of feelings, thoughts, and bodily sensations. From a mindfulness presence, clients can view their most painful feelings, memories, and thoughts as an “observer” without judgement and can come to accept them and let them go. The mindfulness skills also enable the development of more flexible ways of interpreting language in all forms to predict, plan, and guide behavior. In Embracing Your Demons: An Overview of Acceptance and Commitment Therapy, Russell Harris, M.D. highlights the key elements of ACT. The six core principles of ACT used to develop psychological flexibility are:

• “Defusion – learning to perceive thoughts, images, memories and other cognitions as what they are—nothing more than bits of language, words and pictures—as opposed to what they can appear to be—threatening events, rules that must be obeyed, objective truths and facts.
• Acceptance – making room for unpleasant feelings, sensations, urges, and other private experiences; allowing them to come and go without struggling with them, running from them, or giving them undue attention.
• Contact with the present moment – bringing full awareness to your here-and-now experience, with openness, interest, and receptiveness; focusing on, and engaging fully in whatever you are doing.
• The Observing Self – accessing a transcendent sense of self; a continuity of consciousness that is unchanging, ever-present, and impervious to harm. From this perspective, it is possible to experience directly that you are not your thoughts, feelings, memories, urges, sensations, images, roles, or physical body.
• Values – clarifying what is most important, deep in your heart; what sort of person you want to be; what is significant and meaningful to you; and what you want to stand for in this life.
• Committed action – setting goals, guided by your values, and taking effective action to achieve them”.

According to Harris, each of the principles uses specific methodology, exercises, homework, and metaphors (Harris, 2021). ACT does not attempt to banish certain feelings or thoughts but is all about responding to life in ways of thinking and behaving that lead to a happy and meaningful life.

Training Opportunity

If your interest in ACT has been sparked, perhaps learning more about it has moved up your list of priorities. Learning more about the principles and techniques for use with behavioral health clients – or even yourself – is easy with the upcoming opportunity from CASAT Training: Flourishing: Enhancing Psychological Flexibility and Other Core Concepts of Acceptance and Commitment Therapy (and Tools You Can Use).  This webinar is coming up on February 8, 2021 from 9:00 am – 11:00 am PST. The presenters are Steven Hayes, PhD, who developed this treatment modality, and Tom Lavin, LMFT, LCADC.

Description from the CASAT Training website: “Developing psychological flexibility: This set of skills combines to give us psychological flexibility. Psychological flexibility is the ability to feel and think with openness, to attend voluntarily to your experience of the present moment and move your life in directions that are important to you, building habits that allow you to live life in accordance with your values and aspirations. It is about learning not to turn away from what is painful, instead turning toward your suffering in order to live a life full of meaning and purpose. In this webinar, Dr. Steven Hayes will share tools you can use from his book, “A Liberated Mind: How to Pivot Toward What Matters. The proven plan to overcome negative thoughts and feelings, turn pain into purpose, and build a meaningful life.”

Learning Objectives:

1. Describe how psychological flexibility can improve one’s  quality of life.
2. Describe the ACT concept of “Acceptance – learning from pain”
3. Identify one way you can use either Dr. Russ Harris’s list of values or the “Quality of Life Inventory” to help clients identify what is truly important to them.
4. Identify Dr Frankl’s three ways of experiencing meaning.

About the Presenters:

Steven C. Hayes, PhD. – Steven C. Hayes is a Nevada Foundation Professor of Psychology in the Behavior Analysis Program at the University of Nevada. An author of 46 books and over 650 scientific articles, he is especially known for his work on “Acceptance and Commitment Therapy” or “ACT” which is one of the most widely used and researched new methods of psychological intervention over the last 20 years. Dr. Hayes has received several national awards, such as the Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapy. His popular book Get Out of Your Mind and Into Your Life for a time was the best-selling self-help book in the United States, and his new book A Liberated Mind has been recently released to wide acclaim. His TEDx talks have been viewed by over 3/4 of a million people, and he is ranked among the most cited psychologists in the world.

Tom Lavin, LMFT, LCADC, Psychotherapist – Tom Lavin is a Licensed Marriage and Family Therapist and a Licensed Alcohol-Drug Counselor with over 40 years’ experience helping individuals, couples, and families address challenging life issues. Clinical Faculty, University of Nevada School of Medicine, Psychiatry and Behavioral Sciences. Tom is also the recipient, “Impact Award” from the Association for Contextual Behavioral Sciences.”

For additional resources and links about ACT, visit the CASAT OnDemand Resources & Downloads page.

References

Bond, F. W. & Bunce, D. (2000). Mediators of change in emotion-focused and problem-focused worksite stress management interventions. Journal of Occupational Health Psychology, 5, 156-163

Dahl, J., Wilson, K. G., & Nilsson, A. (2004). Acceptance and commitment therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial. Behavior Therapy, 35, 785-802

Harris, R. (2021). Embracing Your Demons: An Overview of Acceptance and Commitment Therapy. Retrieved January 13, 2021, from https://www.psychotherapy.net/article/Acceptance-and-Commitment-Therapy-ACT#section-the-goal-of-act

Hayes, S. C., Bissett, R., Roget, N., Padilla, M., Kohlenberg, B. S., Fisher, G., et al. (2004). The impact of acceptance and commitment training on stigmatizing attitudes and professional burnout of substance abuse counselors. Behavior Therapy, 35, 821-836.

Hayes, S. L. (2021). Acceptance & Commitment Therapy (ACT). Retrieved January 13, 2021, from https://contextualscience.org/act

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