Eric Foreman
April 9, 2026
Behavioral Health, Mental Health, Professional Development, Psychotherapy, Recovery

Acceptance and Commitment Therapy (ACT): A Different Way to Think About Recovery

By Eric Foreman

We’ve all heard some version of this: accept what you can’t change, change what you can, and know the difference. In recovery—especially in 12-step spaces—that idea becomes a way of life.

But here’s the part we don’t talk about enough: most people don’t struggle with substance use because they’re weak or unmotivated. They struggle because substances work—at least in the short term. They take the edge off anxiety. They quiet shame. They help people escape stress, trauma, or loneliness, even if just for a moment.

That’s where Acceptance and Commitment Therapy (ACT) comes in. ACT doesn’t ask you to fight your thoughts or eliminate cravings. Instead, it teaches you how to live a meaningful life alongside them—so you don’t need substances to cope in the first place.

So what does ACT actually do?

ACT is built around something called psychological flexibility—basically, the ability to stay present and make choices that line up with who you want to be, even when things feel hard (Hayes et al., 2006).

Because the truth is, a lot of substance use comes from trying to avoid uncomfortable thoughts and feelings—what researchers call experiential avoidance (Hayes et al., 1996). The problem is, the more we try to avoid those experiences, the stronger they tend to come back,
ACT helps break that cycle.

What this looks like in real life

Instead of saying, “I need to get rid of this craving,” ACT helps you learn: “I can have this craving and not act on it.”

Instead of believing every thought that shows up, like: “I can’t handle this without using,”

ACT teaches you to step back and notice: “I’m having the thought that I can’t handle this.”

That small shift? It creates space—and that space is where change happens.

ACT focuses on a few key skills:

Making room for uncomfortable feelings instead of fighting them
Not getting stuck in your thoughts
Staying grounded in the present moment
Reconnecting with what actually matters to you
Taking small, consistent steps toward that life

Why this matters for recovery

Research shows ACT can help reduce substance use, improve engagement in treatment, and support long-term recovery (Lee et al., 2015; Twohig et al., 2018). But honestly, the real value is simpler than that:

ACT helps people stop organizing their lives around avoiding pain—and start building lives around purpose.

That’s a big shift.

Why it works so well in college recovery

In programs like NRAP, students aren’t just trying to stay sober—they’re trying to build a life. They’re going to school, forming relationships, figuring out who they are, and deciding what matters.

ACT fits naturally into that process. It supports students in:

Staying grounded during stress
Navigating identity and growth
Building meaningful connections
Making choices aligned with their future

Because recovery isn’t just about not using. It’s about creating a life where using doesn’t make sense anymore.

The bottom line

ACT helps people move:

From avoiding → to facing
From shame → to self-compassion
From surviving → to actually living

And that’s the kind of recovery that lasts.

References

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.

Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168.

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25.

Lee, E. B., An, W., Levin, M. E., & Twohig, M. P. (2015). An initial meta-analysis of Acceptance and Commitment Therapy for treating substance use disorders. Drug and Alcohol Dependence, 155, 1–7.

Twohig, M. P., Levin, M. E., & Hayes, S. C. (2018). Acceptance and Commitment Therapy as a treatment for anxiety and depression: A review. Psychiatric Clinics of North America, 41(4), 751–770.