Acceptance Commitment Therapy (ACT)

Wings Recovery for Men uses ACT because our goal is to provide you with as many tools in your tool box as possible so that you can thrive in your daily life.

What is Acceptance Commitment Therapy (ACT)*

ACT is an approach to psychological intervention defined in terms of certain theoretical processes, not a specific technology. We can define ACT in theoretical and process terms as a psychological intervention based on modern behavioral psychology, including Relational Frame Theory (RFT), that applies mindfulness and acceptance processes and commitment and behavior change processes to the creation of psychological flexibility.
The core conception of ACT is that psychological suffering is usually caused by the interface between human language and cognition, and the control of human behavior by direct experience. Psychological inflexibility is argued to emerge from experiential avoidance, cognitive entanglement, attachment of a conceptualized self, loss of contact with the present, and the resulting failure to take needed behavioral steps in accord with core values.
Buttressed by RFT, an extensive basic research program on an associated theory of language and cognition, ACT takes the view that trying to change difficult thoughts and feelings as a means of coping can be counterproductive, but new, powerful alternatives are available, including acceptance, mindfulness, cognitive defusion, values, and committed action.
Research seems to be showing that these methods are beneficial for a broad range of clients. ACT teaches clients and therapists alike how to mentally alter the way difficult private experiences function rather than having to eliminate them from occurring at all. This empowering message has been shown to help clients cope with a wide variety of clinical problems, including depression, anxiety, stress, substance abuse, and even psychotic symptoms. The benefits are as important for the clinician as they are for clients: ACT has been shown empirically to quickly alleviate therapist burn-out. In addition, we are learning that these same processes help us understand and change a variety of other behavioral problems, including such areas as human prejudice, work performance, or the inability to learn new things.

The Six Core Processes in ACT

The general goal of ACT is to increase psychological flexibility—the ability to contact the present moment more fully as a conscious human being and to change or persist in behavior when doing so serves valued ends. Psychological flexibility is established through six core ACT processes. Each of these areas is conceptualized as a positive psychological skill, not merely a method of avoiding psychopathology.
Acceptance
Acceptance is taught as an alternative to experiential avoidance. Acceptance involves the active and aware embrace of those private events occasioned by one’s history without unnecessary attempts to change their frequency or form, especially when doing so would cause psychological harm. For example, anxiety patients are taught to feel anxiety, as a feeling, fully and without defense; pain patients are given methods that encourage them to let go of a struggle with pain, and so on. Acceptance (and defusion) in ACT is not an end in itself. Rather, acceptance is fostered as a method of increasing values-based action.
Values
Values are chosen qualities of purposive action that can never be obtained as an object but can be instantiated moment by moment. ACT uses a variety of exercises to help a client choose life directions in various domains (e.g., family, career, spirituality) while undermining verbal processes that might lead to choices based on avoidance, social compliance, or fusion (e.g., “I should value X” or “A good person would value Y” or “My mother wants me to value Z”). In ACT, acceptance, defusion, being present, and so on are not ends in themselves; rather, they clear the path for a more vital, values-consistent life.
Being Present
ACT promotes ongoing nonjudgmental contact with psychological and environmental events as they occur. The goal is to have clients experience the world more directly so that their behavior is more flexible and thus their actions more consistent with the values that they hold. This is accomplished by allowing workability to exert more control over behavior and by using language more as a tool to note and describe events, not simply to predict and judge them. A sense of self called “self as process” is actively encouraged: the defused, nonjudgmental ongoing description of thoughts, feelings, and other private events.
Self as Context

As a result of relational frames such as I versus you, now versus then, and here versus there, human language leads to a sense of self as a locus or perspective and provides a transcendent, spiritual side to normal verbal humans. This idea was one of the seeds from which both ACT and RFT grew and there is now growing evidence of its importance to language functions such as empathy, theory of mind, sense of self, and the like.


In brief the idea is that “I” emerges over large sets of exemplars of perspective-taking relations (what are termed in RFT “deictic relations”), but since this sense of self is a context for verbal knowing, not the content of that knowing, its limits cannot be consciously known. Self as context is important in part because from this standpoint, one can be aware of one’s own flow of experiences without attachment to them or an investment in which particular experiences occur: Thus defusion and acceptance is fostered. Self as context is fostered in ACT by mindfulness exercises, metaphors, and experiential processes.

Cognitive Defusion

Cognitive defusion techniques attempt to alter the undesirable functions of thoughts and other private events, rather than trying to alter their form, frequency, or situational sensitivity. Said another way, ACT attempts to change the way one interacts with or relates to thoughts by creating contexts in which their unhelpful functions are diminished.


There are scores of such techniques that have been developed for a wide variety of clinical presentations. For example, a negative thought could be watched dispassionately, repeated out loud until only its sound remains, or treated as an externally observed event by giving it a shape, size, color, speed, or form. A person could thank their mind for such an interesting thought, label the process of thinking (“I am having the thought that I am no good”), or examine the historical thoughts, feelings, and memories that occur while they experience that thought. Such procedures attempt to reduce the literal quality of the thought, weakening the tendency to treat the thought as what it refers to (“I am no good”) rather than what it is directly experienced to be (e.g., the thought “I am no good”). The result of defusion is usually a decrease in believability of, or attachment to, private events rather than an immediate change in their frequency.

Committed Action

Finally, ACT encourages the development of larger and larger patterns of effective action linked to chosen values. In this regard, ACT looks very much like traditional behavior therapy, and almost any behaviorally coherent behavior change method can be fitted into an ACT protocol, including exposure, skills acquisition, shaping methods, goal setting, and the like. Unlike values, which are constantly instantiated but never achieved as an object, concrete goals that are values consistent can be achieved and ACT protocols almost always involve therapy work and homework linked to short-, medium-, and long-term behavior change goals. Behavior change efforts in turn lead to contact with psychological barriers that are addressed through other ACT processes (acceptance, defusion, and so on).


Taken as a whole, each of these processes supports the other and all target psychological flexibility, the process of contacting the present moment fully as a conscious human being and persisting or changing behavior in the service of chosen values. The six processes can be chunked into two groupings. Mindfulness and acceptance processes involve acceptance, defusion, contact with the present moment, and self as context.


Indeed, these four processes provide a workable behavioral definition of mindfulness (see Fletcher & Hayes, in press, in the Suggested Reading list). Commitment and behavior change processes involve contact with the present moment, self as context, values, and committed action. Contact with the present moment and self as context occur in both groupings because all psychological activity of conscious human beings involves the now as known.

*Information is provided by American Psychological Association