Acceptance commitment therapy (ACT)

Acceptance and commitment therapy (ACT) pronounced “act,” is an active evidence-based brief-therapy, developed by Hayes and others since the late 1980s. It has been found to have been successful (through randomised control trials), in helping adults and children with a range of issues including anxiety, insomnia, depression, PTSD, relationship difficulties, pain and long-term conditions, teenagers etc. to live more fulfilled and meaningful lives. Its general principles are applicable to everyone though, including those coping with normal everyday issues that present challenges to them, including stress at work and parenting difficulties and has also been applied to organisations and teams, in business and other sectors.

ACT is growing in popularity, along with other ’third way behavioural therapies’ (such as mindfulness based CBT). It is being more widely used, for example, in the NHS, as it is simple to understand and easy to apply in different situations and settings, only requires short-term therapy, promotes client autonomy and incorporates mindfulness practices.

In ACT you are encouraged to be present and notice thoughts and feelings (through being mindful) and to learn ways of being more ‘accepting’ (or willing to make space for the things you cannot change, including uncomfortable thoughts and feelings). This can feel counter-cultural as our usual tendency is to try to deny, 'get rid' of or push away unpleasant feelings or thoughts, but it is our struggle with trying to get rid of them that can actually cause further problems for us because it is exhausting and can lead us to think even more about our issues.

In ACT, metaphors are often used to explain principles, for example, trying to get rid of thoughts and feelings can be likened to trying to push a beach-ball under water in a pool - the more you try the more it keeps bobbing back out of the water. Instead, through ACT you can learn to take the ball (your difficult thoughts and feelings) and allow it to float in the water alongside you, and to be free to have fun and enjoy the pool!

This leads to the other part of ACT - which involves committing to take steps or action, towards living the kind of life you want to live, based on your values (the things that are important to you in how you want to live or the kind of person you want to be).

In doing so, you will develop ‘psychological flexibility’ to live life more fully, even in the midst of life’s difficulties. In summary ACT involves being present, being open to all that life brings and taking action based on your values.