New ways to help with anxiety with ACT

For many years, CBT (Cognitive Behavioural Therapy) has been heralded as one of the most effective ways to help people with anxiety. Because of the quite clear structure of CBT, it has offered a simple way to measure 'results' of treatment. CBT lends itself to a more quantitative way of measuring effectiveness than many other therapeutic approaches, which also means that although studies may demonstrate the benefits of CBT, it doesn't mean that it is the only effective approach to working with anxiety. It is just easiest to measure. More and more people are recognising that longer term therapy is also important.

Certainly in the short term, CBT can help many clients reduce the symptoms of anxiety and improve their quality of life. However, over time some people find that the anxiety returns.

Many people suffer from anxiety and panic attacks. How can we help them in the longer term?

ACT (Acceptance and Commitment Therapy) is an approach to treatment that has been proven to be effective.

What is ACT?

ACT is a model developed by psychologist Dr. Steven Hayes and has been shown to be effective in treating anxiety as well as other mental health disorders. Although the roots of ACT are born from CBT and is in the category of 'third wave CBT', the approach integrates many other therapeutic approaches and looks at how to transform the individual relationship with emotions such as anxiety and the related thoughts.

One major goal of ACT is to help people live more meaningful and purposeful lives. Many people who suffer with emotions such as anxiety spend so much of their time trying to deal with the anxiety that they lose sight of what is really important to them in life. Instead, most of their time and energy is spent trying to get rid of anxiety or avoiding situations or experiences where they might experience it. As a result, they actually end up increasing their experience of suffering.

Several studies have shown that when people try to reduce or suppress their anxiety, the feelings actually grow stronger.

Therefore, rather than follow an approach of symptom reduction, ACT explores ways to help people accept their experience, including their thoughts and feelings. Essentially this is largely about creating a new relationship with our experience, rather than try to change it.

One important method to help with this is mindfulness. Mindfulness has grown in popularity in the West for many years, although it has been around for centuries. The practice of mindfulness involves focusing one's awareness on the present moment. During practice, it is natural to have other thoughts and feelings and the practice involves acknowledging and accepting those thoughts, feelings and body sensations and then bringing our awareness back to the present moment.

Developing acceptance can naturally take some practice and clients will usually be given 'homework' between sessions to help develop this new way of 'being'.

Another important area is in helping clients to be clear about what is important to them in life; their values. For so long they have focused on the experience of anxiety, what is really important to them may have been ignored. It is a little like they have been looking through a narrow lens, at part of a picture representing struggle. By creating a new focus on values, the camera lens zooms out and focuses on a different part of the picture that helps people develop a new focus on life, where anxiety no longer consumes them.

The many studies on ACT have suggested that it is a more effective and long term approach to dealing with anxiety than traditional CBT models. ACT also allows and indeed encourages integration of other therapeutic modalities, which perhaps makes it a more appealing approach for integrative therapists to explore.