Acceptance and Commitment Therapy

The Substance Abuse and Mental Health Services Administration reports that acceptance and commitment therapy, commonly known as “ACT,” was first implemented about 20 years ago, and has been fully systemized since 1999. Even so, it remains a therapy that hasn’t been comprehensively covered in the mainstream media. As a result, there may be hundreds or even thousands of people who could benefit from this approach, but who may not even know that it exists. This article may help, as it will outline how ACT typically works, as well as who might benefit from participation.

Accepting Life

acceptance and commitment therapyMany therapy programs attempt to change the triggers that can bring about a spate of negative behaviors. By removing the pressures that people live with on a daily basis, therapists hope to allow their clients to live a life that’s a bit more peaceful and placid, so they’ll have the space in which to make better choices. Often, this is a technique that really works, and people who have this kind of help are able to soothe their distress through elimination or avoidance. However, there may always be new demons that pop up and new challenges to face, and unless people have strong skills, they might be plunged right back into poor behavior in the face of this new pressure.

Acceptance and commitment therapy functions just a bit differently. Instead of helping to remove distress and pressure, therapists hope to help their clients to accept the pain and suffering that comes with life. They might always experience a little emotional distress in the face of struggle, but they might not ever be required to act upon the pressures they face. With ACT, people learn to observe, accept and then choose to act.

Being Aware

workPeople can’t choose whether or not to act unless they’re taking note of their surroundings, and measuring their response to those triggers. In ACT therapy, clients are encouraged to be mindful and focused on the present. They might learn how to meditate, so they can strengthen their ability to eliminate distractions and cue in to their responses. Then, as the day passes, these clients might be asked to really pay attention to the events that take place, along with their reactions to those events. Keeping detailed notes in a journal may help, as this can allow clients to discuss their troubles in detail in therapy.

Defusing Pain

Once awareness is easy to obtain, clients might be asked to function as an impassive judge over the events of the day. They can take stock of their feelings, but they might use their intellect when choosing whether or not to respond. In an article in the journal Behavior Research and Therapy, authors refer to this technique as “cognitive defusion,” and they suggest that it can be accomplished in many different ways.

For example, when people are presented with a distressing thought, they can:

  • Repeat that thought aloud, until it becomes a series of meaningless syllables
  • Give the distressing thought a color or a shape, in order to treat it as an object that can be handled
  • Thank the mind for presenting an interesting thought
  • Label the thought by using the words, “I am having the thought that…”

These ideas may seem silly, but they have the ability to separate a thought from the immediate need to act. A person can just observe and take note, treating the thought as an abstraction and not a command.

Finding the Center

Acceptance and commitment therapy is also designed to put people in touch with their own inner compass. During the course of a busy and hectic life, people can become accustomed to the idea that they simply react, like a cork bouncing in a bucket of water, without the ability to influence the action. Finding values can give people purpose, so they can make decisions that are based on the things that are important, and the goals they want to achieve in life. Counselors might provide people with homework assignments that can help them to define what’s important to them, and what they think might define a healthy and happy life. When people are presented with a decision or a negative thought, they can apply their values to the problem and the solution might become clear. When values are in play, those decisions might be much healthier than they would be if the person was simply reacting and not thinking.

Understanding Treatment

In an article in Social Work Today, authors suggest that acceptance and commitment therapy sessions are creative and playful. Clients might be presented with metaphors that can explain the difficult concepts the therapist is attempting to teach. Games or puzzles might also play a role, as they can help people to use different parts of their brains in order to deal with a complicated problem. Some sessions last just minutes, while others might take up a much longer period of time. Most clients are asked to do a significant amount of homework, however, as the real lessons of ACT are best obtained when people are operating in the real world and dealing with real challenges.

ACT might be provided to almost anyone facing a mental health issue, according to a study in the journal Behavior Modification, as it’s been associated with reductions in anxiety, depression, poor quality of life and poor life satisfaction. It’s also a useful tool for people with addictions, as the therapy might help people to separate their drug behaviors from the low emotional states that trigger their drug use. ACT might also help addicted people to understand that their drug use is interfering with their values.

Important Considerations

Acceptance and commitment therapy does involve accepting the world and the struggles that might mar an otherwise happy life, but there are limits to the damage that should be observed and not acted upon. For example, women in abusive relationships might not use ACT to help them accept their daily beatings. Instead, a woman might use ACT to help her separate from her partner’s mental illness. The beatings aren’t her fault, an ACT therapist might help her to understand, and she can choose to leave. In no way should ACT be used as a substitute for the end of a dangerous situation.

Similarly, ACT can sometimes allow people to continue in behaviors others might find unhealthy, such as:

  • Expressions of anger
  • Social isolation
  • Lack of career advancement
  • Low economic status

For some people, these behaviors are associated with feelings of happiness, and they’re in accordance with their values. ACT isn’t designed to make everyone alike or socially acceptable. It’s designed to allow people to achieve happiness, and sometimes, one person’s happiness can be unconceivable to others.

If you’d like to find out more about how acceptance and commitment therapy might fit into your healing program, please contact us. Our admissions specialists would be happy to discuss our treatment programs at length.