Acceptance and commitment therapy, or ACT, is a cognitive-behavioral model of psychotherapy.[1] It is an empirically based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways[2] with commitment and behavior-change strategies, to increase psychological flexibility. Originally this approach was referred to as comprehensive distancing.[3] ‘ACT’ is spoken as a single word, not as separate initials.

Dr. Russ Harris provides several free ACT tools on his site including:
The Complete Worksheets for The Confidence Gap
The Complete Worksheets for ACT With Love
The Complete Set of Client Handouts and Worksheets from ACT Made Simple
The Quick Guide to Case Conceptualization, from appendix 1 of ACT Made Simple
ACT In A Nutshell Metaphor: Objections and Responses: from Chapter 1 of ACT Made Simple
The Psychological INFLEXIBILITY Assessment, from chapter 2 of ACT Made Simple

ACT is developed within a pragmatic philosophy called functional contextualism. ACT is based on relational frame theory (RFT), a comprehensive theory of language and cognition that is framed as an offshoot of behavior analysis. ACT differs from traditional cognitive behavioral therapy (CBT) in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to “just notice”, accept, and embrace their private events, especially previously unwanted ones. ACT helps the individual get in contact with a transcendent sense of self known as “self-as-context” — the you that is always there observing and experiencing and yet distinct from one’s thoughts, feelings, sensations, and memories. ACT aims to help the individual clarify their personal values and to take action on them, bringing more vitality and meaning to their life in the process, increasing their psychological flexibility.[3]

While Western psychology has typically operated under the “healthy normality” assumption which states that by their nature, humans are psychologically healthy, ACT assumes, rather, that psychological processes of a normal human mind are often destructive.[4] The core conception of ACT is that psychological suffering is usually caused by experiential avoidance, cognitive entanglement, and resulting psychological rigidity that leads to a failure to take needed behavioral steps in accord with core values. As a simple way to summarize the model, ACT views the core of many problems to be due to the acronym, FEAR:
– Fusion with your thoughts
– Evaluation of experience
– Avoidance of your experience
– Reason giving for your behaviour

And the healthy alternative is to ACT:
– Accept your reactions and be present
– Choose a valued direction
– Take action

ACT commonly employs six core principles to help clients develop psychological flexibility[4]:

1. Cognitive defusion: Learning to perceive thoughts, images, emotions, and memories as what they are, not what they appear to be.
2. Acceptance: Allowing them to come and go without struggling with them.
3. Contact with the present moment: Awareness of the here and now, experienced with openness, interest, and receptiveness.
4. Observing the self: Accessing a transcendent sense of self, a continuity of consciousness which is unchanging.
5. Values: Discovering what is most important to one’s true self.[5]
6. Committed action: Setting goals according to values and carrying them out responsibly.

ACT is sometimes grouped together with Dialectical behavior therapy, Functional Analytic Psychotherapy, and Mindfulness-based Cognitive Therapy as The Third Wave of Behavior Therapy[13][14] which Steven C. Hayes defined in his ABCT President Address as follows:

Grounded in an empirical, principle-focused approach, the third wave of behavioral and cognitive therapy is particularly sensitive to the context and functions of psychological phenomena, not just their form, and thus tends to emphasize contextual and experiential change strategies in addition to more direct and didactic ones. These treatments tend to seek the construction of broad, flexible and effective repertoires over an eliminative approach to narrowly defined problems, and to emphasize the relevance of the issues they examine for clinicians as well as clients. The third wave reformulates and synthesizes previous generations of behavioral and cognitive therapy and carries them forward into questions, issues, and domains previously addressed primarily by other traditions, in hopes of improving both understanding and outcomes.

Similarities are also found with the awareness-management movement in business training programs, where mindfulness and cognitive-shifting techniques are being employed to generate rapid positive shifts in mood and performance[15].

ACT has also been adapted to create a non-therapy version of the same processes called Acceptance and Commitment Training. This training process, oriented towards the development of mindfulness, acceptance, and values skills in non-clinical settings such as businesses or schools, has also been investigated in a handful of research studies with good preliminary results.

The emphasis of ACT on present-mindedness, direction and action is similar to other approaches within psychology that, unlike ACT, are not as focused on outcome research or consciously linked to a basic science program, including more humanistic or constructivist approaches such as narrative psychology, Gestalt Therapy, Morita Therapy[16], or Re-evaluation Counselling among many others.

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