Acceptance and Commitment Therapy (ACT)

Is what you’re doing giving you a rich, full and meaningful life? If the answer is yes, then you probably don’t need to change anything or attend therapy. However, if the answer is no, you may want to consider therapy and this therapeutic approach in particular to maximise your potential for a rich, full and meaningful life.

We will all experience frustration, disappointment, rejection, loss and failure at some point in our lives. We will all experience aging, illness and injury also. Unfortunately, we will all face our own death and the death of loved ones. And on a regular basis, we will experience painful feelings that we wish would ‘go away’ – anger, hurt, shame, fear and sadness to name a few. Acceptance and Commitment therapy (ACT) is a model of therapy that teaches people how to handle these painful experiences and the thoughts and feelings that accompany them in a more helpful way.

For example, Jeff was in a road traffic accident in 2012 which left him with chronic back pain. For the first three years following the crash, Jeff took various pain medications and attended physiotherapy and acupuncture numerous times. He requested investigations into the source of his pain and became a regular at his local GP surgery requesting pain relief and referrals to other agencies to ‘get rid of his pain’. Jeff started to feel depressed and hopeless about his situation. He stopped going out and meeting friends as he felt he couldn’t relax and enjoy the company as he kept thinking about his pain. He lost his confidence and developed low self-esteem. He felt too anxious to go to work as he couldn’t face being around others and struggled to focus on daily tasks. Eventually, he gave up work and barely left the house. He would lie in bed for long periods of time to ease his pain only to find that when he tried to get up, he felt worse than before he went to bed. He started to use alcohol to switch off from negative thoughts and numb his painful feelings.

What Jeff didn’t realise was that everything he was doing to ‘get rid of his pain’, ‘control his pain’, ‘push his pain away’ was in fact taking him further away from what he wanted to achieve – a rich, full and meaningful life. Unfortunately, no one could take away the pain inflicted upon Jeff in his road traffic accident; but we could help change his relationship with his pain and teach him how to focus on what is important to him in life. In this way, we would hope that Jeff would be able to live a valued and meaningful life despite his pain. 

ACT:

• Helps you to develop skills and strategies to deal with difficult experiences in a more helpful way so that they have less impact and influence over your behaviour, for example, avoidance.
• Helps you to clarify what is truly important and meaningful to you - i.e. your values - then use that knowledge to motivate you to change your life for the better and move towards those values.

                      ACT Hexaflex – The six core processes of Acceptance and Commitment Therapy (Harris, 2009)

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When you combine these processes together, you develop 'psychological' flexibility. This is the ability to be in the present moment, with awareness and openness, and commit to action guided by your values. The greater your ability to be present, open and do what matters to you most, the greater the impact on your wellbeing and in turn, you will experience a better quality of life.

ACT differs from CBT in that instead of challenging distressing thoughts by looking for evidence and coming up with a more rational response (CBT), in ACT, the thought is accepted as a thought, e.g. "I'm having the thought that I’m stupid and worthless". ACT aims to help people defuse their thoughts from their behaviour using a variety of strategies including Mindfulness and metaphors.

Who would benefit from this therapy?

Acceptance and Commitment therapy is utilised and helpful for a range of psychological difficulties; in particular, for individuals who have long term physical health conditions, depression, anxiety, disorders including OCD and social phobia, workplace stress, weight control, psychological adjustment to cancer, smoking cessation and sleep problems.