Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) is a third-wave cognitive-behavioral approach
that emphasizes psychological flexibility by helping individuals accept difficult emotions
while committing to values-based actions. Unlike traditional CBT, which focuses on
changing thoughts, ACT encourages accepting them and responding in a way that aligns with
one's values.
Core Processes of ACT (The Hexaflex Model)
ACT is based on six core psychological processes that enhance psychological flexibility:
1. Cognitive Defusion (Distancing from Thoughts)
Helps individuals detach from their thoughts rather than taking them as literal truths.
Example: Instead of saying "I am a failure," reframe it as "I am having the thought
that I am a failure."
2. Acceptance (Embracing Thoughts & Feelings)
Encourages openness to all experiences, including painful emotions, instead of
avoiding or suppressing them.
Example: A person with social anxiety accepts discomfort while engaging in social
interactions instead of avoiding them.
3. Present Moment Awareness (Mindfulness)
Cultivates attention to the present rather than being stuck in past regrets or future
worries.
Techniques: Grounding exercises, mindful breathing, observing emotions without
judgment.
4. Self-as-Context (Observing Self)
Teaches individuals to see themselves as an observer of experiences rather than being
defined by them.
Example: Instead of saying "I am anxious," say "I notice that I am feeling anxious."
5. Values Clarification (Identifying Meaningful Directions in Life)
Helps individuals define their core values (e.g., relationships, career, health) and align
their actions accordingly.
Example: If family is a value, taking steps to spend more quality time with loved
ones.
6. Committed Action (Taking Steps Toward Values-Based Goals)
Encourages goal-setting and taking consistent action aligned with values, even in the
presence of discomfort.
Example: A person with a fear of public speaking commits to giving a speech because
it aligns with their career goals.
ACT in Practice: Techniques and Exercises
✅ Leaves on a Stream (Cognitive Defusion Exercise)
Imagine thoughts as leaves floating down a stream, watching them pass without
clinging to them.
✅ The "Passengers on the Bus" Metaphor
Imagine thoughts as noisy passengers on a bus. Instead of letting them take control,
continue driving toward values.
✅ Tug-of-War with a Monster
Visualize struggling with a monster (representing a problem). The harder you pull, the
stronger it gets. Instead, dropping the rope (acceptance) reduces suffering.
✅ Mindful Breathing
Focus on the breath as an anchor to the present moment.
✅ Values Assessment & Commitment Plan
Identify top values and set small, actionable steps toward living them.
ACT vs. Traditional CBT
Aspect ACT CBT
Approach to Thoughts Accepts them without struggle Challenges and changes them
Focus Psychological flexibility Symptom reduction
Emphasis Living according to values Restructuring negative thoughts
Techniques Mindfulness, acceptance Cognitive restructuring, exposure
Applications of ACT
ACT is effective in treating:
✔ Anxiety disorders
✔ Depression
✔ Chronic pain
✔ PTSD
✔ OCD
✔ Substance use disorders
✔ Workplace stress
Would you like more details on ACT interventions for a specific issue?
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