Acceptance and commitment therapy is a therapeutic technique that falls under the CBT (cognitive behavioral therapy) umbrella. CBT therapy targets a person’s cognitions (or thoughts), behaviors, and feelings. A cognitive behavioral therapist may use a variety of techniques such as Acceptance and Commitment Therapy to enhance their practice.
ACT practitioners use a CBT lens to view our clients and their current situation, past experiences, and future goals. As a clinician I share with my clients in early stages of therapy that if we can change one of the following – affect (feelings towards oneself or those close to us), behavior (actions or lack there of), and cognitions (thoughts about ourselves and the world around us) – then the other two will follow with persistent work towards change.
ACT can be explained in two parts which may seem obvious by the name, but it can be trickier than that.
Part one is acceptance.
“Accept” by definition of Merriam-Webster is to give admittance or approval to. In therapy, the clinician would encourage the client to accept their thoughts, feelings, or behaviors. The challenge is in overcoming the feelings that are negative or unwanted. Many of our thoughts or feelings are out of our control and happen unconsciously.
What ACT does is allow the client to accept some of the things that they cannot or are unwilling to change. However, it does not always mean that we are “okay” with it.
For example: A person is looking to lose weight and become healthier to eventually improve sense of self. The clinician would assist the client in accepting their negative or even irrational thoughts and beliefs about oneself.
A typical CBT way to go about this is to challenge a person think more positively about themself. More specifically, the clinician would point out the various strengths or evidence against the clients beliefs. Instead, the clinician could simply take the ACT approach. This challenges the client to accept their negative thoughts about oneself as it is not something they can always control.
Now comes part two which for many clients is the easier part of this process.
Part 2 of ACT is commitment.
Commitment is process in which the clinician asks the client for dedication- to be committed in their actions towards change. This part of the process is the tangible actions steps the client can make in order to reach their goal. So if we continue to go with the person mentioned above the clinician would help the client make a tangible list of actions steps towards their goal of gaining healthier habits and improving sense of self. This list might include practicing one self care technique weekly, finding an exercise activity they are comfortable with and can practice weekly, eating healthy daily, and replacing negative behaviors, such as undereating to shed weight, to eating smaller meals more frequently. This list of action steps would change per person and could be modified over time.
Simply put, the goal of ACT is to accept that some things we cannot change and might be uncomfortable or painful, yet if we wish to live a happy and fulfilled life, we must become comfortable in the messiness and commit towards making change.