How Does Acceptance and Commitment Therapy Work?

How Does Acceptance and Commitment Therapy Work?

How Does Acceptance and Commitment Therapy Work?

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Identity Counseling Psychology is an Ann Arbor counseling and psychotherapy practice specializing in therapy for anxiety disorders, clinical depression, grief, trauma, relationships, substance abuse, panic attacks, self-esteem, identity, motivation and more. Our licensed therapists are passionate about helping patients live their most fulfilled lives, and our team is experienced in a variety of therapeutic approaches, techniques and frameworks, including Acceptance and Commitment Therapy (ACT). If you’re interested in starting counseling or learning more about how ACT can help you or a loved one, contact us today. 

What is Acceptance and Commitment Therapy?

Acceptance and commitment therapy is a modern form of psychotherapy, or talk therapy, performed by a licensed mental health professional like a therapist, counselor, psychologist, or social worker. ACT is an action-oriented approach to therapy, using mindfulness techniques to help patients develop psychological flexibility and live a life that’s more in line with their goals and values.

ACT is a unique approach to counseling because it doesn’t consider patients with psychological distress or symptoms of a mental health disorder to be pathological. Patients of ACT are not viewed as flawed or damaged, and the goal of therapy is not to “fix” them. Rather than trying to control, relieve, change or avoid a negative emotion or the side effect of a mental health condition, ACT seeks to help patients accept and learn to live with the uncomfortable cognitive patterns that other therapies try to get rid of or reduce. ACT encourages self-love and empathy for all of one’s emotions and experiences, no matter how troubling or potentially destructive they may seem, giving patients the chance to move on with their lives and thrive as the person that they are. 

What Does Acceptance and Commitment Therapy Treat?

ACT can be offered as individual counseling, couples counseling or group counseling, and as both long-term and short-term treatment. Acceptance-commitment therapy can be helpful for a wide range of clinical populations and mental health concerns. Unlike most modern forms of therapy, symptom reduction isn’t the goal when it comes to ACT, although it is almost always a byproduct. 

One objective of the acceptance-commitment approach is to help patients stop viewing their unwanted thoughts and feelings as “symptoms” of a disorder. Instead, they’re encouraged to start viewing distress, in whatever form it may come, as an uncomfortable, but harmless and temporary event in their minds, separate from who they are as people. Therapists practicing ACT know that once a mental health struggle is labeled as a “symptom,” there’s a subsequent struggle to fix or get rid of that symptom. In ACT, the goal is to accept the struggles that we have without allowing them to create even more struggles or hold us back from being who we want to be. 

Acceptance and Commitment Therapy has been used effectively to help treat the following mental health concerns:

How Does Acceptance-Commitment Therapy Work?

The main goal of Acceptance and Commitment Therapy is to help patients develop psychological flexibility, which can be defined as “the ability to be present, open up, and do what matters.” In ACT sessions, patients focus on three key processes: letting go of emotional control, acceptance of unwanted private experiences (thoughts, memories, emotions, cognitive patterns, etc.), and commitment toward living a life in line with their core values. 

Letting Go of Emotional Control

ACT begins with the patient confronting their own agenda of emotional control. Most patients come to therapy in hopes of learning to control painful feelings and fix unwanted emotional responses, having failed in their past attempts to do so. The therapist encourages the patient to examine the ways in which they’ve tried to cope with, avoid or find relief from the mental health issue that they came in for. What are the strategies they have used to gain emotional control? 

The therapist and the patient run through the list together, making note of the strategies that can be harmful if used long term, and confronting which strategies actually end up making the patient feel worse than the unwanted emotion itself. They then take a realistic look at the efficacy of the emotional control strategies that may seem harmless. Have they helped consistently? Have they helped significantly? Are they worth the time, energy and money that the patient has put into them? How do they impact the patient’s quality of life? 

Some examples of strategies to control emotional discomfort might include:

  • Therapy that aims to change unwanted cognitive processes
  • Antidepressant / anti-anxiety medication
  • Drinking alcohol before bed 
  • Not opening up to new people 
  • Avoiding social events
  • Therapy that analyzes one’s childhood
  • Blaming genetics, parents, or upbringing for mental health issues
  • Deep breathing
  • Watching TV
  • Eating
  • Gambling
  • Smoking cigarettes
  • Self-harm
  • Ruminating
  • Chastising oneself

When patients come to the realization that their attempts at emotional control are part of the problem, not the solution, they become more open to the idea of letting go and learning to accept themselves as they are. In ACT, patients learn that when they resist emotional discomfort, not only do they become distressed by the distress itself, but they also do whatever they can to make the feeling go away, regardless of the long term costs. 

Mindfulness

There are six core principles of ACT used to help patients develop psychological flexibility. The first four principles are techniques based in the practices of mindfulness. 

Defining features of mindfulness that are important to psychological flexibility and ACT include:

  • Living in the present moment
  • Engaging fully in what you’re doing rather than getting lost in thought
  • Bringing awareness to your here-and-now experience and accepting it with openness 
  • Calmly acknowledging your thoughts, feelings, and bodily sensations
  • Allowing your feelings to come and go as they are, letting them be instead of trying to control them

Values Clarification

The last two core principles of ACT employ exercises in something called values clarification, which helps patients remember the values that are most important to them in life. Once a patient defines their values, they can learn to use them as a compass, pointing them in the right direction when painful emotions or coping mechanisms begin to lead them astray or cloud their judgement. Making a commitment to acting in line with these values allows patients to take purposeful action in their lives and behave in ways that reflect them at their core, rather than in ways that are a response to their psychological discomfort.

For example, a patient seeking anxiety treatment may list “spending meaningful time with family” as one of their core values. The next time they’re invited to a triggering family gathering, they’ll still feel anxiety, despite their time in ACT. Maybe they’re scared of being judged by their parents, or maybe they’re worried about being compared to their siblings. This anxiety will still come up, but now, instead of allowing it to guide their decision making, they’ll remember their commitment to their core values and attend the family event despite their discomfort. In the past, the patient may have decided to drink a few beers before the event to take the edge off, or make an excuse and stay home. But in ACT, patients find the inner strength and willingness to accept and feel unwanted emotions so that they can live a life that reflects what they value. 

Six Core Principles of ACT

The following principles are employed throughout Acceptance and Commitment Therapy with the goal of helping patients reach a state of psychological flexibility. Through mindfulness and values clarification exercises, these principles encourage them to accept their truths and live more fulfilled, purpose driven lives.

  1. Cognitive Defusion – Defusing threatening or uncomfortable thoughts, memories, and cognitions by recognizing them as nothing more than an ever changing stream of pictures, words and sounds that exists in the mind. Understanding their temporary and harmless nature disarms them, and they’re no longer seen as threats that must be obeyed, or objective truths and facts about one’s character.  
  2. Acceptance – Making room for unpleasant emotions, sensations, urges and cognitions, allowing them to come and go without struggle or analysis. 
  3. Contact with the present moment – Bringing full awareness to the present moment with openness and receptiveness to whatever it is that one experiences.  
  4. The Observing Self – Observing thoughts and feelings as something separate from one’s true self and not part of the essence of what makes them who they are. 
  5. Values – Clarifying what’s most important to someone in their life, and what sort of person they want to be. 
  6. Committed Action – Setting goals and taking action that is guided by one’s core personal values. 

How IDENTITY Can Help

Identity Counseling Psychology offers psychotherapy services in Ann Arbor, MI to adults, teens, kids, and families for a variety of mental health issues. Our therapists are trained in mindfulness techniques and a variety of therapeutic approaches, including Acceptance and Commitment Therapy. If you think that you or someone you know might benefit from ACT, mindfulness, or a multimodal approach to therapy, contact us today to set up an intake appointment or learn more about our practice.


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