What Is Acceptance and Commitment Therapy?

Medically Reviewed by Minesh Khatri, MD on May 14, 2023
4 min read

Acceptance and commitment therapy (ACT therapy) is a type of mindful psychotherapy that helps you stay focused on the present moment and accept thoughts and feelings without judgment.

It aims to help you move forward through difficult emotions so you can put your energy into healing instead of dwelling on the negative. With the help of a licensed professional, you'll pick up a collection of coping mechanisms specifically designed for your situation, which you can use throughout your life to handle challenging experiences.

ACT therapy works by focusing on accepting life experiences as they come, without evaluating or trying to change them. It's a skill developed through mindfulness exercises that encourage you to build a new and more compassionate relationship with difficult experiences. Doing this can free you from obsessive negative thinking so you can have peace of mind and healing.

Acceptance. Start by accepting emotions and feelings that may feel like they're out of your control and mindfully accept the experience.

Direction. Commit to a positive approach that will help push you forward while resisting the temptation to rehash the past.

Action. Take charge and make a conscious decision to stick with the positive direction you chose. Stay resilient, no matter what life throws at you.

When you go to an ACT therapy session, you can expect to go through the following stages.

Building rapport. During your first few sessions, you'll sit with a therapist and talk about some of the challenges or struggles you're facing. You'll discuss your mental health and talk about things you've tried in the past that may or may not have worked.

Deeper awareness. Your therapist will help you identify areas you may have negative thoughts about or hesitate to discuss with others. They can help you work through painful memories while making peace with the things you cannot change.

Core values. During ACT sessions, you will also be encouraged to explore your core values and identify what's important to you. How do you want to identify yourself? What do you want your life to look like?

Actions. After you've identified your recurring thought patterns and what you'd like to prioritize, your therapist will help you start to make a change. The emphasis of this phase is to accept what you can't change while focusing on changing things within your control.

Commitment. Once you've experienced ACT, your therapist will help you find ways to incorporate it into your everyday life. The purpose is to make a well-thought-out plan so you can continue what you learned in the long run.

Mindfulness plays an important role in ACT therapy.

Mindfulness offers you a way to ground yourself in the present by paying attention moment-by-moment to your feelings, physical sensations, and outside environment. Mindfulness exercises and mindfulness techniques can help support your ACT therapy practice by developing nonjudgmental acceptance of your thoughts and feelings. Instead of trying to change things, rehashing the past, or imagining a future, you remain in the moment.

The beauty of mindfulness is that it can be practiced anytime, anywhere. You can be at work, at home, or even socializing with friends and family. All you have to do is bring your attention back to the present moment, grounding yourself with your breath and paying attention to the sounds, scents, and activities happening around you.

While this may sound like a small change, the benefits of mindfulness are incredible. Many people find that practicing mindfulness has brought them peace, purpose, and a renewed sense of happiness.

ACT therapy can help with a variety of mental health conditions, including:

  • Stress regulation
  • Work stress
  • Anxiety
  • Depression
  • Substance abuse
  • Phobias (irrational fears)

Initial studies that test the effectiveness of ACT are promising, including randomized trials of the treatment as an addition to standard psychosocial therapy or as a stand-alone treatment compared to other treatments. 

More research is needed to compare ACT to different empirically-supported approaches, such as 12-step facilitation and traditional relapse prevention. Studies are also needed to look into precisely how ACT is helpful or how it works, like studies that examine its behavior change mechanisms. 

Right now, the evidence for ACT in the treatment of substance use disorder is encouraging yet limited.

Therapists for ACT may be social workers, psychologists, psychiatrists, or other kinds of mental health professionals. No matter what type of therapist you choose to work with, make sure they meet the following criteria:

  • An advanced degree in a mental health field
  • Licensure to practice in the state where you live
  • Additional experience and training using ACT