Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) is a mindfulness-based therapy that rests on the premise that the more time and energy we spend on trying to avoid or control our mental and emotional experiences, the more we contribute to our own psychological suffering. With ACT, the focus is on reducing our internal struggle and suffering by relating to our thoughts and feelings more effectively and with greater flexibility. Through the ACT process, I help individuals break away from old unhelpful stories and scripts, take action that is guided by their values, and learn to increase flexibility in their social and private worlds, all for the purpose of leading a rich and meaningful life.
"Embrace your demons, and follow your heart."
-Russ Harris, M.D.
What is ACT?
Having been credited as an existential humanistic cognitive behavioural therapy, ACT encourages individuals to accept the givens of life, rather than applying various control strategies to avoid both internal and external experiences, while taking committed action that is guided by one values for the purpose of living a rich and meaningful life, hence, as the name of the therapy suggests: acceptance and commitment. Described as one of the new, third wave of mindfulness-based, cognitive behaviour therapies—where dialectical behaviour therapy (DBT) is also housed—ACT encourages one to be present, open up, and do what matters most. These three principles wholly encompass the ACT hexiflex that is the basis for the treatment approach. It presumes that when one is able to integrate these concepts, that person is able to achieve “psychological flexibility” (as opposed to “psychological rigidity”) to help him/her handle painful thoughts and feelings effectively in such a way that they have much less impact and influence, and to help the individual clarify what is truly important and meaningful for the purpose of taking action that enriches life.*
How can ACT help me?
ACT is an evidence-based treatment approach that is effective with a wide array of issues, including, but not limited to:
Abuse & Trauma
Behavioural Addiction (e.g. alcohol, drugs, sex, gambling, smoking, etc.)
Grief & Loss
Mood Disorders (including Bipolar Disorder)
Obsessive-compulsive Disorder (OCD)
Post-traumatic Stress Disorder (PTSD)
Suicide & Self-harming Behaviours
In ACT, the goal is to move away from:
Lack of Contact with the
This involves being in a state of auto-pilot, or just going through the motions. When we are out of contact with the present moment, we may find ourselves getting caught up in our thoughts, particularly about the past and future, which is not always useful, helpful, or effective.
Undoubtedly, we need the part of ourselves that rationalises, analyses, judges, and problem solves to help us survive our day-to-day life. Our 'thinking self' is a very valuable quality of our human existence. However, when this part of us operates in overdrive, we may find that this is not only unhelpful, but adds to our suffering.
This process refers to our relationship with our thoughts. When we are 'fused' with our thoughts, we are caught up and tangled with them. They may be all we see, blinding us to being able to see the big picture.
Control and Avoidance
When we try to control our painful emotions, we tend to fight with them, resist them, avoid them, or get overwhelmed by them. In ACT, we look at the various control and avoidance strategies you have tried, and to what extent they have been helpful or costly to your experience.
Out of Touch with Values
When we are living out of touch with our values, we tend to experience discomfort that reflects this remoteness, and can manifest in feelings of guilt, depression, anxiety, shame, regret, or anger.
Sometimes, the actions we take don't seem to bring us closer to where we want - or who we want - to be. This ineffective, 'unworkable' action can contribute to our feelings of 'stuckness.'
In ACT, the goal is to move towards:
Being in Contact with the Present Moment
Learning to be more present reduces the tendency we have to worry about the future or ruminate over the past. Mindfulness practice is a major component to the ACT framework that encourages awareness in the present moment, including your awareness of your internal and external experiences.
Also referred to as 'pure awareness.' This core process can be very helpful for those who are quite rigid in the way they view their self and their being-in-the-world, as it encourages flexibility, authenticity, and adaptability.
This process refers to our relationship to our thoughts. 'Defusing' from our thoughts reduces the struggle that arises when we are all tangled up with them by teaching us how to look at our thoughts, rather than from them, and to let thoughts come and go rather than holding on to them tightly.
Reducing the degree to which we judge our feelings as good or bad, and to make room for all feelings-both pleasant and unpleasant - without having to struggle with them. You don't have to like it or want it, but you can learn to let go and make room for the discomfort for the purpose of doing what matters most.
Values are those things that matter most to us in life. They reflect the person we want to be, the relationships we have to have, and the life we want to lead. Values exploration serves as the basis for which you choose to direct one’s life.
Committed action marks the steps one takes towards a value-driven goal. When we take effective, committed action that is guided by our values, we reduce the unnecessary suffering that we feel when we are stuck in unhelpful patterns of thinking and being.
Recommended ACT books and resources:
ACT with Love by Russ Harris, MD
The Happiness Trap by Russ Harris, MD
The Reality Slap by Russ Harris, MD
Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated From Anxiety by Kelly G. Wilson, PhD
Acceptance and Commitment Therapy for Interpersonal Problems by Matthew McKay, PhD, Avigail Lev, PsyD, and Michelle Skeen, PsyD*
ACT Made Simple: A Quick-Start Guide to ACT Basics and Beyond by Russ Harris, MD*
Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition Ed. by Steven C. Hayes, Victoria M. Follete, and Marsha M. Linehan*
Mindfulness for Two: An Acceptance and Commitment Therapy Approach to Mindfulness in Psychotherapy by Kelly G. Wilson, PhD*
A Practical Guide to Acceptance and Commitment Therapy Ed. by Steven C. Hayes and Kirk D. Strosahl*
*These are written for clinical use by professional practitioners.
The following links have useful resources that cater to experiential learning and practice of ACT. Click on the link below for more information:
Russ Harris, MD resource pages: