Acceptance And Commitment Therapy ( Act )

What is acceptance and commitment therapy ( ACT )?

Acceptance and commitment therapy (ACT) is a relatively new form of behavior that at the end of the 20th century has been developed by the American psychologist Steven C. Hayes. ACT clients are taught to focus on things that can influence them directly, such as their own behavior, rather than try to gain control over experiences that can not be influenced directly, such as emotions and thoughts (this is called experiential avoidance) . This implies an acceptance-oriented attitude to these emotions and thoughts. Core of ACT is the philosophy that the fight against inevitable issues ultimately at the expense of a valuable life. Since March 2011, ACT in the United States officially recognized as evidence based.

Core Processes

The treatment takes place on the basis of six core processes:

-Cognitive defusion: learning separating cognitions (knowledge, ideas or beliefs) and behavior. You can do anything but your mind can enter, so what you give the choice to the "advice" that your brain you to follow or not.
-Mindfulness: the ability to freely judgment in the here-and-now to observe your experiences and undergo without taking action to avoid experiences, check or hold
-Acceptance: learn to stop fighting against the inevitable things in life, including human suffering
-Self-as-context: learning to see yourself in context (coherence) with your surroundings, your problems are not who you are
-Clarifying values: determine what is truly valuable in life, such as health, relationships, friendship, development, spirituality, creativity, etc.
-Dedicated action or commitment: the willingness to change your behavior step by step in the direction of the values to which you have attached yourself

The model assumes that all core processes are interrelated and can not be seen in isolation. In combination, the application of these processes lead to the ultimate goal of ACT: psychological flexibility, also called mental flexibility. The core processes are displayed in the so-called hexaflex, a hexagon of which the points represent the various processes which are aimed at the central target.

Theoretical background

ACT stems from the behavioral analysis, and is founded on the so-called Relational Frame Theory (RFT). Conceptual (with the same theoretical and philosophical basis)) ACT is closely related to other forms of so-called third generation behavioral therapy, such as dialectical behavior therapy (Linehan), attention focused cognitive behavioral therapy (mindfulness), behavioral activation and functional analytic therapy (FAP). The main distinction with cognitive-behavioral therapy (CBT) is that CGT focuses on symptom relief, by changing the content of thought, while ACT focuses on changing the relationship that a customer with his thoughts, thus changing the function of these thoughts.

ACT has been influenced by Buddhist insights in the inevitability of human suffering, but religion is not part of the treatment. However, it is a lot of work with mindfulness exercises (mindfulness). In addition, much use of metaphors, the therapeutic relationship, experiential exercises and humor.


In recent years, empirical research has shown that ACT is an effective treatment for various psychological and physical problems. According to research by means of so randomized trials, and clinical case reports that ACT is effective to include Chronic Pain, anxiety, phobias, depression, psychotic disorders, obsessive-compulsive disorders, eating, work-related problems, life problems / elderly, epilepsy, and diabetes. ACT-interventions have also been shown to be effective in improving athletic performance in healthy people.

Manuals and self-help books

Besides empirical articles are general practical manuals for therapists and manuals available for specific sasaran areas such as depression, psychological trauma, anxiety disorders, and chronic pain. In addition, a number of self-help books on the market for people who suffer from depression, anxiety, trauma, worry, diabetes, chronic pain, anger, dealing with dementia in the family and anorexia nervosa.


Over time, a number of criticisms formulated about ACT and RFT, particularly cognitive-behavioral psychologists:

-Though ACT does not say to focus on changing the content of thinking, acceptance of complaints can be formulated as a change in the "thinking about having symptoms.
-ACT is nothing new: the insights of ACT have been known in other psychotherapeutic currents, such as client-centered approach or psychoanalysis.
-ACT researchers are overly enthusiastic: they walk on the empirical facts ahead
-RFT is an overly complex model of human thought, the active element may be explained by existing cognitive-behavioral models.

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