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  • Writer's picturedrpaulafreedman

Who is ACT the right approach for?

Hi yall and welcome back to this week’s blog!

Today I want to talk about one of my favorite types of mental health treatment, Acceptance and Commitment Therapy or ACT. Specifically, we’re going to talk about whether ACT is the right approach for YOU.

There’s a lot of conversation out there about mental health lately, and I’m so happy therapy is becoming much less stigmatized, but I think it’s important to talk about how therapy isn’t one-size-fits-all. There are TONS of different theories and approaches to therapy, and some are going to work better for some people than others.

In case you’re new here, I’m Dr. Paula Freedman, a licensed clinical psychologist and the owner of HumanKind Psychological Services. I’ve been using ACT for close to 10 years to help people from all different backgrounds deal with anxious thoughts, self-criticism, depression, addiction, and all kinds of mental health struggles.

So before you can know if ACT is right for you, we have to talk a bit about what it actually is! If you want a deeper dive into the ACT basics, be sure to head to my YouTube channel, I made a video about this a few weeks back!

What is Acceptance and Commitment Therapy (ACT)?

For today, the quick elevator pitch of ACT is that it’s a process for building what’s called psychological flexibility. This is our ability to adapt and adjust our perceptions, interpretations, and responses to events from moment to moment, based on the context and circumstances, in a way that aligns with our personal values.

Psychological flexibility is important because it’s associated with better emotion regulation, higher distress tolerance (your ability to handle stressful situations without getting intensely overwhelmed), lower levels of depression and anxiety, better quality relationships, and better quality of life.

According to ACT, there are six processes that keep us stuck in our struggles and pain, and each of these six ways we get stuck also has a process for getting UNstuck and building that psychological flexibility. These change processes are Acceptance, Cognitive De-Fusion, Being present, Self-as-Context, Defining valued directions, and Committed Action.

The model that illustrates the six processes for getting unstuck are referred to as the “Hexaflex,” because they make the shape of a hexagon and their goal is to help us develop that psychological flexibility. Even without diving into each one, just from the names alone you can probably see they involve a combination of mindfulness and acceptance processes, and committed action processes. To build psychological flexibility, you practice building tolerance and awareness of the present moment and you also identify patterns of behavior that are important to you to engage in and then act accordingly.

The big thing that sets ACT apart from other approaches to therapy is that most other approaches try to get rid of your symptoms. The goal is usually to help you become less depressed, less anxious, or more confident. While these are great goals, they’re not always realistic, and oftentimes your effort to get rid of an unwanted feeling will backfire so that the feeling becomes even MORE consuming! That’s why the goal of ACT is to change your RELATIONSHIP with your symptoms, not to get rid of them.

In ACT, we believe that sometimes, painful or uncomfortable feelings are just a natural part of being alive. All human beings experience sadness, fear, worry, and discomfort. So we can’t ever eliminate these uncomfortable experiences completely, and when we try to get rid of them, we often create more suffering for ourselves in the process.

So remember, ACT isn’t about feeling BETTER. It’s about FEELING better!

Who can benefit from ACT?

The short answer is, a lot of people will find ACT to be really helpful in their everyday life. There is evidence that ACT is effective for anxiety, depression, trauma, body image and eating disorders, substance abuse, OCD, chronic pain, and relationship difficulties, among other things.

It has been used for everything from insomnia to perfectionism to coping with a natural disaster or divorce. The biggest area where ACT has been found effective is with chronic pain – both physical pain and emotional pain. As we just discussed, ACT assumes that pain is a natural part of being alive but suffering, aka our reaction to pain, is within our control. So pain is inevitable, but suffering is optional. This is completely different from most other approaches to mental health symptoms and often, this is why ACT can be helpful for people who haven’t found success with other types of therapy.

One of the reasons I love ACT so much is that it’s the first approach that clicked for me on a personal level, as someone with lifelong anxiety struggles. A lot of other approaches to therapy try to tell you to change your thoughts, think more positively, or “talk back” to your thoughts to convince yourself that the thing you’re worrying about is irrational or unrealistic. That might work for some people, but it never worked for me. I KNOW the stuff I worry about is illogical most of the time, but it still BOTHERS me! I like that ACT doesn’t try to convince me that my worries are unreasonable or irrational. Instead, it tells me that my worries are just words in my brain. They may be true, or they may not be true, but either way, they’re just thoughts and I don’t need to try to get rid of them. Just because a worry is in my mind does not mean I have to take it seriously or treat it as worthy of my energy.

ACT is what’s called third-wave cognitive behavioral therapy. You may have heard of cognitive behavioral therapy, or CBT, which became super popular around the 1960s and to this day is still one of the most popular therapy approaches. CBT is focused on changing your belief system by challenging the automatic thoughts that pop into your head throughout the day. CBT focuses on the relationships between your thoughts, feelings, and behaviors.

ACT is similar to CBT because it’s also focused on your thoughts, feelings, and behaviors, but it focuses on them in a bit of a different way. Instead of trying to challenge or change the thoughts that bother us, ACT teaches us how to ACCEPT those thoughts.

The more you try to avoid or get rid of a thought or an emotion, the more power that emotion has over you. So if you’re feeling sad, instead of getting rid of the sadness, you might learn how to focus on accepting it while it’s there, noticing it as it comes and goes and changes, and not letting it dictate your behaviors.

Just because you feel sad or frustrated or angry doesn’t mean those feelings have to dictate your behaviors. You have control over your behavior, regardless of how you feel inside. That’s where values clarification comes in handy. By identifying what type of person you want to be (for example, kind, respectful, honest) you can also get clear on how you want to behave in a given situation. Instead of lashing out at your partner when you’re angry, you can breathe through the anger and speak to your partner in a way that you’ll feel proud of looking back on the interaction.

How does ACT work?

As we talked about before, ACT uses six core processes to help you build flexibility in the face of life’s stressors and struggles. One of the processes is about being present, aka mindfulness. By practicing mindfulness, you stop labeling your experiences as good or bad, right or wrong and start treating them with curious and nonjudgmental observation. You learn how to notice them without attaching too much meaning to them.

You do the same thing with thoughts, through a process called cognitive defusion. This is a process where you notice your thoughts as just random words in your brain, and even the words are just random combinations of letters and sounds. Not all thoughts are important or accurate, so not all thoughts are really that deserving of your attention.

Another significant process in ACT is values clarification. This is where you figure out what really matters to you in life. What type of person do I want to be? What characteristics and qualities do I want to embody?

Once you have those answers, you use those values to guide your everyday life actions and decisions through a process called committed action. So, if kindness is a value of mine, then I’m going to commit to it by noticing when I have the urge to yell at someone I love for making a mistake, take a breath, and instead treat them with the kindness that I know will make me proud of myself later.

Limitations and considerations

Even though I’m a huge fan of ACT, I also know it’s not the right approach for everyone. Some people want to dig deeper into their childhoods and focus on analyzing the deeper meaning of their desires and behaviors. ACT is more focused on the present. It’s not that ACT doesn’t consider the past at all, it’s just not the biggest area of focus.

ACT is also kind of abstract, which can be tricky for people who like to think more concretely or who tend to have a more practical way of processing information. There are lots of metaphors and storytelling in ACT to help us communicate some of those more abstract ideas and concepts and make them more relatable, but not everyone is into that style and that is totally okay!

Lastly, some people just want a quick fix or want to solve problems in the short-term, which might make them a better fit for something like brief or solution-focused therapy.

All of this is to say, Acceptance and Commitment Therapy is not the right approach for everyone. That’s why we have different options and approaches to therapy, so you can get the approach that best suits YOU. Plus, most therapists (myself included) use what’s called an integrative style, meaning we weave together approaches from multiple different theories, so very rarely will you get a therapist who ONLY uses a single theory to guide their work.

I know I’ve said this before, but I’ll say it again, ACT can be absolutely life-changing. If you like the sound of it, I would encourage you to ask your therapist if they’re familiar with ACT, and if you don’t have a therapist, but you’re considering going, maybe you want to look for a therapist who is trained in ACT!

If you’re on the search for a therapist who specializes in Acceptance and Commitment Therapy, a great place to start would be the Association for Contextual Behavioral Science, which is the overseeing body that regulates ACT-related research and practice. On their website, you can find a directory of ACT providers, and you can also learn more about the theory and the research that’s been done on it with different populations.

Also remember you can always contact us at HumanKind Psych! All of our therapists are trained in ACT and happy to bring this approach into your work together.

Feel free to check out my YouTube channel for insightful and informative videos on various topics related to mental health and personal growth (Like and subscribe if you’d like to also check out my future videos), sign up for my newsletter, and also follow me on Instagram (@mindfuldrpaula) for updates on the launching of my new Instagram paid subscription service and how to sign up.

Everyone deserves to live a meaningful, purposeful and fulfilling life. That is why I am so dedicated to teaching people about the power of Acceptance and Commitment Therapy. If you learned something today or there’s something you want to know more about, don’t forget to drop a comment.

My goal is to make mental health content that is accessible to everyone and helpful for your everyday life! ❤️


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