ACT – The Absolute Basics; Acceptance & Commitment Therapy
In this post I begin a series of writing dealing with ACT, Acceptance and Commitment Therapy. The details below are basic, but perhaps just enough to develop more interest in learning about ACT. Here we go!
1) Act, developed mainly by Steven Hayes Ph.D.and based on a foundation of Relational Frame Theory, uses both language and cognition as key components of therapy. However, ACT goes much further than RFT.
2) Act utilizes the Hexaflex Model to ground the therapy process. Within this model ACT focuses on flexible contact with the present moment, no matter what that contact is. It suggests that acceptance of difficulties works better than avoidance of them, in fact showing how avoidance of personal problems often makes condition worse emotionally. Self-as-context is emphasized. The focus is on cognition, emotion, and behavior of the person seeking help. Values are used in congruence with motivation, and cognitive diffusion is taught to free the person from deep “stuckness” in unhelpful thoughts. Finally, once a behavioral action plan is agreed upon, ACT works to obtain clear commitment to action by the person who is suffering. In summary, ACT does its best to reduce/eliminate cognitive and behavioral inflexibility. Ultimately, ACT strives to enhance and expand psychological flexibility on the part of the person seeking help.
3) ACT emphasizes the utter importance of a strong clinical relationship, alliance and trust in therapy. Without such a therapeutic relationship, it is unlikely there will be constructive, positive change.
4) Act utilizes helpful metaphors and reinforcing clinical interventions to support positive change. Act intends to reduce the power on unhelpful verbal rules used by the person hoping to change. For example, ACT notes the hopeless futility of avoiding personal problems and works to get the person unstuck from unhelpful thoughts, emotions, and behaviors. With both personal acceptance of your own cognition, emotion, and behavior (they are important but they are NOT you) – and commitment to valued actions – ACT hopes to improve what needs to be changed in a collaborative relationship.
5) ACT skill building occurs in interactive experiential actions and experiments; ACT pays close attention to positive changes that may occur. In the process ACT is both interpersonal and intrapersonal in nature. With costs-benefits analysis and various forms of behavioral functional analysis, ACT supports personal goals and improved stimulus control via contingencies of reinforcement (very behavioral here).
6) ACT has shown effectiveness in dealing with depression, anxiety, and addictions. More recently, ACT has modified its approach to improve outcomes in trauma treatment. In this process ACT recognizes self-medication contingencies, the role of avoidance in making things worse, as well as intrusive cognitions, emotions, and behaviors. Act hopes to use skillful means (mindfulness in acceptance and defusion) to reduce rigid reactions and fears. Act is flexible enough to complement other forms of evidence-based therapies.
For more information refer to Harris, R. (2019). ACT Made Simple. Oakland, CA: New Harbinger Publications or the various articles and book written by Steven Hayes on this topic.
Anthony R. Quintiliani, PhD., LADC
From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton Sangha
Author of Mindful Happiness