Acceptance and commitment therapy

I’d like to talk to you about one of the third-wave CBT therapies, which is proving to be very effective alongside the more traditional CBT methods.

A 2015 review found that ACT was better than placebo and typical treatment for depression, addiction and anxiety disorders. Its effectiveness was similar to traditional treatments like CBT.

ACT, unlike CBT which teaches more control or reversal of thoughts and feelings, suggests that just observing, noticing and accepting these events will lead to embracing them instead of avoiding them at all costs.

The core conception of ACT is that psychological suffering is usually caused because we have a natural inclination to avoid the physical sensations, thoughts and feelings, as well as other internal cues (e.g., memories) that we perceive as unpleasant (the term for this is experiential avoidance), because we get entangled in our thoughts, and resulting growing psychological rigidity leads to increased estrangement with what is essential for us (our core values).

ACT views the core of many problems to be due to FEAR:

• Fusion (taking our thoughts to be a true reflection of reality and self: “I think therefore I am”)

• Evaluating experience (typically on a good – bad continuum)

• Avoiding experiences (especially feared ones, which in turn does not allow one to experience the fact that the event is governable)

• Reason-giving for behaviour (focusing on excuses for not doing such and such thing)

The healthy alternative is, of course, to ACT:

• Accept your reactions and be present

• Choose a valued direction

• Take action

Kelly Wilson, Steven Hayes and Russ Harris seem to be three of the major proponents of this form of therapy. All of their books are well worth reading. Some are general in nature, geared towards training therapists and others are more of a set-help nature.

Russ Harris:

• (with Steven Hayes) The happiness trap: How to stop struggling and start living: A guide to ACT (also available as an illustrated version and pocket book)

• (with Steven Hayes) ACT made simple (a good introduction to the concepts)

• Confidence gap

• Reality slap

Steven Hayes:

• (With Spencer Smith) Get out of your mind and into your life

• Acceptance and commitment therapy

• Mindfulness and acceptance

Kelly Wilson:

• Several training manuals in conjunction with other authors

• (with Troy DuFrene) Things might go terribly, horribly wrong: A guide to life liberated from anxiety

• One title specific to overcoming substance abuse with ACT

ACT uses six main techniques to help clients develop psychological flexibility (the opposite of the rigidity explained above):

1. Cognitive defusion: techniques to reduce the tendency to reify (i.e., to take for object) thoughts, emotions, memories and images.

2. Acceptance: Allowing thoughts to come and go without struggling with them.

3. Contact with the present moment: Awareness of the here and now, experienced with openness, interest, and receptiveness.

4. Observing the self: Accessing a sense of self.

5. Values: Discovering what is most important to one’s true self.

6. Committed action: Setting goals according to values and carrying them out responsibly.

https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy

A-Tjak, JG; Davis, ML; Morina, N; Powers, MB; Smits, JA; Emmelkamp, PM (2015). “A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems.”. Psychotherapy and psychosomatics. 84 (1): 30–6.