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What Is Acceptance and Commitment Therapy (ACT)?

Acceptance and commitment therapy, or ACT, was founded as a model to help patients participating in behavior therapy. According to Brandon A. Gaudiano, Ph.D., ACT was derived from a specific model called Relational Frame Theory and expands on the idea that a combination of mindfulness, acceptance strategies, and changes in behavior will result in what is called “psychological flexibility.” 

Psychological flexibility means that a traumatized brain can learn to utilize these strategies in order to stay in the present moment and consciously make changes and choices that benefit the patient. The alternative is an avoidance technique called “cognitive fusion” or “experiential avoidance,” where the patient struggles to break free of rigid rules or think beyond the literal meaning of words or phrases. The main goal of obtaining psychological flexibility through ACT is for patients who struggle with mental health concerns, trauma, triggers, or impulsive choices to stay in the present moment and actively make choices that are healthier for the mind, body, and soul. 

How ACT Works

ACT works in six stages, according to a study published in the Behavior Analyst. Each stage of ACT is a stepping stone for the other in order for the patient to grow and expand their knowledge on staying “in the moment” and responding to their thoughts in a healthy way. 

The six stages of ACT are:

  • Acceptance

Acceptance of distressing external experiences is the opposite of experiential avoidance. For a patient, accepting the fact that bad things happen and they have to deal with them is healthy. It’s okay to acknowledge that an external event is distressing as they move forward with more beneficial thought processes to deal with distress.

  • Cognitive Diffusion 

Cognitive diffusion means consciously understanding that thoughts do not need to inspire action or dominate behavior. Cognitive diffusion can be a physical behavior change that will be present in the future, or it can be a new thought process adopted when a distressing external experience occurs. For example, a physical cognitive diffusion behavior for a patient with depression may be to say the depressive thought out loud, accepting the thought as just that — a thought that does not require action.

  • Awareness of the Present Moment

Practicing awareness of the present moment is a way for the patient to take a step back from the tornado of thoughts spiraling in their head and observe where they are physically and mentally in the “here and now.” Based on what is possible in the moment, having this awareness can help a patient pause and make a healthier behavioral decision.  

  • Sense of Self 

In this stage, establishing a sense of self means developing a broad and conscious idea of what your “self” is, detaching from the literal self, and focusing on self as a context. Focusing on the physical or mental sense of self can also be beneficial when staying in the present moment and consciously recognizing where your thoughts might be leading you.

  • Personal Values and Direction 

Here, the patient will establish a set of personal values, boundaries, and a direction or course of action they would like to take. They will identify their strengths and learn how to use ACT to develop psychological flexibility for their weaknesses. Developing personal values and direction will determine their desired behavior in reaction to internal thoughts that result from external actions.

  • Commitment to Personal Values and Direction 

Commitment to these values is a mantra for the patient to use their personalized set of values throughout their daily lives. The patient will live their life with their ACT training in mind and their values consciously present as they face distressing external conflict. As the patient commits to those values, they can continue making healthy decisions and maintaining healthy behaviors as a result. 

How ACT Compares to Cognitive Behavioral Therapy (CBT)

If you have heard of ACT, you may have also heard of cognitive behavioral therapy (CBT). ACT and CBT are very similar. The most fundamental difference in the structure of the two therapeutic modalities is in the goal. Per a study published in the Journal of Consulting and Clinical Psychology, ACT is designed for broader aims of psychological flexibility, allowing the patient to adjust to stressors and observe healthier behaviors. The main objectives of CBT are to help with symptom reduction through doctor-monitored behavior exposure, cognitive restructuring, and challenging negative beliefs. 

Both CBT and ACT work well for those suffering from addiction, anxiety, depression, PTSD, and other mental health concerns. 

If you or a loved one are struggling with your mental health or you don’t know how to control disruptive or dangerous behaviors, RECO Intensive can help. If your addictive or mental health behavior is getting out of control, we are here for you. It’s okay to feel a loss of control. Your recognition of this lack of control means you’re one step closer to getting help for yourself. Here at RECO Intensive, we offer a safe space to communicate your thoughts and assess your behaviors. RECO Intensive offers both Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) as means to reach your mental health and behavioral goals. You are not alone in this journey. At RECO Intensive, we are here to help you in a setting with no shame and no judgment. Let’s get back to a brighter future. To learn more, call RECO Intensive today at (561) 464-6533.

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