What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT) is a type of psychotherapy developed in 1982 by psychologist and researcher Steven C. Hayes. Over the past 25 years, ACT has become a widely used evidence-based behavioral therapy and recognized as an effective technique for the treatment of a variety of physical and psychiatric disorders.

This technique is action-oriented and focuses on mindfulness, status quo, and behavior change without first changing or eliminating uncomfortable thoughts and feelings.

This article will discuss how ACT works, what it can help with, benefits, risks, costs, and more.

What is ACT?

Acceptance and Commitment Therapy (ACT) is a counseling and psychological intervention that combines strategies of mindfulness, acceptance, and behavior change. ACT shows that a person is able to change their behavior without first changing or eliminating their thoughts and feelings. It can be applied to a variety of conditions and is process-centric and flexible to meet human needs.

ACT operates on the idea that a change in action can happen before a change in mindset. Rather than working to control or eliminate unwanted, uncomfortable, or distorted thoughts and feelings, people can simply observe thoughts or feelings, accept what they cannot change, and commit to actions that make their lives better.

Essentially, ACT helps people accept that painful thoughts and feelings can coexist with healthy behavioral changes and improved quality of life.

how does this work

ACT provides a way of life that reduces pain and suffering by consciously accepting all that life has to offer, including discomfort, and choosing to live according to your goals and values. ACT involves six core processes or skills. During the ACT, the therapist works with the client to use guided exercises and activities based on these principles to help the client develop mental flexibility.

What is mental flexibility?

Mental flexibility is the ability to be present in the moment, to be aware of thoughts and emotions without being controlled by them, and to react to situations in a way that still aligns with one’s values ​​and goals.

The six core processes are:

  1. Cognitive dissociation: The person realizes that their thoughts are just an idea and not necessarily a fact. They don’t allow their thoughts to control them, and they examine their thoughts from curiosity rather than judgment.
  2. Acceptance: The person is willing to experience difficult feelings and emotions, such as anxiety or pain, rather than fight them. They don’t shy away from these unwanted emotions, feelings, and sensations.
  3. Flexible focus on the present: The person is able to focus on what is happening inside and outside the present moment and adjust their behavior accordingly, rather than meditating (contemplating; worrying) about the past or future.
  4. Self-context: Instead of insisting that a person assigns an absolute identity or label to themselves (e.g., lazy, useless, stupid, productive), the person is able to shift their perspective to observe current awareness of how they feel and think about themselves They are always changing.
  5. Values: This person identifies and articulates what is most important to them, such as basic hopes, values, goals (eg, being there for family, doing meaningful work). These values ​​help provide direction in the face of changing and challenging situations.
  6. Commitment to Action: This person develops a commitment to doing things in accordance with the values ​​they have identified. They may constantly revisit their goals and change them, but they will always align with their values.

How the ACT can help

Research shows that ACT can help treat a variety of mental conditions, including:

  • frustrated
  • anxiety
  • Psychopathy (loss of touch with reality)
  • substance use disorder
  • chronic pain
  • Post Traumatic Stress Disorder (PTSD)
  • Obsessive Compulsive Disorder (OCD)
  • Affective (mood) disorders (mental disorders that primarily affect a person’s emotional state)
  • pressure

ACT is good for anyone

While the ACT has been shown to be effective in addressing certain psychological conditions, it was developed to strengthen the six core skills listed above. These skills can help anyone facing difficulties in life.

By increasing mental flexibility and continuing to work toward worthy goals, a person may experience greater satisfaction with life despite any mental, physical, or situational challenges.


There is no specific set of techniques used in ACT. Instead, therapists use the ACT method to flexibly apply general strategies. Through the ACT method, a variety of cognitive and behavioral exercises are used to guide people in strengthening the six core skills associated with mental flexibility. These can be tailored to the psychological condition the individual wishes to address, or to the environment.

For example, the ACT protocol can range from short interventions completed in minutes or hours to interventions requiring many sessions. ACT can also be applied to groups, individual lessons, classroom settings, couples therapy, reading therapy, workplace training, and more.

ACT uses smart, creative and often fun exercises to help people increase their awareness of their beliefs, thoughts and actions. It also helps them determine whether their actions are helping to effectively solve problems and move toward their values ​​and goals. Typically, metaphors, paradoxes, and empirical exercises are used to apply these six concepts/skills.

Examples of Mindfulness Practices

Here are some examples of mindfulness exercises that can be used to strengthen core skills and cognitive distraction:

  • thanks for an idea
  • Watching the thoughts go by as if they were written on the leaves flowing down the river
  • repeat words out loud until only sounds remain
  • give shape, size, or texture to thoughts
  • Practice marking the process of thinking (eg, I don’t think I’ll ever make it)
  • Practice taking action on thoughts that directly contradict thoughts (eg, saying “I can’t walk” when a person walks across a room)

More ACT techniques can be found at the Society for Contextual Behavioral Sciences.


The goal of ACT is to move from rigid and rigid thinking to developing mental flexibility, which is often considered the pinnacle of health and well-being. Research has also shown that developing mental flexibility leads to many other mental health benefits, changes in healthy behaviors, and enhanced adaptation.

The benefits of mental flexibility include:

  • The ability to remain present and aware of the present moment and its emotions, feelings and thoughts
  • Be more open and receptive to emotional experiences
  • Identify and adapt to situational needs by changing their mindset and choosing behavior accordingly
  • Use their spiritual resources effectively
  • better regulate your emotions
  • Balancing competing desires, needs, and areas of life
  • Recover from stressful events and difficulties, plan and work towards life goals
  • higher quality of life

What is stress and how do I recognize it?


To date, 260 meta-analyses, systematic and narrative reviews, and 860 randomized controlled trials have supported the efficacy of ACT in the treatment of mental and physical disorders. Numerous national and international organizations indicate that ACT is supported by research including, but not limited to:

  • American Psychological Association
  • Society for Clinical Psychology
  • U.S. Department of Veterans Affairs
  • U.S. Department of Health and Human Services
  • WHO
  • UK National Institute for Health and Care Excellence


Unfortunately, psychotherapy like ACT is often expensive, especially if you don’t have insurance. Depending on your state and the qualifications of the practitioner, a single session can range from $65 to over $200. You can also seek low-cost services through federally funded health centers, college and university health centers, or ask your therapist if they offer variable payment options.

6 Free or Low-Cost Health Insurance Options

When to talk to your doctor

If you’re currently facing difficult life changes, battling a mental health or psychological disorder, or just looking for ways to improve your quality of life, talk to your trusted healthcare professional to find out if you could benefit from ACT.


Acceptance and Commitment Therapy (ACT) is an action-oriented psychotherapy. ACT focuses on implementing mindfulness and behavior change before changing or eliminating uncomfortable thoughts and feelings. It operates through six core processes: cognitive dissociation, acceptance, flexible attention to the present, self-as-context, values, and commitment to action.

You don’t have to be diagnosed with a mental disorder to benefit from the ACT. ACT techniques can be applied to any life problem such as anxiety, depression, PTSD, substance use disorder, chronic pain, psychosis, eating problems or stress.

ACT can improve your quality of life by teaching you to live more in the moment and provide strategies for coping with difficult situations, feelings, and emotions that may arise. ACT can help you fully embrace life while continuing to work toward your goals and live by your values.

VigorTip words

Starting therapy can feel like a daunting task, especially if you’re battling an illness, mental health issue, or stressful life event. Acceptance and commitment therapy may be a more approachable therapy because it is flexible and has been shown to be effective for people going through a variety of experiences.

If you are interested in starting the ACT, please contact your healthcare provider and/or your insurance company. They can help you find qualified mental health professionals who can help you through your journey.

Frequently Asked Questions

  • How long does the ACT take?

    Depending on the protocol used, the type of setting, and the client’s goals, the duration of ACT can vary, from short-term interventions completed in minutes or hours to interventions that require multiple treatments.

  • How many treatments are there?

    There are five main types of treatment: psychoanalysis, behavioral therapy, cognitive therapy, humanistic therapy, and integrative therapy. Each main method has subcategories.

    understand more:

    Types of mental health treatment

  • How much does the treatment generally cost?

    Unfortunately, treatment costs are not standardized. Prices may depend on a range of factors, including whether you have health insurance, what your coverage is, geographic location, and the therapist’s years of experience, specialty, certification, and training.

    understand more:

    How to get help paying for health insurance