In the ever-evolving field of mental health, therapists continually explore and integrate new modalities to better support their clients. One of the approaches that has gained considerable traction and demonstrates profound efficacy is Acceptance and Commitment Therapy (ACT). During a recent episode of the Therapist Thrival Guide podcast, therapists Miranda Barker, Michael Atkinson, and Allison Affolter delved into the intricacies of ACT. This blog post will unpack their enlightening discussion, providing an introduction to ACT, its principles, and practical applications.
ACT, pronounced as a single word, rather than an acronym, offers a unique blend of behavioral and mindfulness-based techniques. The core objective of ACT is to help individuals lead richer, more meaningful lives by aligning their actions with their values, while also accepting the challenges and difficulties that are an inherent part of the human experience. This acceptance fosters psychological flexibility, a critical factor in maintaining mental well-being.
Whether you’re a seasoned clinician seeking to expand your therapeutic arsenal or someone curious about contemporary mental health treatments, understanding ACT can provide valuable insights. Let’s dive into what makes ACT a compelling choice for both therapists and clients alike.
What is ACT?
Acceptance and Commitment Therapy, or ACT, is a form of psychotherapy that emerged from the third wave of cognitive behavioral therapy (CBT). According to Michael, ACT is “about helping people to live a richer, more meaningful life based on what they value while also navigating and accepting all the difficult situations that we inevitably go through as human beings.”
ACT doesn’t just aim to reduce symptoms like anxiety or depression. Instead, it focuses on helping clients engage in value-based behaviors, even when they’re experiencing difficult emotions.
Six Core Processes of ACT
ACT operates on six core principles, which together help to develop something called psychological flexibility. Here’s a look at these principles and how you can integrate them into your practice:
1. Acceptance
ACT encourages clients to accept their internal and external realities. As Michael explains, “Acceptance is about acknowledging… not necessarily liking or wanting, but acknowledging reality as it is.”
2. Cognitive Defusion
This process helps clients detach from harmful or unhelpful thoughts. As Allison highlights, it’s about recognizing, “I notice I’m having the thought that I’m worthless,” rather than believing and identifying with that thought.
3. Being Present
Mindfulness is key in ACT. According to Michael, the goal is to be aware of the present moment, including one’s own thoughts and feelings, rather than losing oneself in the past or future.
4. Self as Context
This principle helps clients see themselves as more than their thoughts or feelings. Michael refers to this as fostering an “observational self,” allowing a person to step back and view their experiences without over-identifying with them.
5. Values
Identifying values is central to ACT. The idea is to find out what truly matters to the client. As Allison puts it, “If I really value honesty, how can I live that out through my behaviors every single day?”
6. Committed Action
Finally, ACT focuses on helping clients take actionable steps towards their values, even when it’s uncomfortable. Michael suggests encouraging clients to ask themselves, “How do you want to show up in your situations?” and take small, committed actions towards that.
Keep in mind that each of these processes do not act as steps—they are not something you do in chronological order. Instead, you are learning and integrating it together.
Practical Tips for Therapists
If you’re considering incorporating ACT into your practice, here are some practical tips based on Michael and Allison’s insights:
Start with Values
Begin sessions by exploring what matters most to your clients. Michael says he often uses values work as an entry point because it’s accessible and immediately relevant.
Incorporate Mindfulness
Both Michael and Allison utilize mindfulness exercises in their sessions. Allison recommends the “dropping anchor” exercise, which helps clients ground themselves during emotional storms. You can also use simple breathing techniques such as 4-7-8 breathing or square breathing.
Use Experiential Exercises
ACT is very hands-on. Include exercises that require clients to engage with their thoughts and emotions directly. The Happiness Trap by Russ Harris is filled with practical exercises you can incorporate into your sessions.
Teach Cognitive Defusion
Help clients detach from unhelpful thoughts by using defusion techniques. Encourage them to phrase their thoughts differently—”I’m having the thought that…” instead of accepting negative thoughts as truths.
Model ACT Principles
Model the principles of ACT during your sessions. Allison mentions using language that normalizes clients’ experiences: “Hey, I’m noticing this. What are you noticing in your body?”
Encourage Committed Action
Help clients take small steps towards their values. As Michael points out, committed action might be as simple as deciding to read a chapter from a helpful book you’ve recommended.
Utilize Metaphors
Michael believes in the power of metaphors to convey complex ideas simply. Whether you compare the mind to the sky with emotions as passing weather or use the Hexaflex model’s interconnected processes, metaphors can make ACT concepts more relatable.
Applying ACT in Your Practice
Getting started with ACT doesn’t require an expensive certification. Here’s some advice from Allison and Michael on how you can begin to integrate ACT into your therapy practice:
Self-Education
“Just start doing your research. Listen to podcasts about it. Pick up some of the books,” suggests Allison. She encourages therapists to start implementing what they learn in their own lives first, to see what resonates with them.
Practice Regularly
ACT is about doing rather than just talking. Michael emphasizes, “It’s really more of an experiential kind of therapy. It’s a lot more active.” Regularly practicing ACT principles, both personally and professionally, can help you become more comfortable and skilled in this modality.
Leverage Flexibility
One of the key strengths of ACT is its flexibility. “ACT literally meets clients where they’re at,” Allison explains. This allows you to tailor your approach to each client’s unique needs, whether they’re dealing with anxiety or navigating the complexities of a life transition.
Integrate with Other Modalities
ACT is versatile and can be blended with other therapeutic approaches. “I find myself using ACT a lot, but in conjunction with humanistic principles as well as compassion-focused therapy,” says Allison. This integrative approach allows for a richer, more nuanced therapeutic process. Allison also adds that she uses it with Accelerated Resolution Therapy and other modalities she’s trained in—even with couples’ work.
Use Tools and Worksheets
For those who are new to ACT, having concrete tools can be incredibly helpful. Allison recalls, “When I was first starting out as a therapist, I got the book “Act Made Simple” [by Russ Harris]. There are so many worksheets and different tools that go along with the various topics.” These can provide structure and guidance, especially useful for therapists in the early stages of incorporating ACT into their practice.
Encourage Client Engagement
Actively involving clients in their treatment can significantly enhance the therapy process. Michael advises, “Help clients design and find pockets for practicing mindfulness and self-talk.” Whether it’s suggesting mindfulness exercises to do in the car or recommending books for further reading, giving clients actionable steps can deepen their engagement.
Recommended Resources
Allison and Michael recommend several resources for getting started with ACT:
– Books: “ACT Made Simple” by Russ Harris is a comprehensive guide that therapists can use as a therapist’s manual. “The Happiness Trap,” also by Russ Harris, is designed for both therapists and the general public, providing exercises and insights that can be applied in therapeutic settings and in everyday life.
– Online Courses and Trainings: There are many courses available online that can deepen your understanding of ACT. Michael mentioned a course by Russ Harris that he found particularly beneficial.
– Podcasts and Webinars: Listening to podcasts or attending webinars can provide ongoing education and insights into how other therapists are applying ACT principles.
Final Thoughts
ACT offers a unique and effective way to help clients navigate their mental health challenges by focusing on values and committed action. By leveraging acceptance and mindfulness, therapists can guide clients to become more psychologically flexible and live more meaningful lives.
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