Acceptance & Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a modern, evidence-based psychological intervention that combines mindfulness strategies with behaviour change techniques. Its core aim is to help people live a meaningful life while accepting the pain that inevitably comes with it.

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Core Principles of ACT (The “Hexaflex” Model)

1. Acceptance – Opening up to unpleasant thoughts and feelings without trying to control or avoid them.

2. Cognitive Defusion – Learning to observe thoughts without being dominated by them.

3. Present Moment Awareness – Being fully aware of the "here and now" with openness and curiosity.

4. Self-as-Context – Developing a sense of self that is constant, even as thoughts and feelings change.

5. Values – Identifying what truly matters to the individual.

6. Committed Action – Taking steps aligned with personal values, even in the presence of difficult emotions.

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Who ACT is suitable for

ACT has been successfully applied to a wide range of mental health and life challenges, including:

• Depression and anxiety

• Chronic pain

• Substance use disorders

• Post-traumatic stress disorder (PTSD)

• Obsessive-compulsive disorder (OCD)

• Eating disorders

• Workplace stress and burnout

• Autism and ADHD (as part of a broader treatment approach)

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ACT is especially suitable for individuals who:

• Struggle with avoidance of painful thoughts or feelings

• Want to build psychological flexibility

• Are looking for values-based, action-oriented therapy

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Who ACT may not be suitable for (or requires adaptation)

ACT may be less appropriate or require modification for:

• Individuals with severe cognitive impairments who cannot engage in reflective exercises

• Those experiencing acute psychosis (unless therapy is modified by experienced clinicians)

• Clients who strongly prefer problem-solving or symptom-elimination approaches, as ACT focuses more on acceptance and values-driven action

In such cases, ACT may still be helpful when combined with other therapies (e.g. CBT, medication, DBT).

 

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References

• Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.

• Harris, R. (2019). ACT made simple: An easy-to-read primer on acceptance and commitment therapy (2nd ed.). New Harbinger Publications.

• Twohig, M. P., & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: A review. Psychiatric Clinics of North America, 40(4), 751–770. https://doi.org/10.1016/j.psc.2017.08.009

• Association for Contextual Behavioral Science. (n.d.). What is ACT? Retrieved from https://contextualscience.org/act