Pain is a part of life. That is not a pessimistic statement. It is the starting point of Acceptance and Commitment Therapy. ACT does not try to eliminate difficult thoughts or feelings. It teaches you how to make room for them while still moving toward the life you want to live. The goal is not to feel better in the short term. It is to build a life that is meaningful, even when it includes discomfort.
At Artisan Counseling, our licensed counselors use ACT within individual counseling to help clients develop psychological flexibility and align their actions with their values.
ACT (pronounced as the word “act,” not as initials) was developed by psychologist Steven Hayes in the 1980s. It belongs to the “third wave” of behavioral therapies, alongside DBT and other approaches that incorporate mindfulness and acceptance into a behavioral framework.
ACT is based on the idea that much of human suffering comes not from pain itself but from the struggle to avoid it. When you try to suppress, control or escape from difficult thoughts and feelings, those efforts often make things worse. ACT calls this experiential avoidance, and research shows that it is a common factor across many mental health concerns.
Instead of fighting your internal experiences, ACT teaches you to observe them, accept their presence and choose your behavior based on what matters to you rather than on what you are trying to avoid.
ACT is organized around six processes that work together to build psychological flexibility.
Acceptance. Learning to make room for difficult thoughts, feelings and sensations rather than trying to eliminate them. Acceptance is not resignation. It is a willingness to have your experience without wasting energy fighting it.
Cognitive defusion. Creating distance between you and your thoughts. Instead of being fused with a thought like “I am a failure,” defusion helps you notice the thought without being controlled by it. Techniques may include repeating a thought in a silly voice, labeling it (“I am having the thought that…”) or simply observing it as it passes.
Present moment awareness. Practicing mindfulness to stay in contact with the here and now rather than being pulled into rumination about the past or worry about the future.
Self-as-context. Developing the perspective that you are not your thoughts, emotions or experiences. You are the awareness that observes them. This distinction creates space between who you are and what you are going through.
Values. Identifying what matters most to you, not what other people expect or what you think you should care about, but what genuinely gives your life meaning and direction.
Committed action. Taking concrete steps that are aligned with your values, even when doing so is uncomfortable. This is where the “commitment” in ACT comes from.
ACT has been studied across a wide range of mental health and behavioral concerns. It may be helpful if you are dealing with:
A meta-analysis published in Behaviour Research and Therapy found that ACT produces outcomes comparable to CBT across multiple conditions, with particular strength in areas involving experiential avoidance and chronic conditions.
ACT sessions are active and experiential. Your counselor will use a mix of conversation, metaphor, mindfulness exercises and behavioral experiments.
Metaphors. ACT uses metaphors extensively to illustrate concepts. For example, the “passengers on the bus” metaphor helps you see how difficult thoughts and feelings can be present without being in charge of where you are going.
Mindfulness exercises. You may practice brief mindfulness or defusion exercises during session to build the skills in real time.
Values work. Your counselor will help you clarify your values and identify where your behavior is and is not aligned with them.
Behavioral commitments. Each session may include a discussion of specific actions you can take during the week that move you toward your values, even when your mind tells you it is too hard or pointless.
ACT is typically delivered in 8 to 16 sessions, though it can be integrated into longer-term treatment depending on your needs.
Mindfulness is one of six processes in ACT, but ACT also includes values clarification, behavioral change and cognitive defusion. It is a broader approach than mindfulness alone.
CBT aims to change the content of your thoughts. ACT aims to change your relationship with your thoughts. Both are effective, and some counselors use elements of both.
ACT includes brief mindfulness exercises, but it does not require formal meditation practice. The goal is awareness, not a specific meditation routine.
Yes. ACT has a strong and growing evidence base across anxiety, depression, chronic pain, substance use and other conditions.
ACT is delivered within the context of licensed counseling and billed as a standard therapy session. Most insurance plans cover it. Contact 757.503.2819 to verify.