Acceptance and Commitment Therapy or ACT (pronounced ‘act’) is a modern form of Cognitive Behaviour Therapy (CBT) that is widely recognised as an effective treatment for a range of difficulties.

ACT aims to help people live rich, vital and meaningful lives. Therapy involves teaching people skills to:

  • deal more effectively with distressing and painful thoughts and emotions;
  • clarify what really matters to them and what they want their life to be about; and
  • engage in behaviours that are guided by their values.

ACT has been researched extensively and found to be effective for people with a wide range of problems including:

  • anxiety disorders;
  • depression;
  • obsessive-compulsive disorder;
  • workplace stress;
  • chronic pain;
  • diabetes management;
  • adjustment to cancer;
  • smoking cessation; and
  • borderline personality disorder.

ACT is also useful for people struggling with issues related to parenting, relationships, sleep, and performance anxiety.

Because ACT targets processes common to a range of problems of daily living, it is especially helpful for people with co-morbid conditions. Its heavy use of metaphor and “hands on” learning also make ACT ideally suited to low literacy populations.

Mindfulness is a mental state of active, open, attention to the present moment. Mindfulness skills are taught in ACT to help people deal with difficult thoughts and emotions. However, mindfulness is just one element of ACT, which also teaches ways to help people move towards living by their values.

ACT is an adaptation of traditional CBT. The table below shows the main points of differentiation between the two therapies using anxiety as an example.

   Traditional CBT ACT
Therapy goal Reduction in symptoms of anxiety. Improved quality of life. Accepting
anxious thoughts and feelings rather
than struggling with so that anxiety has less impact and influence on behaviour when it shows up.
Treatment of anxious
thoughts		 Cognitive restructuring skills are
taught to examine and change
difficult ‘threat-related’ thoughts.		 Cognitive “defusion” skills are taught used
to disentangle or distance from
‘threat-related’ thoughts.
Treatment of anxious
feelings/sensations		 Control of symptoms is emphasised;
e.g., symptom-monitoring, relaxation
training and cognitive restructuring		 Acceptance of anxious feelings,
sensations and emotions (and
control of behaviour) is emphasised;
e.g., mindfulness, values guided
action