What is Acceptance And Commitment Therapy (ACT)?

ACT is a psychotherapy approach which involves aspects of mindfulness, acceptance and behavioural change to encourage the development of psychological flexibility. It has been found that engaging in ACT enhances individuals’ quality of life and overall well-being. 

ACT has been referred to as a “third wave psychotherapy”, along with other therapies, including Dialetical Behaviour Therapy (DBT) and Mindfulness-Based Cognitive Therapy (MBCT). These types of therapeutic approaches are based on fundamental behaviour therapy principles, however they add other ingredients into the mix. 


If one were to contrast CBT and ACT, a fundamental difference is the approach that each takes to how an individual should handle uncomfortable thoughts. In traditional CBT, unhelpful thoughts are challenged and one learns to gather evidence for and against negative thoughts in order to produce an alternative or balanced thought. However, in an ACT approach, one learns that difficult thoughts cannot always be challenged. Nor is that seen as the point. Instead, we must learn to take them along with us and still engage in things that are important to us.

What Is Psychological Flexibility and Why Is It Important?

Psychological flexibility, in ACT, has been described by Twohig and Levin (2017) as “…the ability to stay in contact with inner experiences, allow them to be there when useful, see thoughts as just thoughts, have a strong sense of life direction, and pursue things that are meaningful.” (p. 754)

What this means is that individuals can learn to be mindful and accepting of difficult thoughts and feelings and still engage in meaningful activities and life goals

A measure called the Acceptance and Action Questionnaire (AAQ 2) was designed to measure features of psychological flexibility and experiential avoidance. Several studies have found that when an individual scores low on this measure they often experience:

  • Increased anxiety
  • Increased depression
  • Decreased work performance
  • Declines in overall wellness
  • Worry

What Will I Learn in ACT?

Therapists practising ACT work from what is called the Relational Frame Theory. Within this theory, there are 6 main concepts that we are thinking about and delivering to individual:

1. Present Moment Awareness: this involves focusing on becoming aware of emotions and thoughts that arise in the present moment. This allows for people to learn greater awareness of their thoughts and feelings and become more mindful of the current moment. Mindfulness allows individuals an opportunity to make different choices than they might have otherwise made.

2. Self as Context: individuals will sometimes only define themselves by their thoughts and feelings. In ACT, we want people to learn to embrace their ideal self and acknowledge what that might look like. It is important to learn that we are not simply the content of our thoughts, we are also the context in which our thoughts occur.

3. Defusion: when we defuse from difficult thoughts and feelings, we are able to unhook from them. This allows people to then be able to gain distance and perspective from their thoughts. This enables individuals to make different choices and act in ways that matter to them and are not driven by anxious thoughts or other unhelpful thinking styles.

4. Acceptance/Allowing: this involves working towards acceptance of difficult thoughts and feelings. Although we might not want to experience these, we often still do. We also want to still be able to live a fulfilling life, despite unpleasant thoughts and feelings. This can involve showing compassion towards oneself, allowing for curiosity towards different experiences and making space for challenging thoughts, feelings and body sensations.

5. Values: one can think of values as the directions of a compass. We never arrive at the destination of “west” but we can keep moving in that direction and visit goals along the way. We never stop wanting to be a “kind partner” or a “good parent”. We do meet goals that are aligned with our values (e.g., helping our child with their homework).  Values are important discussion points within ACT as we want to think about the type of person an individual wants to be and what is meaningful to them.

6. Committed Action: this can involve goal setting and ensuring that the goals we set are related to behaviour change that is measurable and observable. Problem solving can occur to ensure that goals are being met in small steps that are meaningful to the individual.

What Types of Problems will ACT Help Me With?

Therapists may take a primary ACT approach or will incorporate it into the work they are doing. At FTPS, we use ACT for a variety of issues, either as a stand alone treatment or as part of other evidence-based care:

  • Anxiety
  • Depression
  • Obsessive Compulsive Disorder
  • Body Focused Repetitive Behaviours
  • Perfectionism

How Do I Find Out More about ACT at Forward Thinking Psychological Services?

At FTPS, we offer ACT for adolescents and adults. Our services are provided by clinicians who have training and experience in this approach. Our adolescent services are delivered by our clinicians on our team who provide specialized adolescent therapy, given their training and background. 

If you are interested in learning more about our ACT services, please reach out to us at info@ftpsych.ca 

Contact us today! We would love to hear from you and help you move forward on the path to wellness.