Master Your Thoughts — and Your Life — with Acceptance Commitment Therapy (ACT), Skylark Counselling Clinic Website, April 2025
This article was written by Lise Boullard and originally published on the Skylark Counselling Clinic Website.
Originating in the ‘80s and used to treat depression, substance abuse and phobias, the behavioural therapy is making a resurgence.
What is Acceptance Commitment Therapy (ACT)?
Mindfulness is a buzzword these days with everyone from Fortune 500 CEOs to stay-at-home moms touting its benefits. But techniques that promote mind-body awareness have been the cornerstone of behavioural therapies for decades.
One such modality is Acceptance and Commitment Therapy (ACT). Considered a Third Wave behavioural therapy following Cognitive Behavioural Therapy (CBT) in the 60s, it’s based on the idea that we are not our thoughts. Through ACT, we can learn to observe our thoughts and emotions, accept them, then create distance to gain sovereignty over them. This frees up the energy we once used to resist our suffering, allowing us to channel it toward our most important values and goals.
This idea that our thoughts and feelings are separate from us, and malleable, was significantly developed by University of Nevada professor Steven C. Hayes in the mid 80s. Hayes’ own experiences with debilitating panic attacks, which he discusses in honest detail in this Ted Talk, greatly informed his work.
The professor’s research initially focused on how language — both our internal and external dialogue — impacts our internal experiences, an idea he dubbed Psychological Flexibility. This eventually led to the creation of Acceptance Commitment Therapy in 1986.
How ACT Differs from Other Therapies
ACT takes a unique approach to managing our internal dialogue as compared to other behavioural therapies including CBT:
Approach to Thoughts and Emotions
While CBT focuses on identifying, reducing or eliminating our self-defeating internal dialogue to change feelings and behaviours, ACT takes a more flexible and curious perspective. Through mindfulness techniques, clients can begin to recognize their suffering and compassionately view it as a natural part of the human experience. ACT suggests that painful thoughts and healing can peacefully coexist — we don’t need to wait until we are “fixed” to live a meaningful life.
Therapy Techniques
ACT uses strategies like defusion, mindfulness and acceptance, while CBT relies on exposure therapy, role playing and cognitive restructuring.
Counsellor/client Dynamic
CBT follows a top-down approach, with therapists directing treatment, but ACT is more collaborative. Here, clients and counsellors work through a series of mindfulness exercises and techniques, then craft a plan to support clients in living a more values-aligned life.
Timeframe
CBT is generally more goal-oriented and used to address a specific problem in the short term, but ACT techniques are designed to be integrated into a client’s life for either the short or the long-term.
Values
ACT therapists dedicate a significant portion of treatment to exploring client values and goals, but these don’t play as prominently in CBT.
What Happens in ACT Therapy?
During ACT therapy, practitioners draw on six groups of techniques: acceptance, cognitive defusion, contacting the present moment, self as context, values, and committed action.
Present moment awareness: During ACT sessions, mindfulness strategies help clients draw attention to mind/body sensations, as well as thoughts that arise. For a client struggling with anxiety, the therapist may ask her to sit quietly, tune into her self talk and body sensations, then write down what comes up.
Values: ACT practitioners take time to get to know their clients, asking a series of questions to determine core values and the goals they want to achieve in their lives.
Defusion: Here, counsellors guide clients through exercises to help them view thoughts and emotions as fleeting, malleable and completely separate from themselves. For example, a therapist may ask a client to write down her anxious thoughts on a piece of paper, and physically place the piece of paper in her pocket. Creating this physical distance between the client and her thoughts can help her realize how much power she has over them.
Self as context: To further position clients as objective, non-judgemental observers, ACT therapists guide clients in developing the “self as context”. For example, the practitioner may ask the client to write down “I’m noticing that I’m thinking the thought that I’m anxious right now,” as opposed to simply “I’m thinking the thought that I’m anxious right now.”
Acceptance: With this new awareness and distance from their suffering, ACT practitioners support their clients in leaning into it, helping to dissipate it. The emotional and physical energy that was once used to resist the anxiety can now be channelled toward daily activities.
Committed Action: With this new perspective, counsellors work to support clients in taking committed action toward their most important values and goals. In the case of a patient struggling with social anxiety, this may look like attending a work event and engaging in conversation with their boss and colleagues, even while experiencing anxious feelings, because attending the event is important for them and their career goals.
Is ACT right for you?
ACT has proven effective for a range of mental health disorders including depression, anxiety disorders, substance abuse, chronic pain, PTSD and phobias. It’s also helpful for people looking to better manage daily stress, and can take place with or without medication.
If you’re interested in exploring ACT as a treatment modality, we’re here to support you. Here at Skylark, our therapists specializing in ACT techniques work collaboratively with clients, helping them navigate challenging emotions and thoughts, break unproductive patterns and lead more fulfilling lives.
Get matched with a counsellor today