What Is Acceptance And Commitment Therapy? UK Options
There are hundreds of different types of talk therapy, each with its own approach and applications. The type of therapy that might be best for a given individual typically depends on the mental health challenges they're experiencing and their goals for treatment. One common form of talk therapy today is acceptance and commitment therapy (ACT). Here, we’ll take a look at ACT as a practice, along with its history and how it may benefit mental and emotional health.
What is acceptance and commitment therapy (ACT)?
This nonjudgmental strategy may help individuals come to relate to their thoughts and feelings in a different way. The ACT approach typically involves mindfulness—a nonjudgmental approach to present thoughts and feelings—which research suggests may help protect against psychological distress.
The history of ACT and the influence of relational frame theory (RFT)
American psychologist Steven C. Hayes created ACT in the 1980s. The development of ACT was influenced by the clinical psychology concept known as relational frame theory (RFT). Both practices focus on changing the way people respond to psychological pain.
Relational frame theory posits that there’s a relationship between language and external stimuli. For example, after being in a car accident where you were hit by a red car, you may associate red cars with a negative experience. Therefore, after seeing a red car going forward, it’s typically your present thoughts that are causing distress rather than the car itself.
RFT’s explanation of how the mind works forms the foundation for ACT as a practice. Today, various professional organizations, such as the Association for Contextual Behavioral Science, use and recommend the use of ACT to support clients facing a variety of challenges.
How ACT works: key components of treatment
Understanding how ACT works can help you decide if it might be a treatment method you’d like to pursue. ACT aims to use various methods to enable you to relate to your thoughts and feelings in a different way. Here are some key aspects.
Acceptance and mindfulness
Acceptance is a central part of ACT. This tenet invites you to approach thoughts and feelings with kindness and compassion. Acceptance and mindfulness exercises are chances for you to acknowledge thoughts and feelings and let them pass without judgment.
Studies suggest that, when combined, acceptance and mindfulness interventions may help improve stress-related and social relationship outcomes. Here are some exercises that an ACT professional might teach to help their client foster acceptance and mindfulness:
- Accept that some everyday situations are beyond your control and that the present moment is the only moment that exists.
- Practice meditation by sitting quietly in a comfortable position with your eyes closed. As thoughts or physical sensations arise, aim to simply watch them without judging or engaging. No thought or feeling is right, wrong, bad, or good.
- Choose how to respond to situations without letting your feelings be the deciding factor. Remember that you have control over your actions.
Cognitive defusion
A technique that’s used in various psychotherapies, cognitive defusion helps you detach from present feelings and view them more objectively. Cognitive defusion plays an important role in mindfulness-based strategies for pain regulation, so it can be especially helpful for people living with adverse physical symptoms. Here are some ways to practice cognitive defusion, a skill that a person can sharpen in therapy:
- Practice classifying thoughts using neutral labels like “thought” or “anxiety” without engaging further.
- Repeat distorted and untrue thoughts out loud in different tones to disrupt them.
- Imagine thoughts as advertisements, letting them pass by without attributing much importance to them.
- Challenge your thoughts, reminding yourself that they’re products of your own mind and may not always reflect reality.
The self as context
This technique is a way of recognizing that your true self is higher than your thoughts and feelings, which may help you become a conscious observer of them. A metaphor commonly used to depict this is the sky and clouds. You are the sky, vast and always present, while your thoughts are the clouds passing by. Depending on the weather, clouds are always changing and moving while the sky remains the same.
Committed action and values
Committed action is closely related to psychological flexibility, meaning the opportunity to respond to life situations in accordance with your values—even if your response doesn’t support your present thoughts and feelings. For example, if you value your physical health and well-being, you may go for a morning walk or run, even when you feel like staying in the comfort of your bed. Research suggests that people who show committed action experience higher levels of mindful awareness and life satisfaction as well as less stress and fewer symptoms of depression and anxiety.
Other potential mental health benefits of ACT
The experiential exercises taught during ACT therapy—such as mindfulness meditation, committed action, and acceptance—may impact both your mental health and physical well-being. Committed action empowers you to stay on track, whether it’s with reaching your fitness goals or maintaining meaningful relationships. Acceptance helps you foster joy and self-compassion in your life—which can be useful as self-compassionate people report better overall physical health, lower stress, and better health behaviors. Similarly, mindfulness meditation can help you to connect to the present moment and live a more meaningful life.
The research on acceptance and commitment therapy (ACT) for anxiety and depression
Anxiety and depression are prevalent mental health conditions in the UK today, and ACT is one of several talk therapy approaches that may help address symptoms. Research suggests that outcomes of ACT for depression and anxiety can be positive and similar to those associated with cognitive behavioral therapy.
ACT is also a promising therapy for social phobia, a specific type of anxiety disorder, with research suggesting that it may help improve emotional regulation and attentional bias. The ACT model incorporates mindfulness skills and other practices that may help clients relate to anxiety in a healthier way.
Acceptance and commitment therapy: UK treatment for other mental health conditions
ACT can have many potential applications for clients in the UK. In addition to treating anxiety and depression, this form of therapy may also be a beneficial treatment component for those living with:
- Eating disorders
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Chronic pain
- Substance use disorder
- Addiction
Acceptance and commitment therapy: UK anxiety and depression treatment options
Depression and anxiety are mental health conditions that can cause negative thoughts and painful emotions such as guilt, worthlessness, worry, and hopelessness. ACT can be effective for these conditions since, in acceptance and commitment therapy, acceptance of difficult feelings with self-compassion and mindfulness is key. It can give clients the chance to navigate, accept, and distance themselves from negative thoughts and feelings rather than getting caught up in them.
Individuals who are looking for acceptance and commitment therapy or other forms of mental health care in the UK have options. Talking therapies are free for eligible UK residents through the National Health Service (NHS) when you self-refer or get a referral through your GP. Care from independent providers is also available for a fee, which may be paid out of pocket or with medical insurance, if applicable. Another option is online therapy through a platform that serves the UK, like BetterHelp, with subscriptions as low as £65, billed every four weeks.
ACT options online
Online therapy has been increasing in popularity in recent years. Online providers can offer many of the same modalities as in-person professionals, including ACT. With an online platform like BetterHelp, you can tap into a network of thousands of therapists, counselors, and clinical psychologists in the UK who are trained to practice ACT. They offer flexible scheduling and clear pathways of communication—including video call, audio call, and in-app messaging—so you can receive the care you may need from anywhere with an internet connection.
Is ACT effective online?
As with many forms of psychotherapy, acceptance and commitment therapy can often be effectively provided online. Studies on the topic suggest that online acceptance and commitment therapy may help improve well-being, life satisfaction, and mindfulness. That means individuals who are more comfortable with virtual care or find it more convenient can feel confident in the quality of support they will receive.
Takeaway
Frequently asked questions
What is acceptance and commitment therapy in the UK?
Acceptance and commitment therapy (ACT) is a type of cognitive behavioural therapy (CBT). It usually employs mindfulness practices to help clients accept their life experiences, rather than judging them or attempting to change them. Learning to make healthy contact with the present moment and being aware of the world around you can be a valuable skill.
What are the four As of acceptance and commitment therapy?
In ACT (the one-word representation of this type of therapy), the concept of acceptance is broken down into four As: acknowledge, allow, accommodate, and appreciate. Learning to accept your thoughts, feelings, and experiences is often an ongoing process, but ACT can help you develop the skills and techniques necessary to stop fighting against reality.
What are the six principles of acceptance and commitment therapy?
The six principles of ACT include acceptance, cognitive defusion, contacting the present moment, self as context, values, and committed action. Using these principles in everyday life can enhance mental health and increase psychological flexibility by enabling individuals to accept unpleasant thoughts and emotions rather than assign value to them.
Who is acceptance and commitment therapy not good for?
Although ACT can be helpful for many people, it’s not necessarily the right therapeutic approach for everyone. Those who are experiencing psychosis or an emotional crisis, as well as those with cognitive impairments, may benefit from other types of treatment.
Who is suitable for acceptance and commitment therapy?
Studies suggest that teenagers and adults tend to benefit the most from ACT. It’s often helpful for individuals living with anxiety, PTSD, depression, grief, and chronic pain, such as the pain associated with multiple sclerosis.
What is the difference between acceptance and commitment therapy and CBT?
Acceptance and commitment therapy is a type of CBT. The main difference between these modalities is that CBT usually aims to adjust difficult thoughts, while ACT seeks to help clients accept them without judgment. ACT can lead clients toward the idea of accepting their thoughts and acting in accordance with their values.
What are the three pillars of acceptance and commitment therapy?
The three pillars of ACT include acceptance, direction, and action. These can also be seen as stages of the therapeutic process, with the action stage involving goal-setting and taking action to make necessary changes.
When shouldn’t you use acceptance and commitment therapy?
Acceptance and commitment therapy isn’t suitable for individuals experiencing active psychosis or suicidal behavior. It may not be helpful for children, as it requires clients to think in an abstract manner, and children may not yet have this ability.
How long does acceptance and commitment therapy last?
It’s common for this type of therapy to last approximately eight to 16 sessions. These sessions are usually 50 minutes each. However, each individual may require a slightly different treatment plan.
Do you have to be certified in acceptance and commitment therapy?
There currently isn’t a certification process for ACT. However, you can attend ACT training events and workshops.
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