Acceptance and Commitment Therapy (ACT) is a psychotherapy approach which helps with endurance problems. Endurance problems are issues such as addictions, weight loss, living with chronic conditions and existential issues. ACT works by;
- Helping you to identify your fundamental values.
- Develop the skills and mental tools to cope and thrive with your life challenge.
ACT can be broken down into several key elements;
Value driven living.
In ACT a value is a direction to move your life in. This could be summarized as something like ‘health’, or ‘family’. The client is then encouraged to identify whatever steps they can taken, from where they are currently in life, to improve their engagement with this value. This means that the value of ‘health’ does not mean being a certain weight, or eating 5 portions of fruit and veg, these are goals and are different. For example, the value of ‘health’ means doing more healthy things than you currently do, so if you currently average 1 portion of fruit and veg a day, how can you increase this to more than 1 portion a day?
The key with values is improvement, not specific attainment. By being aware of your life values you can start making daily decisions based on them, leading to a more meaningful life.
Acceptance of experience.
This can also be characterized as openness to experience or willingness to experience. This includes both negative and positive experience. Acceptance is there to counter the tendency to avoid difficult experience. Avoiding difficult experience often results in us being stuck in patterns of behavior. Choosing to experience the difficulty to get through to a better place is important to help us through to freedom. To give an example, for the addicted this can mean allowing themselves to experience the sensation of craving whilst not acting upon it.
Mindfulness
Mindfulness is a meditative practice which encourages contact with the the present moment, within ACT this has a twofold use;
- Encouraging contact with the present. It is thought that a preoccupation with the past or future locks us into pathways of behavior. To counter this ACT encourages spending more time actively in the present moment and with your experience. This enables you to be aware of that experience, without judging it, defining or categorizing it. Within ACT it is argued that all experience can be coped with on a moment by moment basis.
- De-fusion and observer self. Within ACT it is argued that we tend to believe we are our thoughts and feelings. The practice of mindfulness allows us to adopt an ‘observer’ position. From the observer position we can perceive the information from our thoughts, feelings and body as information not as who we are, this is called de-fusion.
What does Acceptance and Commitment Therapy (ACT) help with?
ACT has demonstrable effectiveness with; depression, anxiety, substance abuse(1), social anxiety(2) and has been seen to benefit those with serious physical issues in their psychological reaction to those issues(3). All of which has led some to suggestion that it could be an alternative to the ubiquitous cognitive behavioral therapy (CBT) in mainstream mental health services(4). As an alternative to CBT it has a lot to recommend it as the exercises within it feel quite different to CBT and thus it offers a different approach for those who don’t fit the CBT mold.
As a practitioner of ACT I have used it in different ways. Sometimes I use it in full, sometimes using elements of it within a wider intervention. It has proven useful with; coaching clients, supporting the neurodivergent with coping with life challenges, with substance abuse clients (mostly alcohol and cocaine users), pornography addictions, survivors of life changing accidents and people with chronic pain.
Acceptance and Commitment Therapy (ACT) and hypnosis
Many hypnotherapists have found that ACT fits well into hypnotherapy. Some of the mindful exercises make excellent hypnotic inductions. In addition, ACT contains within it a number of visual metaphors designed to illustrate points. These metaphors can be delivered as immersive visualizations in hypnosis to deepen the learning. Further, as the mind appears to be more open to learning in hypnosis all the ways of thinking introduced as part of an ACT intervention appear to be more deeply engaged with.
If you are considering Acceptance and commitment therapy or hypnotherapy for issues such as;
- Pornography addiction.
- Sex addiction.
- Substance abuse.
- Anxiety.
- depression.
- Living with chronic conditions.
You may wish to contact Dr Matt, an experienced hypnotherapist and Diplomat member of the BSCH to arrange a free consultation.
References
- Gloster AT, Walder N, Levin ME, Twohig MP, Karekla M. The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of contextual behavioral science. 2020;18:181-92.
- Mattikoppa NV, Harshitha G, Yahiya GKM, Paluru MS. Efficacy of Acceptance and Commitment Therapy in Social Anxiety Disorder: A Systematic Review and Meta-analysis. Journal of Psychiatry Spectrum. 2025;4(1):111-20.
- Fattahi A, Mazini F, Jaberghaderi N, Rajabi F, Derakhshani M, Laki M. Effectiveness of acceptance and commitment therapy for distress, emotion regulation, and self-compassion in patients with cardiovascular disease: a randomized clinical trial. Trends in Psychiatry and Psychotherapy. 2025;47:e20230685.
- López-Pinar C, Lara-Merín L, Macías J. Process of change and efficacy of acceptance and commitment therapy (ACT) for anxiety and depression symptoms in adolescents: A meta-analysis of randomized controlled trials. Journal of Affective Disorders. 2025;368:633-44.