What is Acceptance and Commitment Therapy (ACT)

by | Oct 10, 2025 | Acceptance and commitment therapy (ACT), addiction, anxiety, Depression, pornography addiction, Sex addiction

mindfulness

Acceptance and Commitment Therapy (ACT) is a psychotherapy approach which helps with endurance problems such as addictions, long term weight loss, chronic problems and existential issues. It works by helping you to identify your underlying values and develop the skills and mental tools to cope and thrive with whatever your life challenge is.

I break ACT down into three key elements;

  1. Value driven living – In ACT a value is a direction to move your life in, this could be summarized  something like ‘health’, or ‘family’. The client is then encouraged to identify whatever steps they can take 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 is improvement not specific attainment. By consciously being aware of your life values you can start making daily life decisions based on them, leading to a more meaningful life.

 

  1. Adopting 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, which 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.

 

  1. Mindfulness – Mindfulness is a meditative practice which encourages contact with the the present moment, within ACT this has a twofold use;

 

  1. Encouraging contact with the present – It is thought that a preoccupation with the past or future locks us into pathways of behavior which are limiting. 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.

 

  1. 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 which 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 an actually different approach for those who don’t fit the CBT mold.

As a practitioner of ACT I have used it in different ways, sometimes in full, sometimes using elements of it within a wider intervention. It has proven useful with life coaching clients, support of the life challenges of the neurodivergent, 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 a hypnotheraputic intervention. Some of the mindful exercises make excellent hypnotic inductions and as such can be introduced and practiced even before the decision to formally adopt an ACT approach is taken. In addition, ACT contains within it a number of visual metaphors designed to illustrate points, when delivered as immersive visualizations in hypnosis the learning can be deep and profound. 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.

 

References

 

  1. 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.
  2. 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.
  3. 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.
  4. 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.