Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT)
What is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy (ACT) is classed as a third wave psychological behavioural therapy designed to encourage people to embrace their thoughts and feelings rather than trying to challenge them or change them. In contrast to CBT, ACT supports people to not fight or feel guilty for their thoughts or feelings but rather accept they exist and recognise that is okay.
How does ACT work?
It may seem confusing at first, especially if people are used to other talking therapies such as CBT which is based on challenging unhelpful thought processes, however ACT, when paired with Mindfulness Based Therapy (MBT), offers clinically effective treatment.
ACT works by encouraging people to develop psychologically flexibility rather than a rigid approach by the practice of self-acceptance and positive self-talk. ACT involves commitment to facing your problems head-on rather than avoiding the stresses associated with it. This may mean allowing yourself to feel what you feel, even if it is considered negative or unhelpful.
Why might I need it?
Working with a therapist, you will learn to listen to your own self-talk, or the way you talk to yourself specifically about traumatic events, problematic relationships, physical limitations, or other issues.
ACT can help decide if an issue requires immediate action and change or if it can be accepted for what it is while you learn to make behavioural changes that can affect the situation. Looking at what hasn’t worked in the past to help reduce repeated patterns of behaviour.
Once you have faced and accepted your current issues, you make a commitment to stop fighting your past and your emotions and, instead, start practicing more confident and optimistic behaviour, based on your personal values and goals.
What problems can it help with?
ACT has been used effectively to help treat:
- Workplace stress
- Test/exam anxiety
- Social Anxiety Disorder
- Obsessive Compulsive Disorder
- Chronic Pain
- Eating Disorders
- Addictions and Substance Abuse.
How many sessions would I need?
This will depend on the individual. ACT is often delivered as one to one sessions but can also work well in small groups and larger workshops. The therapist will get an understanding at assessment about what issues you mat present with and what goals you want to achieve.
Making the decision to engage in any form of therapy is a commitment and for most people, a lifelong commitment to continue leading the best life they can.
ACT incorporates six Core Processes which guide patients through therapy to help develop psychological flexibility including:
- Cognitive Diffusion;
- Being Present;
- Self as Context;
- Committed Action.
These will be explained if Acceptance and Commitment Therapy (ACT) is found to be the right choice of therapy for you.
Acceptance and Commitment Therapy Case Study
Mohammad moved to the UK when he was in his teenage years with his parents. He settled in the countryside with his parents and was used to living in a rural setting. He studied hard and completed a degree in Engineering.
He was offered a job opportunity to work for a well-known company but that would mean him having to leave his home and relocate. He made the decision to move to London which was new environment for him. He struggled with the commute to his new place of work every day as he had to get on a busy train to get there.
This caused him to experience intense feelings of anxiety and he dreaded the thought of travelling everyday even though he really liked his job. He often didn’t want to buy his ticket and would call in sick if he felt too anxious to go.
He was assessed for support after he talked to his GP. He was 3 months into his new job at this stage. Mohammad explained during assessment that the journey made him feel anxious as there were a lot of people and he felt suffocated when the train was particularly busy.
He also expressed that he feared he would miss his train or that the train would not show up or be delayed which caused him to worry about getting to work. Mohammad understood that if he wanted to keep his job, that he would accept that he needed to continue making the journey and due to the time he started work, there was no alternative route or train that he could get, which meant he was always travelling during peak time.
The therapist discussed with Mohammad if there were alterative options regarding travel. Mohammad said that he could not make alternative plans to get to work (he did not drive and did not feel that this was something he wanted to do at the present time).
Mohammad developed self-talk he would use if he had thoughts about traveling such as ‘It is okay that you feel anxious’ , ‘You know that you can do this even if it is uncomfortable’ ‘You’ve bought the ticket now so it’s okay to get on the train’ and ‘You know you need to get on the train to get to your job which you enjoy a lot.’
Mohammad started to collect his train tickets over a period of 12 months to show that he managed to travel and once the ticket was bought, he would need to continue with his journey. Mohammad collected his tickets to accept that he could make the journey and that nothing bad had happened as a result.
He began to grow more confident that he could travel and accepted that this was part of his daily routine and that it was okay to feel anxious about this.
Mohammad used the collection of tickets as a way of acceptance about the situation and the feelings he was experiencing. After 12 months of using this technique, he and was able to continue commuting without the need to continue collecting his tickets.
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