Acceptance and Commitment Therapy (ACT)
What is Acceptance and Commitment Therapy?
Acceptance and commitment therapy (ACT) is a form of psychotherapy that builds upon traditional cognitive behavioral therapy (CBT) by adding new elements. The goal of ACT is to help clients to increase their psychological flexibility, defined as being fully present in the current moment while engaging in behavior that aligns with chosen values. In ACT, pain and discomfort are considered to be a natural, unavoidable part of life. A key principle of ACT is acceptance of unwanted thoughts, feelings, and physical sensations, as opposed to trying to change or to eradicate them. ACT encourages clients to cultivate a balanced, broad view of their thoughts, feelings, and physical sensations. In ACT, it is proposed that symptoms are not the problem; the problem is focusing on those symptoms and reacting to them by engaging in maladaptive behavioral responses. Mindfulness is central to ACT, as is committed action that is in line with one’s identified values, goals. Although ACT is a newer form of psychotherapy, it is evidence-based.
What Is Involved in Using ACT to Treat Children and Adolescents with OCD, Anxiety, and Related Disorders?
Children and adolescents respond quite well to ACT, and we modify ACT skills to make them developmentally appropriate. Defusion is an ACT skill that involves viewing thoughts as simply thoughts, rather than as facts. Clients learn to identify thoughts that are not helpful or useful and to detach from them. ACT also makes use of “the observing self.” Clients are taught to mindfully observe, with curiosity, their thoughts, feelings, and sensations, instead of mindlessly reacting to them. Children, and some adolescents may have difficulty identifying and observing their thoughts, but they can learn to be more aware of their emotions, physical sensations, and behavior. Even young clients can readily identify what is important to them (their values) and whether or not their behavior is working for them, meaning if their behavior is getting in the way of them doing what they want to do. We motivate children and adolescents to respond differently by helping them to understand the rewards that will result from behavioral change, which creates committed action. While much of the previous research on ACT has shown it to be an effective treatment for adults, more recent evidence points to ACT’s effectiveness when applied to children and adolescents.