Quick links for Acceptance and Commitment Therapy
- How can Acceptance and Commitment Therapy help treat addiction?
- What are the core processes of Acceptance and Commitment Therapy?
- What are the benefits of Acceptance and Commitment Therapy?
- What are the downsides of Acceptance and Commitment Therapy?
- References for Acceptance and Commitment Therapy
Acceptance and Commitment Therapy, commonly known as ACT, is a form of Cognitive Behavioural Therapy (CBT) based on the idea that attempting to remove or avoid any form of emotional or mental pain will only increase it.
Instead, we must learn to accept these uncomfortable thoughts and feelings as opposed to pushing them away and work on identifying and committing to our personal values in order to live a happy and fulfilled life of our choosing.
ACT aims to change the way that we experience certain thoughts and emotions, rather than change the thoughts and emotions themselves.
This form of treatment does not attempt to heal the root cause of the pain – rather, it teaches a range of techniques and strategies known as psychological flexibility.
This teaches us how to be aware of our thoughts and reactions, allowing us to choose how we deal with situations as opposed to reacting automatically and habitually. [1]
Therapist taking notes with a patient during Acceptance and Commitment Therapy
While ACT does not consciously attempt to reduce the severity of the emotional or mental pain, focusing instead on our reaction to the pain, studies have shown that this form of treatment can have an indirect effect on the root cause of these uncomfortable feelings and emotions.
Focusing on thought patterns, internal dialogue and a greater understanding of oneself, ACT can be either a long-term or short-term treatment and usually consists of one-on-one sessions lasting from 30 minutes up to two hours.
The sessions are often based on workbooks and other exercises that allow the individual to explore their personal values and understand how they react to uncomfortable situations.
How can Acceptance and Commitment Therapy help treat addiction?
Patient speaking with a therapist during Acceptance and Commitment Therapy
Addiction can often develop when an individual is attempting to hide from their emotional, physical or mental pain.
ACT treatment can help to bring this pain to the surface and allow them to face it directly.
The individual will learn to accept this pain while simultaneously identifying and committing to their personal values, allowing them to react and live in a more mindful way.
This form of therapy does not attempt to consciously heal the pain that may have lead to the addiction – instead, the healing comes when the individual accepts the pain and learns to make room for it alongside other feelings such as joy, anger and stress.
Identifying their personal values can help an individual struggling with addiction make the behaviour changes necessary in order to recover.
If they consciously decide that they want to be someone who is free from addiction and substance dependency, they will be able to take steps towards that goal in spite of how they may feel at that moment.
Any cravings and triggers will hold less power as they will have the ability to step back and react to the situation in accordance with their values. [2]
What are the core processes of Acceptance and Commitment Therapy?
Therapist and patient talking together in a home during Acceptance and Commitment Therapy
ACT teaches psychological flexibility, which is the awareness of our own thoughts and the ability to consciously decide how we will react to stressful situations.
The opposite is psychological rigidity – for example, a cannabis addict may automatically reach for cannabis whenever they experience an unpleasant emotion.
If they could take a step back and realise that they are trying to avoid certain feelings that they don’t want to deal with, they could make a conscious decision to instead accept the feelings and choose not to use cannabis in that situation.
This form of treatment aims to guide individuals towards psychological flexibility through the development of six core processes, all of which are vital skills that can increase the chances of long-term recovery from a substance use disorder.
Below are the six core processes of ACT: [3]
1. Acceptance
When you accept an unpleasant emotion or experience, you are not asking for more of the same or resigning yourself to a life of unhappiness.
Acceptance is about allowing uncomfortable thoughts into your life along with the understanding that they are simply part of the human experience, not to be avoided or pushed away.
2. Cognitive Defusion
Cognitive defusion is the act of stepping back from your thoughts and understanding that they are not statements of fact, but merely unspoken words or images that can be observed before they pass by.
Your thoughts do not define you and they do not have to control your life.
ACT teaches various methods of observing your thoughts, allowing for healthy detachment and self-acceptance.
Acceptance and Commitment Therapy in progress at a drug and alcohol rehab clinic
3. Being Present
Mindfulness is a vital part of the ACT treatment programme and involves focusing on the present moment, rather than the past or the future.
It is based on the idea that all we have is right now – we cannot change what has happened, or what will happen.
ACT teaches mindfulness strategies such as meditation and body scanning, all of which are designed to help us slow down and appreciate the beauty of the present.
4. Self as Context
This principle involves seeing ourselves as separate from our thoughts and emotions.
We can choose to observe our feelings objectively, taking a step back before we react.
In this way, it is possible to experience emotions and sensations and continue to move forward with our lives, no matter how uncomfortable these feelings may be.
5. Personal Values
One of the most important aspects of ACT treatment is the process of identifying your personal values and understanding what is most important to you.
These are the things that drive you in life, and many people are not consciously aware of their own personal values. ACT is an opportunity to flesh out these values and create tangible, concrete goals for yourself.
6. Committed Action
In order for ACT treatment to be effective, patients must commit to working towards their personal values and taking the necessary steps to improve their lives.
These actions are mindful and carefully considered, with concrete goals that can actively be progressed and achieved.
What are the benefits of Acceptance and Commitment Therapy?
Patient and therapist sat in chairs and in deep conversation during Acceptance and Commitment Therapy
ACT comes with a wide range of benefits, many of which extend past the point at which treatment ends.
Some of these benefits include:
1. Teaching new thought patterns through Acceptance and Commitment Therapy
When uncomfortable situations and feelings arise – as they will inevitably do – It can sometimes feel as though the only option is to numb the pain with some form of substance.
ACT provides another solution, as this form of treatment can teach you how to sit with these feelings and accept them for what they are.
You will learn that there is no need to escape from them as it’s possible to live a happy and fulfilled life despite the presence of uncomfortable emotions and difficult situations.
2. Building resilience
ACT teaches psychological resilience and flexibility while dealing with the initial addiction, and these skills can be carried and developed for years to come.
It may be impossible to escape the challenges and difficulties that appear as you move through life, but the resilience built through ACT will allow you to deal with these problems as they arise instead of escaping into self-destructive behaviours.
Patient on a sofa speaking to a smiling therapist during Acceptance and Commitment Therapy
3. Promoting self-confidence during Acceptance and Commitment Therapy
Learning to accept your current situation and past experiences instead of fighting against them with negative self-talk and substance abuse can help to build confidence and raise self-esteem.
Throughout ACT treatment you will begin to see positive changes brought about by your own behaviour and new thought patterns.
The understanding that you have control over your feelings and reactions is empowering and in turn, can lead to more positive change in the future.
4. Scientifically proven
A number of studies [4] have proven that this form of treatment is effective at treating substance abuse disorders, with a significant reduction in substance use and even complete abstinence and recovery.
ACT is a promising option for addiction treatment and should be recommended as an option for individuals who require some form of talking therapy as part of their aftercare treatment.
What are the downsides of Acceptance and Commitment Therapy?
Young person undergoing Acceptance and Commitment Therapy
Along with the positives of ACT, it’s important to discuss the potential downsides of this form of treatment.
Some of these downsides include:
1. Highly structured
Most ACT treatments involve a number of worksheet tasks and specific topics that must be discussed.
The focus is less on the history of the addiction and more centred around the practice of mindfulness and defining personal values.
As a result, this form of therapy is more structured and not as easily personalised compared to cognitive or dialectical behavioural therapy, which may not be suited to some patients.
2. The fixed principles of Acceptance and Commitment Therapy
This form of treatment may be less effective if the patient does not agree with the basic principles.
ACT is based on the idea that trying to remove or avoid your pain will only make it worse and that accepting the current situation and committing to your personal values is a key step towards recovery.
This can seem contradictory to other forms of therapy, and as a result, some patients may struggle to accept the principles of ACT. In this case, another treatment such as cognitive behavioural therapy may be better suited.
You can learn about local rehabs offering this type of treatment here.
References for Acceptance and Commitment Therapy
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635495/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524566/
- https://contextualscience.org/the_six_core_processes_of_act
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524566/
