Acceptance and Commitment Therapy

By: Suzanne Feinstein, PhD

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Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that falls under the broader category of cognitive-behavioral therapies. ACT was developed by Steven C. Hayes in the late 1980s and has gained popularity as an effective approach for helping individuals cope with a wide range of psychological issues and improve their overall well-being.

ACT is based on the idea that psychological suffering often arises from the attempt to control or avoid uncomfortable thoughts, emotions, or experiences. It emphasizes acceptance of these inner experiences and encourages individuals to commit to taking actions that align with their values and life goals. ACT aims to help individuals move beyond psychological defense mechanisms like denial which can hinder their personal growth and well-being.

The following are examples of some principles and techniques of ACT:


ACT encourages individuals to accept their reality as it is. Instead of denying thoughts and feelings, they are encouraged to acknowledge and embrace unpleasant or distressing thoughts and emotions as a normal part of the human experience.

Cognitive Defusion:

This involves learning to “de-fuse” from thoughts, which means recognizing that thoughts are just mental events and not necessarily accurate reflections of reality. By distancing oneself from unhelpful or negative thoughts, individuals can reduce their impact on their emotions and behavior.


Mindfulness techniques are used in ACT to help individuals stay present in the moment, observe their thoughts and feelings without attachment, and connect with their immediate experience. Mindfulness practices can increase psychological flexibility and reduce emotional reactivity.

Values Clarification:

ACT helps individuals identify their core values and what truly matters to them in life. This can provide a sense of purpose and direction for making choices that align with those values.

Committed Action: 

This involves setting specific, actionable goals that are in line with one’s values and taking steps to work toward those goals. ACT emphasizes taking meaningful action even in the presence of discomfort or fear.


This concept helps individuals see themselves as separate from their thoughts and emotions, fostering a sense of self-awareness and self-compassion.

Contact with the Present Moment:

ACT encourages individuals to connect with their immediate sensory experiences and the world around them, which can help reduce rumination and increase awareness.

ACT has been used effectively to treat various mental health issues, including anxiety disorders, depression, substance abuse, chronic pain, and more. It is particularly well-suited for individuals who are struggling with issues related to emotional avoidance and who want to develop greater psychological flexibility and resilience. ACT therapists work collaboratively with clients to help them live more meaningful and value-driven lives while learning to accept and manage the discomfort that comes with being human.

Here are some examples of how ACT can be applied in various situations:

  • Anxiety and Panic Disorders: Individuals with panic disorder might use ACT to accept the physical sensations of anxiety rather than try to suppress or avoid them. They could commit to facing their fear-inducing triggers regardless of anxiety being present. They can incorporate mindfulness, muscle relaxation and breathing techniques to help them commit to living their best life.
  • Depression: Individuals struggling with depression may work with ACT therapists to align with their core values and then commit to taking action despite those depressive thoughts and unmotivated feelings. Through defusion, they can learn to see thoughts as just thoughts and move through them while pursuing meaningful hobbies or careers.
  • Substance Abuse: In addiction treatment, ACT can help individuals accept cravings and urges without acting on them. They might commit to a sober lifestyle by engaging in recovery-related activities, attending support groups, or seeking help when needed.
  • Chronic Pain Management: For individuals dealing with chronic pain, ACT can help them accept the pain rather than constantly fighting it. They may commit to physical therapy, mindfulness practices, or other activities that improve their quality of life despite the pain.
  • Relationship Issues: Couples struggling with communication and conflicts can use ACT principles to accept their differences and emotional struggles. They may commit to actively listening to each other and making changes in their behaviors to align with their relationship values.
  • Workplace Stress: In a high-stress job, employees can use ACT to accept the stress and anxiety they feel about their job performance. They may commit to maintaining a healthy work-life balance, setting boundaries, and pursuing career goals that align with their values.
  • Weight Management: Individuals struggling  to manage their weight can apply ACT to defuse their body image concerns from their self-critical thoughts. They can utilize mindfulness techniques to break their emotional eating patterns despite their negative emotions. They can commit to healthier lifestyle goals that align with their core values, such as regular exercise and mindful eating.
  • Public Speaking Anxiety: Someone who experiences severe anxiety before public speaking can apply ACT techniques to accept their fear and anxiety. They may commit to speaking engagements as a way to promote their career or contribute to their field.
  • General Stress Reduction: People experiencing high levels of stress can practice ACT by accepting their stressors and committing to self-care routines, relaxation techniques, and stress-reducing activities that align with their values of well-being and balance. 
  • Grief and Loss: Those dealing with grief can use ACT to accept the pain and sadness they feel after losing a loved one. They may commit to memorializing the person, seeking support from others, and continuing to live a meaningful life in honor of the deceased.

These examples illustrate how ACT principles can be applied in various contexts to promote psychological flexibility and help individuals lead more fulfilling lives by aligning their actions with their values, even in the face of difficult emotions and thoughts.

 ACT is a versatile approach that can be adapted to address a wide range of mental health and life challenges.

Advanced Behavioral Health, LLP provides Acceptance and Commitment Therapy (ACT) for individuals who struggle with anxiety, depression, impulse control disorders and other related conditions. Call 646- 345-3010 or email Dr. Suzanne Feinstein at for a free 15 minute consultation to see if you qualify for treatment.

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