Last week we covered the topic of Acceptance and Commitment Therapy (ACT) as an introduction to a more in-depth look at that modality. This week, we’re going to be looking at the 6 core processes within ACT that clinicians use when working with clients.
Acceptance
As one could guess from looking at the name of this therapy, acceptance is a key point. One of the underlying beliefs in ACT is that much of our psychological suffering comes from being unable to accept difficult situations or feelings and that trying to fight against or avoid these is what contributes to us feeling badly. Clinicians work with clients to help them accept these situations as opposed to avoiding them. By coming to acceptance, psychological suffering and distress can be reduced, even if the situation itself doesn’t change.
For example, someone living with a chronic illness is likely unable to do things to change their illness. While treatment can help, there are often still symptoms present. Often, being chronically ill can cause a lot of distress and avoidance. People will avoid doing things out of fear of their chronic illness getting in the way or they may be so focused on their symptoms that it becomes overwhelming. By working to accept their illness and what comes with it, clients can reduce their levels of avoiding life experiences, reduce the level of distress over their symptoms, and increase overall psychological well-being and life satisfaction.
Cognitive diffusion
Sometimes, feelings and thoughts can feel like total truths. We believe the things we feel and think, even if they’re being driven by something like anxiety, depression, or another factor that could be distorting how we view ourselves and the things around us. ACT works by helping clients create distance between themselves and their thoughts. It helps individuals be able to view these thoughts and feelings as separate from themselves. This makes the distressing thoughts less “true” and impactful. Clients are able to accept the thoughts and let them pass.
The techniques used to help clients achieve this are observing the thought without judgement or labeling the thought that comes to someone automatically.
Being present
This is very similar to how DBT operates in helping individuals with borderline personality disorder increase emotional regulation through mindfulness. It encourages individuals to look at events mindfully and to be present instead of trying to interpret them, judge them, or change them. This can help with not only overall well-being but can also help with changing behaviors.
Self as context
Sometimes our thoughts and feelings can affect how we view ourselves and our identity. ACT helps people view themselves separate from these thoughts or events and allow them to form a stable view of themselves. They learn that their identity is not easily changeable by events in their lives and this can increase psychological well-being.
Values
Values are something that are important to many people, however most people don’t really think about what their values are. It’s only after sitting down and thinking about them do we realize we’re able to label and categorize them. Values are things people would ideally like to build their lives around. However, many people have a hard time living their values. This can be because they’re either unsure of them or are living a life that currently does not support them.
By clarifying values, clinicians using ACT can help clients name their values and determine how they would like to change their lives to adhere more to these values. By making these changes, clients can react to situations based on long-term goals versus in the moment desperate feelings.
Commitment/Committed action
This is the part in treatment where individuals make and set goals according to their values. These goals are meant to help them align their lives with their values, allowing for a more fulfilling sense of satisfaction with life. It can also include skill development for those who are experiencing difficulties in certain areas, like interpersonal skills, for example.
