Build Resilience in Acceptance and Commitment Therapy

ACT for Mental Health

ACT is a transdiagnostic therapy, which means it works for many different conditions:⁵

• Anxiety: Data shows that ACT reduces the symptoms of anxiety.
• Chronic pain: ACT improves quality of life for people with chronic pain.
• Depression: After ACT for depression, patients are less likely to have mental health relapses.

• Obsessive-compulsive disorder (OCD): ACT is an effective treatment for OCD, especially when combined with exposure and response prevention (ERP).
• Post-traumatic stress disorder (PTSD): ACT reduces PTSD symptoms and improves emotion regulation.

Because it’s so versatile, ACT might be a good choice for people with co-occurring disorders. That way, you can use the same approach to work toward all your recovery goals.

The Core Principles of Acceptance and Commitment Therapy

ACT promotes psychological flexibility.³ In other words, it helps you find your flow, even as life presents you with challenges. You can use the 6 principles of ACT⁶ to respond in a way that honors your values.

During treatment, your clinician may or may not talk about these core principles. But either way, they’ll serve as the basis for your work in therapy. And because all these concepts support each other, you probably won’t go through them in a linear fashion. Instead, your therapist will bring them up organically.

Defusion

You are not your thoughts. And your thoughts aren’t always facts. But what you think and feel can have a huge impact on your behavior. For instance, if you constantly tell yourself that treatment is too hard, you might start to skip therapy sessions. And then, it doesn’t matter if treatment is actually too hard. If you’re not attending therapy, then your therapist can’t help you heal.

To address this, ACT uses defusion to remove some of the power of your thoughts and feelings. You’ll learn how to look at your thoughts and feelings objectively, and not as intrinsic truths. This can help you accept what you feel and let it go, instead of allowing it to define you.

Acceptance

Acceptance is the ability to feel your feelings without trying to change them. In ACT, you learn how to approach emotions with curiosity instead of judgment. For example, you might get angry at a loved one during family therapy. And then, you might judge that feeling. You could feel ashamed of your own anger, or sad about what caused it. And while those feelings about your own anger are valid, they can quickly lead to a spiral.

Acceptance empowers you to hold space for yourself. If you get angry at a loved one, you can simply sit with that feeling. You don’t have to yell, and you don’t have to shut down your own emotional response. Instead, you can practice mindfulness, exploring how and why you might feel angry. And over time, you can work through that anger, release it, and move forward.

Contact With the Present Moment

Through ACT, you’ll learn to be more present in each moment. It’s all too easy to lose yourself in regret about the past or anxiety about the future. This therapy helps you stay grounded, so you can take action to improve what’s actually happening in your life.

To achieve that, you can learn any number of mindfulness techniques. For example, you could practice breathing exercises, or take up yoga. These skills invite you to engage with the world as it actually is, instead of how you fear it could be.

The Observing Self

This principle of ACT encourages self-awareness. You’ll learn to tell the difference between yourself, your thoughts, your feelings, and your actions.

This objectivity helps you develop self-compassion. For example, feeling bad doesn’t mean you’re a bad person. And by the same token, relapsing into addiction doesn’t define who you are. Objectivity lets you move through painful thoughts, feelings, and situations without giving up on yourself or your goals.

Values

You’ll begin most ACT programs by defining your values.⁶ Your therapist will guide you through an exercise in which you identify your highest ideals. Then, you’ll write them down and refer to them throughout treatment. They may also change over time.

Once you define your values, you can start to plan around them. You can even do that during rehab. For instance, if you value creativity, you might try art therapy or music therapy.

Treatment is just the beginning. As time goes on, your core values can guide you through life. And you can lean on them when you make major decisions. So if you value spontaneity, you might turn down a 9-5 job. Or if you value physical fitness, you might make time to work out every day. There’s no wrong way to live your life. But in recovery, it’s important to build a life that feels meaningful—however you define it.

Committed Action

With this ACT principle, you’ll make and keep commitments to yourself. Typically these commitments are tied to your values. For example, if family is one of your core values, you might commit to cooking dinner for them twice a week.

These simple actions can help you develop confidence. And over time, they’ll build toward larger patterns of behavior. That way, you can improve your relationship with yourself while you work toward external goals.

ACT in Accordance With Your Values

ACT recognizes that your goals are unique. This treatment doesn’t try to change the way you think. And it doesn’t define recovery for you. Instead, ACT guides you gently toward your own values. With the skills you’ll learn in treatment, you can start building a life you love—on your own terms.

View our list of rehabs with ACT to learn about their pricing, housing, insurance options, and more.

Reviewed by Rajnandini Rathod

1. Dindo L, Van Liew JR, Arch JJ. Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. Neurotherapeutics. 2017 Jul;14(3):546-553. doi: 10.1007/s13311-017-0521-3. PMID: 28271287; PMCID: PMC5509623. [↩]
2. Pohar, Ron, and Charlene Argáez. Acceptance and Commitment Therapy for Post-Traumatic Stress Disorder, Anxiety, and Depression: A Review of Clinical Effectiveness. Canadian Agency for Drugs and Technologies in Health, 2017. PubMed, https://www.ncbi.nlm.nih.gov/books/NBK525684/. [↩] [↩]
3. Osaji J, Ojimba C, Ahmed S. The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature. J Clin Med Res. 2020 Oct;12(10):629-633. doi: 10.14740/jocmr4311. Epub 2020 Sep 21. PMID: 33029268; PMCID: PMC7524566. [↩] [↩] [↩]
4. U.S. Department of Veterans Affairs. “Reducing Relapse Risk.” Whole Health Library. https://www.va.gov/WHOLEHEALTHLIBRARY/tools/reducing-relapse-risk.asp [↩]
5. Na, Euihyeon. “Acceptance and Commitment Therapy for Addiction.” Korean Academy of Addiction Psychiatry, vol. 25, no. 1, p. 3. www.academia.edu, https://www.academia.edu/19527124/Acceptance_and_Commitment_Therapy_for_Addiction. Accessed 8 Mar. 2023. [↩]
6. Zhang CQ, Leeming E, Smith P, Chung PK, Hagger MS, Hayes SC. Acceptance and Commitment Therapy for Health Behavior Change: A Contextually-Driven Approach. Front Psychol. 2018 Jan 11;8:2350. doi: 10.3389/fpsyg.2017.02350. PMID: 29375451; PMCID: PMC5769281. [↩] [↩]