Acceptance and Commitment Therapy (ACT)
An evidence-based approach for responding differently to difficult thoughts and emotions while moving toward what matters most.
What is ACT?
Acceptance and Commitment Therapy (ACT) is an evidence-based form of behavioral therapy focused on helping people build psychological flexibility: the ability to stay connected to the present, make room for difficult internal experiences, and choose actions based on what matters rather than being driven primarily by fear, avoidance, or habit.
ACT starts from a pretty human premise: difficult thoughts and feelings are part of life. Anxiety, sadness, uncertainty, self-doubt, frustration, grief, and fear aren’t necessarily signs that something has gone wrong. Problems often grow when enormous amounts of energy go into trying to control, eliminate, outrun, or organize life around avoiding those experiences.
The goal of ACT isn’t to convince you to like discomfort or simply “accept” circumstances that need to change. Instead, we become more intentional about the relationship you have with your thoughts and emotions so they have less power to dictate what you do next.
From there, we focus on your values: What actually matters to you? How do you want to show up in your relationships, work, family, health, community, and life? ACT helps turn those answers into concrete, values-guided action.
What can ACT help with?
ACT can be useful when difficult thoughts, emotions, uncertainty, or old habits start to narrow your choices or pull you away from the way you want to live. Because the approach is broad and flexible, I may use ACT across a range of concerns, including:
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Learning to make room for uncertainty and anxious thoughts without letting them dictate every decision or behavior.
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Identifying what’s actually within your control and responding more intentionally when life feels demanding or chaotic.
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Changing your relationship with harsh internal commentary so that it has less influence over how you see yourself and what you do.
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Clarifying what matters most when there isn’t an obvious “right” answer and taking meaningful steps even when uncertainty remains.
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Noticing the thoughts, emotions, and protective habits that shape how you respond to other people, then practicing choices that better reflect the kind of partner, friend, parent, or person you want to be.
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Reconnecting with your values when life feels overly reactive, routine, or disconnected from the person you want to be, and taking small steps toward a more intentional life.
Watch Steven C. Hayes discuss Psychological Flexibility and ACT here:
What does “acceptance” actually mean?
Acceptance doesn’t mean resignation. This is the misconception prospective clients are most likely to have.
In ACT, acceptance doesn’t mean approving of something painful like staying in a harmful situation, pretending not to care, or giving up on change. It means making room for the internal experiences that are already here (thoughts, emotions, sensations, memories, and uncertainty) so that fighting with them doesn’t become the thing that organizes your life.
Sometimes change means taking action to alter a situation. Sometimes it means tolerating uncertainty while making a difficult choice. Sometimes it means grieving something that can’t be changed. ACT helps us distinguish between what needs action and what needs willingness, while keeping your behavior connected to what matters most. This distinction between acceptance and resignation is something strong ACT-oriented practices emphasize explicitly.
What does ACT look like in a therapy session?
ACT often looks more like traditional talk therapy than EMDR or DBR, but it is still active and experiential.
We might notice a thought that keeps showing up and explore what happens when you treat it as an unquestionable fact versus simply noticing that your mind is producing it. We might also look at something you’ve been avoiding, get curious about what that avoidance protects you from, and consider what it may be costing you.
We may spend time clarifying your values, especially when you’re facing a difficult decision or feeling pulled between competing priorities, and then translate those values into small, concrete actions. ACT can also include mindfulness, metaphors, experiential exercises, behavioral experiments, or things to notice between sessions. The goal isn’t to become perfectly calm; it’s to build more flexibility in how you respond when difficult thoughts, feelings, or circumstances show up.
Frequently asked questions
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ACT is flexible and can be useful across a wide range of concerns, especially when difficult thoughts or feelings are getting in the way of doing what matters to you, but you don’t need to decide before starting therapy.
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No. Acceptance in ACT refers to making room for internal experiences you can’t simply switch off. It doesn’t mean accepting mistreatment, abandoning boundaries, or giving up on changing circumstances that can and should change.
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Not necessarily. ACT often focuses less on deciding whether a thought is “true” or “false” and more on whether treating that thought as absolute truth helps you live the life you want. This process is often called cognitive defusion.
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Values are ongoing qualities of how you want to live and show up — things like being present, courageous, connected, curious, dependable, or compassionate. Unlike goals, they aren’t something you finish or check off a list.
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ACT developed within the broader behavioral and cognitive therapy tradition, but it usually places less emphasis on challenging the content of thoughts and more emphasis on changing your relationship with thoughts, increasing psychological flexibility, clarifying values, and taking meaningful action.
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Sometimes. We may identify small experiments, values-based actions, mindfulness practices, or things to notice between sessions. The point isn’t to assign busywork; it’s to help what happens in therapy translate into your actual life.
Wondering whether ACT might be a fit?
If you’re tired of waiting to feel completely certain, calm, or ready before moving toward the life you want, ACT may offer a useful way forward. We can start with what matters to you and what seems to be getting in the way.