Does ACT try to change negative thoughts?

No. Rather than disputing or changing the content of distressing thoughts, ACT works on a person's relationship to those thoughts through acceptance and defusion, while directing behavior toward chosen values.

What does 'psychological flexibility' mean in ACT?

It refers to the ability to stay in contact with the present moment and to act in line with one's values even while experiencing difficult thoughts and feelings; it is the central target of the therapy.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is a contextual behavioral treatment, often grouped among the 'third-wave' therapies, that aims to increase psychological flexibility rather than to reduce or dispute symptoms directly. Instead of challenging the content of distressing thoughts, ACT teaches acceptance of internal experiences, defusion from unhelpful thoughts, present-moment awareness, and committed action guided by personal values.

Definition

Acceptance and commitment therapy is a contextual behavioral psychotherapy that seeks to increase psychological flexibility, the capacity to remain in contact with the present moment and to act in line with chosen values even in the presence of difficult thoughts and feelings.

Scope

The entry covers ACT's grounding in contextual behavioral science, the six processes of its psychological flexibility model, and the way it contrasts with traditional cognitive change strategies. It treats ACT as a reference topic within evidence-based psychotherapy and is not treatment instruction.

Core questions

How does ACT differ from traditional cognitive therapy in its approach to distressing thoughts?
What are the six processes of the psychological flexibility model?
What is meant by acceptance, defusion, and values-based committed action?
Where does ACT sit within the contextual or 'third-wave' behavioral therapies?

Key concepts

Psychological flexibility
Acceptance
Cognitive defusion
Present-moment awareness
Self-as-context
Values
Committed action
Experiential avoidance

Key theories

Psychological flexibility model (hexaflex): ACT organizes change around six interrelated processes, acceptance, cognitive defusion, present-moment awareness, self-as-context, values, and committed action, that together constitute psychological flexibility, the proposed target of treatment and mechanism of change.

Mechanisms

ACT proposes that suffering is amplified by experiential avoidance and by fusion with unhelpful thoughts. Rather than changing thought content, it targets the person's relationship to internal experiences, cultivating acceptance and defusion while clarifying values and supporting action consistent with them. The unifying mechanism is psychological flexibility, theorized to mediate improvement across a range of problems.

Clinical relevance

ACT exemplifies the contextual or 'third-wave' shift in behavioral therapy and is frequently discussed alongside CBT in the psychotherapy literature; understanding its model clarifies debates about acceptance versus change. This entry is reference material describing the approach and is not a basis for individual diagnostic or treatment decisions.

Epidemiology

Reviews describe ACT as applied transdiagnostically across mental health and behavioral health problems, with psychological flexibility studied as a cross-cutting target; the strength of evidence varies by condition and outcome.

History

ACT was developed by Steven Hayes and colleagues from the 1980s onward, grounded in relational frame theory and a contextual, functional approach to language and cognition, and set out in the 1999 treatment text. It became a prominent example of the contextual 'third wave' of behavioral and cognitive therapies described in later reviews.

Debates

Is ACT meaningfully distinct from cognitive-behavioral therapy?: Some argue ACT's acceptance-based stance and process model differ fundamentally from CBT's emphasis on changing thought content, while others contend the approaches overlap substantially in practice and outcome; the distinction remains debated.

Key figures

Steven C. Hayes
Kelly Wilson
Kirk Strosahl

Seminal works

hayes-1999
hayes-2006
hayes-2011

Frequently asked questions

Does ACT try to change negative thoughts?: No. Rather than disputing or changing the content of distressing thoughts, ACT works on a person's relationship to those thoughts through acceptance and defusion, while directing behavior toward chosen values.
What does 'psychological flexibility' mean in ACT?: It refers to the ability to stay in contact with the present moment and to act in line with one's values even while experiencing difficult thoughts and feelings; it is the central target of the therapy.