Acceptance and Commitment Therapy (ACT)

I have been asked about this approach to therapy. It seems a relatively new arrival in the therapy world being developed in 1986 by Steve Hayes. It has become one of the so-called ‘third wave’ therapies such as Dialectical Behaviour Therapy (DBT) and Mindfulness-based practises.

ACT does contain elements that help readers design experiments for themselves. See –

https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy

…. providing some insight into the model and lead you to web searches able to disclose a lot more!

Elements of Acceptance and Commitment Therapy

In general, Acceptance and Commitment Therapy (ACT) encourages you to accept what is out of your control and encourages you to commit yourself to action to improve your life.  It is an approach intending to maximise your potential.

1017 ACT model

Here is a diagram summarising the elements in the ACT approach.  I will need to explain myself a bit more, below, and this may help you research further.

Contact with the present moment relates to the Mindfulness perspective.

Acceptance

…. is related to the ability to decide between what you can be change and what IS.  ACT has useful things to say about our thought processes and how they can be harnessed to revise our behaviour.

Values

Tthe model seeks to make explicit the values we possess and the ways in which our values help or hinder change.

Defusion

is a specific technique rather similar to the experiment of “Just Noticing” or “Stepping Back”, included on this website. Defusion assumes we can become over-focused on some aspect of our behaviour, particularly the language we use, and this restricts our ability to change that behaviour. For instance, in our language, it is often the case that we blame others, or blame ourselves, for things that go wrong. Both extremes of this Locus of Control (LOC), as it is called,  are unlikely to throw much light on the ‘truth’, whatever that is.  Defusion and stepping back can help us look at the large picture and notice better our own tendency to over-focus.

Committed Action

: for me, this is ACT at its best as it is being very clear about doing something differently and noticing the outcome of your actions and being prepared to change once those outcomes become clear.

Self, as context

This element of the model is interesting. It places you and me at the centre of the process of change and respects our ability to notice and sustain changes we make. However, as with the Values element – see below – I am left uneasy about how this element works in actual practice.

Symptom reduction is not the goal of therapy

This is based on the view that the ongoing attempt to get rid of ‘symptoms’ actually creates a clinical disorder in the first place. Personally, I take the view that symptom reduction could be a good start, if it improves my confidence in my ability to do small, safe experiments.

The ACT model seems to help us to clarify what is important; it does inspire you to experiment. ACT helps by being action-oriented; it encourages you to find your own ways to change.  Change is achieved through teaching skills gleaned from, amongst others, the cognitive behavioural approach (CBT) and Mindfulness.

It is the view that skills need to be taught that starts me asking questions. What are those skills and who defines them?

My comment on the ACT model

ACT has joined the ranks of those models that initiate training programmes. That tends to slide down the slippery slope towards ‘this-is-the-way-to-do-it’.  On my website, I seek to avoid specifying ways in which safe experiments should be designed; I have offered a few ‘cans’; some possibilities!  I refer to this as ‘finger pointing’, but you do not have to follow the direction I offer.  I hope I make it clear who implements the experiment – and who has to respond to the results generated –  it is not me!

There is an implicit assumption in the ACT model that it can define what is a ‘safe experiment’, and it places emphasis on having a guide to help you avoid a small defeat. It is possible to get it wrong but I dispute that inference as defeats are to be avoided. They are necessary to more learning.

The ACT view of Committed Action is troubling. The approach includes a commitment to values in its model. Although this includes a professed respect for education of the self, I do not accept that it is wise to be ‘trained’ by others toward their notion of personal growth.  I’d suggest few training programmes are very focused on an individual learning about themselves, for themselves, and designed by themselves. OK, it’s hard work doing that, but I do not have a short cut to offer.

So, at this point, I become cautious and I take a closer look at the model. When I do this, I find ACT seeks to be a coherent ‘whole’, when it is, in practice, a collection of approaches to safe experimenting.  You do not need to be trained in ACT to explore other models. Also, why are a so few approaches selected over the many hundred available? That is not clear to me. I have no great love of traditional psycho-analytic approach to creating change in the human condition, but I would be reluctant to say it has nothing to offer.

In short, the ACT perspective, when examined up-close, identifies a number of safe experiments already around from existing areas of psychology. For instance, Acceptance is a form of ‘just noticing’, as touched on in this website. Mindfulness, like Yoga, is one approach to experimenting that may help you, but you will not know that until you try it out. Also, it is a very large subject. You can go to Bangor University and do a post-graduate programme in Mindfulness practice!

A specific reservation about ACT

ACT, in common with most models, is less explicit about the importance of you finding out what works for you, although it considers the possibility, see below. Like other models, it rather implies it can tell you what will work for you. It seems to be saying that you can only make progress if you integrate your approach to experiments according to an ACT perspective.

Consider this view from Dr_Russ_Harris in a PDF entitled A Non-technical Overview of ACT:

“ACT assumes that the psychological processes of a normal human mind are often destructive, and create psychological suffering for us all, sooner or later.

This passing assertion fails to respect both the possibility of learning from symptom reduction and the value of learning from small defeats. Where is the evidence for symptom reduction worsening our progress on the ‘scenic route‘?

The quotation sets up an almost neo-Freudian way of thinking: that effective therapy is full of unintended consequences that only a fully-trained expert can help you avoid. I repeat, there is little respect for learning from our small defeats. This is combined with a ‘Project Fear’ that warns you off doing it yourself, lest you get it wrong. 

The best you can do is to accept the hurt that comes with getting it wrong. A real giveaway from Dr Russ Harris is the sentiment that:   “ACT allows the therapist to create and individualise their own mindfulness techniques, or even to co-create them with clients.”   Note the way in which the role of therapist and client are defined. They can EVEN co-create techniques!! What about ‘clients’ creating something for themselves?

My own website says: you go your own way and take the consequences of so doing. I suggest you will progress on a scenic route where your defeats are at least as important as your small victories.

Some further leads

What is a nudge

Designing a nudge

‘Categories’ of nudges

Why ‘small’

An index of all Your Nudge pages

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