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Acceptance and Commitment Therapy (ACT) is an evidence-based psychological therapy that supports people to relate differently to difficult thoughts and feelings, rather than attempting to change or remove them. The focus is on helping a person to behave in a way that aligns with what matters most to them, even when discomfort is present.
Acceptance and Commitment Therapy came out of the work of psychologist Steven Hayes in the 1980s and has accumulated a substantial research base since, spanning anxiety, depression, chronic pain, OCD and a range of other presentations.
At the core of ACT is psychological flexibility, a term that describes the capacity to stay present with difficult thoughts and feelings without being governed by them, and to act according to what matters most rather than what feels least uncomfortable in the moment. That capacity develops through several processes working together, which can be employed flexibly rather than being structured and protocol-driven.
How does ACT differ from CBT?
The main difference lies in how each approach works with difficult thoughts. Cognitive Behavioural Therapy (CBT) works primarily with the content of unhelpful thoughts, identifying cognitive distortions, testing them against the available evidence, and developing more accurate and balanced alternatives. The aim of CBT, broadly, is to challenge what a person thinks and, in turn, how they behave and feel.
Unlike CBT, ACT does not set out to change the content of thoughts at all. An anxious thought is not necessarily examined for accuracy or challenged. Instead the work involves learning to hold it differently, recognising it as something the mind has generated rather than a fact that requires immediate action or debate. The goal is not to feel better as such, but to live more fully and in line with what genuinely matters, even while difficult thoughts and feelings are present. As with any therapeutic model, neither approach is inherently superior to the other, and which one is more helpful depends on the person and their experiences.
What are the core elements of ACT?
Six processes sit at the heart of ACT, though in practice they overlap and can be employed flexibly rather than being worked through in order. The first is acceptance, which in this context does not mean resignation or approval. It involves allowing difficult internal experiences to be present without immediately mobilising against them, on the understanding that the struggle to suppress them frequently costs more than the experiences themselves.
Cognitive defusion addresses how we relate to our thoughts. Someone fused with the thought ‘I am going to fail at this’ experiences it as a statement about reality. Defusion builds the capacity to notice that thought as a thought, created by a mind that produces thoughts constantly, without needing to argue with it or act on it.
Another important aspect of ACT involves supporting a client to understand their values for life, exploring what actually matters to them. Committed action follows from this and involves taking steps in a value-based direction even when the difficult thoughts and feelings remain present.
Present-moment awareness involves developing the capacity to remain in the present moment, rather than rehearsing the past or bracing for the future. Self-as-context is a shift in how a person relates to their own identity, moving away from a fixed story about who they are toward something that can hold difficult experiences without being defined by them.
Who tends to benefit from ACT?
There is a broad range of presentations that can benefit from ACT, including anxiety, depression, OCD, chronic pain, burnout, difficulties with self-worth and perfectionism. ACT often suits people who have spent considerable energy trying to manage or suppress internal experience and reached the point where that effort has become its own problem.
Where a difficulty is chronic or ongoing rather than a discrete episode, the ACT framing tends to be particularly useful, because it does not require the difficulty to disappear before life can proceed.
What does ACT look like in practice at London Bridge Therapy?
ACT at London Bridge Therapy is delivered by qualified Clinical Psychologists and Counselling Psychologists and Expert Integrative Psychotherapists with specialist training in the approach. Sessions tend to be collaborative and exploratory rather than structured around a fixed protocol, with the therapeutic relationship itself forming part of the work.
As with all therapeutic approaches at the clinic, the initial assessment is designed to establish whether ACT is the most appropriate fit for what you are bringing, or whether another approach would be more useful. Where ACT is recommended, the work is tailored to the individual rather than following a generic programme.
If you would like to find out more about ACT or discuss whether it might be relevant for you, visit our Acceptance and Commitment Therapy page or get in touch to arrange an initial consultation.
