Acceptance and commitment therapy (ACT) explained

You might have heard of Acceptance and Commitment Therapy (ACT) through a friend, your therapist, or maybe during a late-night scroll through mental health resources. It sounds promising, but the name itself can feel a bit puzzling. What exactly does it involve, and how can you tell if it's the right fit for you?

In this resource, we’ll explore what is acceptance and commitment therapy, how it works in therapy sessions, and who might benefit from it.

What is ACT?

Acceptance and Commitment Therapy, also known as ACT, is a type of talk therapy that teaches ways to accept life challenges and emotional vulnerability with openness rather than resistance.

In ACT, acceptance means allowing difficult thoughts and feelings, while commitment involves taking action guided by your values. By combining mindfulness with values-based living, ACT supports greater psychological flexibility and emotional resilience.

ACT shares some similarities with Cognitive Behavioural Therapy (CBT), but there’s a key difference. CBT aims to change unhelpful thoughts, while ACT focuses on changing how you relate to those thoughts. 

Six core processes of ACT

ACT is based on six core processes that help develop greater psychological flexibility:

Together, these processes help you respond more flexibly to life’s challenges, improve your emotional intelligence and stability, and stay connected to what’s meaningful for you.

Why ACT isn’t about “fixing” or positive thinking

Most of us are used to the idea that we need to fix or eliminate painful thoughts and emotions to overcome them. But ACT starts from a different place; it recognises that suffering is part of being human.

It’s not about liking your anxiety, grief, or frustrations, but rather, it’s about learning that these feelings are valid, and you don’t necessarily have to fix them right away to move forward in life.

Another common misconception is that ACT is just another version of “think positive.” But it’s actually the opposite. ACT doesn’t ask you to push away your negative thoughts and plaster a fake smile. Instead, it teaches you how to sit with those experiences and respond to them with awareness.

It’s also important to note that ACT isn’t based on forced optimism or surface-level affirmations. It helps people develop mindfulness skills to observe their thoughts and feelings with curiosity rather than judgment. It’s a practical, science-based approach designed to tackle real-life challenges, and not a shortcut to feeling good all the time.

What can ACT help with?

ACT is used to help people manage different mental health and emotional struggles. Different reviews and compiled studies suggest that ACT strategies can be particularly helpful for different conditions, including anxiety, depression, stress, obsessive-compulsive disorder (OCD), substance misuse, chronic pain, and psychosis.

ACT has also shown promise beyond clinical settings. According to research, ACT can help someone manage grief by creating space for emotion while reconnecting with a sense of purpose. Practitioners using ACT in bereavement support have observed that it helps people relate to their grief in a less taxing way and take value-based steps forward, even during intense emotional periods.

Still, ACT isn’t a one-size-fits-all approach. A psychologist or psychotherapist may draw on ACT if they believe it suits your needs, but they might use other approaches too, based on their assessment. It’s always best to talk with a professional to explore what fits your situation best.

What to expect in an ACT session?

For your first ACT session, expect an initial meeting between you and a therapist. It could be a registered psychologist, a trained counsellor, or a psychotherapist with experience in ACT. They’ll take the time to get to know you, understand what brings you in, and talk through what the process might look like.

Sessions can be adapted to suit different stages of life, from childhood to adolescence to adulting. This way, ACT can be helpful regardless of a patient’s age. 

In general, though, you might work on:

• Building awareness and staying grounded in the present during everyday activities

• Learning how to accept difficult thoughts or feelings without getting stuck in them

• Setting goals and making small, values-based changes

• Practising ACT techniques between sessions, sometimes with simple take-home activities

You can expect to pay around $90-$350 per therapy session in Australia. If you have a Mental Health Care Plan and see a Medicare-accredited therapist, part of your therapy cost may be covered, often leaving you with an out-of-pocket fee of just around $80-$100. 

Benefits and risks of ACT

Acceptance and commitment therapy can lead to lasting growth, not just temporary relief. It’s shown to build psychological well-being by helping you stay present, accept what’s out of your control, and take action based on what matters most to you. Some other benefits of ACT include:

• Reduced emotional suffering

• Improved mental health (e.g., reduced anxiety, depression symptoms, or stress)

• Better relationships and communication

• A stronger sense of meaning and direction

But like any form of therapy, ACT isn’t always easy. It often involves facing painful or uncomfortable thoughts and emotions, so you may experience feelings like sadness, anxiety, frustration, or guilt as you work through difficult material. This is a normal part of the process, but your therapist is there to guide you through it at a pace that feels safe and respectful.

Can I do ACT on my own?

Yes, you can explore ACT on your own, especially if you’re just starting or want to build on therapy work. Some common self-guided acceptance and commitment therapy exercises and techniques include:

• Mindfulness practice: Take 5 to 10 minutes to focus on your breath or body sensations without judgment

• Journaling: Write your core values and create goals that reflect what's most important to you

• Cognitive defusion strategies: Step back from unhelpful thoughts and see them for what they are

• The Observing Self Worksheet: Use this worksheet to observe your thoughts and feelings without getting caught up in them

While these self-guided techniques can be a great starting point, working with a trained therapist is often the most effective way to experience the full benefits of ACT. Talked offers access to experienced ACT therapists, allowing you to book sessions at your convenience and get support tailored to your goals.

Final thoughts

ACT offers a compassionate, empowering approach to mental health, one that doesn’t ask you to fight your thoughts or feelings, but instead encourages you to face them with openness and move forward with purpose. 

Whether you're exploring it with a therapist or starting to try out ACT therapy techniques on your own, remember that progress is a process. With practice and patience, ACT can become a powerful tool to help you navigate life’s ups and downs with greater clarity and confidence.

If you're looking for support, Talked makes it easy to find and book ACT-trained therapists who can guide you along the way.

References:

• Beygi, Z., Tighband Jangali, R., Derakhshan, N., Alidadi, M., Javanbakhsh, F., & Mahboobizadeh, M. (2023). An Overview of Reviews on the Effects of Acceptance and Commitment Therapy (ACT) on Depression and Anxiety. Iranian journal of psychiatry, 18(2), 248–257. https://doi.org/10.18502/ijps.v18i2.12373

• Gloster, A.T., Walder, N., Levin, M.E., Twohig, M.P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A therapy of meta-analyses. Journal of contextual behavioral science, 18, 181-192. https://doi.org/10.1016/j.jcbs.2020.09.009

• Ritzert, T.R., Forsyth, J.P., Sheppard, S.C., Boswell, J.F., Berghoff, C.R., & Eifert, G.H. (2016). Evaluating  the Effectiveness of ACT for Anxiety Disorders in a Self-Help Context: Outcomes From a Randomized Waist-List Controlled Trial. Behavior therapy, 47(4), 444-459. https://doi.org/10.1016/j.beth.2016.03.001

• Willi, N., Pancoast, A., Drikaki, I., Gu, X., Gillanders, D., & Finucane, A. (2024). Practitioner perspectives on the use of acceptance and commitment therapy for bereavement support: a qualitative study. BMC palliative care, 23, 59. https://doi.org/10.1186/s12904-024-01390-x