Acceptance and Commitment Therapy (ACT) is an evidence-based psychological therapy that helps people build psychological flexibility. In practical terms, this means learning how to make room for difficult thoughts, feelings, memories, and body sensations while still taking workable steps toward what matters.

Importantly, ACT does not aim to remove all distress from life. That would be a big promise, and not a realistic one. Instead, ACT helps people change their relationship with difficult internal experiences so that anxiety, sadness, fear, frustration, pain, or self-doubt have less power to dictate behaviour [1,2].

At Hennessy Clinical Psychology in Varsity Lakes on the Gold Coast, ACT may be used with adolescents and adults as part of evidence-based psychological therapy. Sessions can be provided in person at Varsity Lakes or by telehealth across Australia.

What Is ACT?

ACT is a modern behavioural therapy that uses acceptance, mindfulness, values clarification, and committed action strategies. It was developed from behavioural science and is closely linked to the psychological flexibility model [1,2].

In simple terms, psychological flexibility means being able to notice what is happening inside and outside yourself, respond with awareness, and take action guided by values rather than being pushed around only by distress, avoidance, habit, or short-term relief [1].

From a practical perspective, ACT is not about giving up, putting up with poor treatment, or pretending that painful things do not matter. It is about learning when to step back from the struggle with thoughts and feelings, and when to take purposeful action.

What ACT May Help With

Furthermore, ACT has been studied across a wide range of mental health, physical health, and wellbeing concerns. Evidence supports ACT as a helpful approach for many people, although outcomes vary from person to person [3,4].

ACT may be considered for difficulties such as:

• Anxiety and worry
• Depression and low mood
• Stress and adjustment difficulties
• Trauma-related distress, when used thoughtfully and safely
• Chronic pain and health-related adjustment
• Sleep-related distress
• Perfectionism and self-criticism
• Emotional regulation difficulties
• Life transitions, grief, and values-based decision-making
• Living with uncertainty, discomfort, or ongoing stressors

The Six Core ACT Processes

ACT commonly works with six overlapping processes. However, these processes are not rigid steps. In therapy, David adapts them to the person and the situation [1,2].

Acceptance

Acceptance means making room for difficult internal experiences when struggling against them is making life smaller. It does not mean liking distress, approving of harm, or becoming passive.

Cognitive Defusion

Defusion means learning to notice thoughts as thoughts, rather than treating every thought as a fact, command, threat, or final judgement.

Contact With The Present Moment

ACT often includes mindfulness skills that help people return attention to the here and now, rather than becoming caught in rumination, worry, or mental rehearsal.

Self-As-Context

This process helps people notice that they are more than any single thought, feeling, role, diagnosis, mistake, or painful story about themselves.

Values

People choose values as directions in life, such as being caring, honest, dependable, courageous, curious, fair, or connected. Unlike goals, values are not ticked off once and finished. They are directions that can guide behaviour.

Committed Action

Committed action means taking workable steps linked to values, even when motivation is low or discomfort is present. This is where ACT becomes practical and behavioural.

How Acceptance And Commitment Therapy Works

Acceptance and Commitment Therapy aims to increase psychological flexibility. In plain language, this means learning to stay present, respond more effectively to challenges, and take action that fits with personal values, even when life feels difficult.

Rather than trying to remove every uncomfortable thought or feeling, ACT helps people build a different relationship with their inner experiences. For example, a person may learn to notice the thought, “I cannot cope,” without automatically treating that thought as a fact or command.

In addition, ACT uses mindfulness skills to support attention in the present moment. As a result, many people become less caught in worries about the future, regrets about the past, or repeated attempts to solve problems that cannot be fully solved by thinking alone.

ACT also helps people clarify what matters most. Once values become clearer, therapy can focus on small, practical actions. Consequently, progress is measured not only by symptom reduction, but also by increased participation in important areas of life.

Although distressing thoughts and emotions may still occur, people can learn skills that support more flexible responses. Over time, many individuals become more willing to experience discomfort when doing so supports movement toward meaningful goals.

ACT And CBT

ACT is often described as a third-wave cognitive behavioural therapy. Traditional CBT often focuses on identifying and testing unhelpful thoughts. ACT is usually less focused on debating whether thoughts are true, and more focused on whether holding onto them tightly is helping the person live well [1,5].

Therefore, both approaches can be useful. Many psychologists integrate ACT with CBT, mindfulness, behavioural activation, exposure therapy, and other evidence-based methods depending on the person’s needs.

Is ACT Evidence-Based?

ACT has a substantial research base. For instance, reviews and meta-analyses suggest that ACT can help with a range of psychological and physical health concerns. In many studies, ACT shows advantages over waitlist, placebo, or treatment-as-usual comparisons [3,4].

However, the evidence does not mean ACT is automatically the best approach for every person or every concern. Some studies suggest that ACT performs similarly to other established active treatments, while other therapies may suit particular presentations or individuals better [3,5]. Therefore, careful treatment planning matters more than the name of the therapy alone.

In Australia, the Australian Psychological Society includes ACT in its evidence-based psychological intervention literature. It also describes ACT as an approach that uses acceptance, mindfulness, commitment, and behaviour change strategies to increase psychological flexibility [6,7].

What ACT Is Not

Sometimes people misunderstand ACT. In particular, ACT is not:

• Positive thinking
• Giving up on change
• Ignoring real problems
• Learning to tolerate unsafe situations
• Trying to feel calm all the time
• A promise that distress will disappear

Instead, it is more helpful to understand ACT as learning how to respond to internal discomfort more flexibly, while taking action that supports a meaningful and workable life.

ACT At Hennessy Clinical Psychology

At Hennessy Clinical Psychology, David may use ACT as a primary therapy approach or combine it with other evidence-based therapies. For example, treatment may include CBT, mindfulness-based strategies, exposure-based therapy, behavioural activation, trauma-informed care, or compassion-focused strategies.

Importantly, therapy is tailored to the person. For some people, ACT focuses on anxiety and avoidance. For others, the work may focus on pain, grief, depression, adjustment, emotional regulation, or rebuilding life after a difficult experience.

Frequently Asked Questions

Is ACT Suitable For Anxiety?

ACT may be helpful for anxiety, particularly when anxiety has led to avoidance, overthinking, reassurance seeking, or a life that has become narrower. Therapy may focus on changing the person’s relationship with anxious thoughts and feelings, while gradually building values-based action.

Is ACT Suitable For Depression?

ACT may help some people with depression by supporting behavioural activation, values-based action, and a different relationship with self-critical or hopeless thoughts. Depression varies, and treatment should be matched to the person’s circumstances and risk level.

Do I Need To Be Good At Mindfulness?

No. ACT uses mindfulness in a practical way. The aim is not to empty the mind or become perfectly calm. The aim is to notice what is happening and respond with more choice.

How Many Sessions Will I Need?

The number of sessions varies. Some people benefit from brief focused therapy, while others need longer-term support. This depends on the nature, duration, complexity, and impact of the concerns being addressed.

Related Reading

• What Is Acceptance and Commitment Therapy (ACT)?
• Therapy Approaches
• Cognitive Behaviour Therapy (CBT)
• Mindfulness-Based Therapy
• Emotion Regulation and Behaviour Change

References

1. Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25. https://doi.org/10.1016/j.brat.2005.06.006
2. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford Press.
3. A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J., & Emmelkamp, P. M. G. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30–36. https://doi.org/10.1159/000365764
4. Levin, M. E., Hildebrandt, M. J., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43(4), 741–756. https://doi.org/10.1016/j.beth.2012.05.003
5. Twohig, M. P., & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: A review. Psychiatric Clinics of North America, 40(4), 751–770. https://doi.org/10.1016/j.psc.2017.08.009
6. Australian Psychological Society. (2024). Evidence-based psychological interventions in the treatment of mental disorders: A literature review (5th ed.). https://psychology.org.au/for-the-public/psychology-topics/evidence-based-psychological-interventions
7. Australian Psychological Society. (2024). Exploring Acceptance and Commitment Therapy. https://psychology.org.au/insights/exploring-acceptance-and-commitment-therapy