ACT - What's it all about?
Acceptance and Commitment Therapy (ACT - etiquette is to say this as the word, not the initials) is both a set of guiding psychological principles that just about everyone who works with ACT aspires towards and it is a form of Cognitive Behavioural Therapy (CBT). Traditionally, ACT is used in therapy for an increasingly wide range of conditions particularly anxiety-related, as well as pain, stress, phobias, addictions, (Forsyth & Eifert, 2007; Hayes, Strosahl, & Wilson, 2011; Harris, 2006). It is largely since 1999 and the release of the first main book on ACT by Hayes, Strosahl, & Wilson (1999) that ACT has attracted the most attention and interest in what is described as a third wave behavioural therapy.
There is a firm base of erudite literature and research on ACT. Rather than rehashing and repeating what Hayes and colleagues and others have said about ACT, the following scenario will be described with a view to illustrating the core principles of ACT, with a dash of Personal Construct Psychology - PCP (Butt, 2008; Butler, 2009; Kelly, 1955).
Read through the scenario, then click on the link at the bottom of this page to download a colour pdf file which covers the main principles in ACT and relates them to the scenario. In so doing, the original work of Hayes, Strosahl, & Wilson (1999) together with what followed in the ACT literature including: Eifert & Forsyth, (2005), Forsyth & Eifert, (2007), Harris (2006, 2009) Hayes, & Strosahl, (2005); Hayes & Smith (2005), Hayes, Strosahl, & Wilson, (2011) and Lundgren & Dahl, (2006) amongst others is acknowledged.
Suppose you are a nurse, doctor, mother, shopkeeper, son, businessman/woman, bus driver, psychologist... whoever. Basically, you like your job but you are struggling with anxiety or thoughts and feelings, which at times, seem to take over. This may have stemmed from a particular incident or just built up over such a long time that you can’t recall being without these feelings. You do not want to have these thoughts and feelings because they disturb your normal happy self and are painful. Some people you know say, “I leave my work at work, once I get home, that’s it, I turn off from all that stuff”. You wonder, “How can they do that?” “Why can’t I do that?” Alternatively, maybe you have been struggling with something personal from the past, an event, a memory, or are worried about what the future holds for you. When you can, you go on holiday to get away from these thoughts and feelings and yet, the holiday is not what you had hoped for because they are still there, troubling you. There are things - people, places, sounds, smells, words, sights that make these feelings worse so you do your best to try not to think about or experience these things.
You have some degree of ‘insight’ because you recognized long ago that this was a problem and you needed to get control and move on. Life is really not going in the direction you had planned. You have tried just about everything, every ‘self help’ technique to escape these feelings but nothing has worked, still they are there, haunting you. You even got some professional help to try and get control over these feelings, psychotherapy, medication, acupuncture; none of that worked so you tried meditation, yoga, relaxation, self esteem books and workshops, assertiveness training, positive self talk, the list is as long as your arm. Your alcohol and or substance use increased over time, which you knew was not helping and made you worry even more. You managed to get that in check by turning to fitness, diet and exercise. Now you are fit but still life is a misery because this stuff you have been struggling with is just still there. In the extreme... “I have tried everything and nothing has worked, I will never be the person I was, I am damaged, I survived but I am damaged”. Sometimes you lie awake at night because your mind is racing with all sorts of thoughts and feelings: I am unhappy, I am miserable, I am ... I can’t .... If only..... It’s not fair... I should... This is not normal, I know everyone has their problems but there must be something really wrong with me because I just can’t break free from these thoughts and feelings. I am sick and tired of this stuff. This is not the sort of life I wanted. I used to like ..... I wanted to .... but now I just don’t have the energy.
Click on the link below for an overview of the core principles of ACT with a dash of PCP related to this scenario.
Butler, R. (Ed.) (2009). Reflections in personal construct theory. Chichester: Wiley-Blackwell.
Butt, T. (2008). George Kelly: psychology of personal constructs, shaper of personal meaning. Basingstoke: Palgrave Macmillan
Eifert, G. & Forsyth, J. (2005). Acceptance and commitment therapy for anxiety disorders. Oakland: New Harbinger.
Forsyth, J. & Eifert, G. (2007). The mindfulness and acceptance book for anxiety: A guide to breaking free from anxiety, phobias and worry using acceptance and commitment therapy. Oakland: New Harbinger.
Harris, R. (2006). Embracing your demons: An overview of acceptance and commitment therapy. Psychotherapy in Australia, 12(4), 2-8.
Harris, R. (2009). ACT made simple: an easy to read primer on acceptance and commitment therapy. Oakland: New Harbinger
Hayes, S.C. & Strosahl, K.D. (Eds.) (2005). A practical guide to acceptance and commitment therapy. New York: Springer-Verlag.
Hayes, S.C. & Smith, S. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. Oakland: New Harbinger
Hayes, S. C., Strosahl, K. & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.
Hayes, S.C., Strosahl, K.D. & Wilson, K.G. (2011) Acceptance and commitment therapy: the process and practice of mindful change. (2nd ed.). New York: Guildford.
Kelly, G. A. (1955). The psychology of personal constructs. New York: Norton.
Lundgren, T. & Dahl, J. (2006). Living beyond your pain. Oakland: Harbinger.
Townsend, P. (1978). Who are you? On Who are You (Record Album). UK: Polydor; USA: MCA.