“ACT work is based more on the psychology of the normal. I think we have every reason to believe that most of the things that people struggle with are based on the failure to bring out normal psychological processes.” – Stephen Hayes
Acceptance and Commitment Therapy (ACT) is a psychotherapy technique that is based upon Cognitive Behavioral Therapy (CBT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.
Mindfulness practices have in general been shown to be effective in treating depression (see http://contemplative-studies.org/wp/index.php/category/research-news/depression/) and anxiety disorders (see http://contemplative-studies.org/wp/index.php/category/research-news/anxiety/) Since Acceptance and Commitment Therapy (ACT) employs mindfulness training it is not surprising that it is also effective for a variety of mental health issues including depression (see http://contemplative-studies.org/wp/index.php/category/contemplative-practice/act/).
ACT contains a number of modules that allow the client to work on particular thoughts and actions that are relevant to the individual’s problems. This allows for component analysis research, where certain ACT modules are used or dropped out and the change in ACT effectiveness measured, thus allowing the assessment of the effectiveness of each component module. In today’s Research News article “Acceptance and Commitment Therapy modules: Differential impact on treatment processes and outcomes”
Villatte and colleagues examined “two ACT component modules; one targeting openness to thoughts, feelings, and sensations and the other emphasizing engagement in meaningful actions.” Participants who were suffering from depression and/or anxiety disorders were randomly assigned to receive ACT therapy emphasizing one of the two modules. In the ACT OPEN module, the client explores the thoughts and ideas about the depression or anxiety and are then encouraged to let go of these thoughts, to let them diffuse, “(e.g. thoughts are observed as if they are leaves floating on a stream).” In the ACT ENGAGED module the client’s own values are explored as guides to orient actions and as sources of satisfaction. They then explore their experiences with an eye toward allowing their values to guide them through the obstacles that occur in everyday life.
Villatte and colleagues found that both modules produced significant improvements in acting with awareness and nonreactivity to thoughts, feelings, sensations. They both also produced significant reductions in anxiety and depression symptom severity, but the ACT OPEN module was significantly more effective than the ACT ENGAGED module. The ACT OPEN module only produced significant improvements in cognitive diffusion and experiential acceptance. Both modules also produced clinically significant improvements in quality of life and values based action, but the ACT ENGAGED module was significantly more effective than the ACT OPEN module.
Hence they found that the module emphasizing letting go of thoughts and ideas about their problems, ACT OPEN, was more effective in reducing the symptoms of anxiety and depression than the module emphasizing applications of the individual’s own values to guide actions, ACT ENGAGED. This finding reinforces the importance of the emphasis of mindfulness practice on letting go of thoughts and focusing on present experience. It suggests that this may be a critical component in mindfulness applications to mental health issues. The fact that the module emphasizing applications of the individual’s own values to guide actions, ACT ENGAGED produced greater improvements in quality of life suggests that the emphasis in mindfulness practice on acting with awareness may be crucial to satisfying engagement in life.
It is possible that letting go is needed as a prerequisite before values based actions are effective. So, values based actions may not be as effective when practiced before practicing letting go. Future research should investigate presenting these modules in different orders. Regardless it is clear that Acceptance and Commitment Therapy (ACT) modules are effective in the treatment of anxiety and depression.
So, ACT for mental health.
“People don’t go into therapy when life is moving forward at a reasonable clip; they go in when life is stuck or going backwards. And it’s not that they get cured or fixed, because humans are not broken, they don’t need to be fixed. They need to be supported in a way that allows them to grow and do a better job over time with the things that they really care about—their kids, their work, their intimate relationships, their sense of participation and connection with the world around them.” – Stephen Hayes
CMCS – Center for Mindfulness and Contemplative Studies