ACT Concepts And Clinical Strategies

Acceptance and commitment therapy (ACT) belongs to the “third generation therapies.” These therapies differ from conventional psychological treatments in that they place more emphasis on certain aspects of mental health. Today we are going to discuss ACT concepts and clinical strategies.

At the heart of third-generation therapies is the idea that the condition is not part of the individual. Instead, the individual is in a difficult situation or problematic circumstances.

The conflicts are thus not part of the person themselves, but arise from their interactions with their current context (which is also influenced by the historical context). The two main principles underlying interventions in third-generation therapies, such as acceptance and commitment therapy, are:

• Acceptance. This strategy consists of radically abandoning the search for happiness or immediate well-being. The key is to normalize uneasiness and discomfort as part of a normal life experience.
• Activation. The idea is to pursue your goals and values ​​despite your discomfort and unhappiness. In this type of therapy, your success is measured by your personal performance rather than by the symptoms you may or may not have.

Steve Hayes, a professor at the University of Nevada, started acceptance and commitment therapy in the 1980s.

Experts define ACT concepts as an experiential, behavioral and cognitive psychotherapy based on relational frame theory (RFT), language theory and human cognition that is part of radical behavior. It encompasses a wide range of clinical resources that help therapists guide patients in achieving acceptance and activation.

The following matters are important in ACT:

• acceptance
• mindfulness
• cognitive deactivation
• dialectics
• values
• spirituality
• relationships

Important ACT Concepts

As we mentioned above, acceptance and commitment therapy is very different from previous therapies, especially with regard to the way you relate to the content of your mind. Another deviation is the rejection of a concrete diagnostic classification.

Instead, the only element that the therapist considers and analyzes is the individual’s behavior and function in context. With that as a basis, we can talk about some key ACT concepts:

• Experiential Avoidance. This is avoiding any symptom, emotion, or thought that makes an individual feel bad. The purpose of this avoidance is to control private events, feelings and sensations and the circumstances that cause them. Experiential avoidance comes from living in a culture that puts well-being and happiness above everything else, even above your own values. It is important to note that experiential avoidance is not always pathological. It becomes pathological when it restricts the way the individual wants to live his life.
• Personal values. These are the things you value most in your life. They are the goals you want to achieve because you believe they will make you happy.

These two ACT concepts put you in a vicious circle. Because you are not willing to suffer (experiential avoidance), you are stuck in a situation that does not fit your personal values. Yet this situation keeps you in your comfort zone.

Clinical Strategies for ACT Concepts

Although acceptance and commitment therapy is not very structured, the first step is usually a functional analysis of the patient seeking treatment.

This analysis enables the therapist to learn about the patient’s values ​​and his commitment to these values. From there, the therapist can set therapeutic goals. The most representative clinical resources of ACT are:

Creative hopelessness

Before the patient enters therapy, he has usually already tried other alternatives. The problem is that their attempts have failed. In fact, sometimes these solutions become part of the problem.

It teaches you that your attempts to solve your problems (worrying, drinking, trying to control everything) are not working and that you need to consider alternatives.

To help patients question these fruitless attempts, therapists use the quicksand metaphor. The more you try to get out of the sand, the further you sink. So it makes sense that you stretch your body and make contact with the sand.

Value orientation

Help the patient clarify what his or her values ​​are, and what direction or paths will help him or her live by those values. Values ​​direct behavior.

Control is the problem

Trying to control your life to avoid suffering often makes it worse. If you tell yourself not to think about pink elephants, what happens?

The more you try not to think about something, the harder it is to get pink elephants out of your head. So you must realize that it is better to stop trying to control the uncontrollable.

Acceptance

When you accept, you open yourself to the experience of the feeling. Confronting your demons may not be pleasant, but it is necessary. It is, of course, important not to pass judgment on it or assign any kind of meaning to it. Just let them be what they are: emotions, sensations, thoughts. Nothing else.

Cognitive Spread

This means that you need to learn how to disconnect from your thoughts and your emotions. No one gets attached to their blood, stool, or other bodily fluids, even though they are technically “part” of you.

Then why should you become attached to your thoughts and emotions? The idea is to come to the conclusion that your thoughts are products of the mind coming from your living brain. Therefore, they are completely normal.

The self as context

This strategy involves realizing that your thoughts and feelings don’t define who you are. It’s one thing to think “I have to be perfect at work,” but it’s another to let this thought define you completely. You are much more than your thoughts.

Dedicated action

Defining goals and committing yourself to fulfill those goals despite the obstacles you encounter along the way.

Exposure

Be fully open to your most painful thoughts and feelings. Exposing yourself means being willing to experience your emotions, and knowing that they will eventually pass.

Mindfulness

Finally, practicing mindfulness is a suitable method in acceptance and commitment therapy. It allows you to change the relationship between your thoughts, feelings, memories, and verbal regulation patterns that you perceive as problematic and are trying to control.

The effectiveness of ACT concepts

Acceptance and commitment therapy has been shown to be effective in several case studies and can be applied in a group or individual setting. An advantage of ACT is that the results continue into the following sessions. With ACT, problems are less likely to become chronic.

The only downside to ACT is how difficult it is to accept your negative thoughts and emotions in a context that values ​​only happiness and contentment.

After all, we live in a culture where happiness is the main goal. We see this message everywhere. Who has never had a moment when you are depressed and someone says to you, “Come on, stop whining! Life is too short!”

This culture of well-being makes it really hard not to reject the negative. The key is to be consistent with your therapy. You should also adhere to the clinical strategies your therapist recommends. Little by little you get used to the habit of radical acceptance and understand that all emotions are valid, necessary and normal.