Acceptance and Commitment Therapy Explained
Acceptance and Commitment Therapy (ACT) is a form of therapy that aims to help people address and overcome destructive thought patterns and habits. In addiction treatment, this is often used in conjunction with medical treatment like physical detox.
The key to this form of therapy is to explore thought patterns and behaviours in a compassionate and nonjudgmental way. Read on to discover how ACT works and how it can help people struggling with addiction towards their recovery.
What Is Acceptance and Commitment Therapy?
ACT aims to help patients develop a sense of awareness when it comes to their past experiences and inner thoughts and also face negative self-talk. It also aims to help people separate their thoughts from their behaviours in order to avoid unhealthy coping dependencies like alcohol addiction. Ultimately, the goal of acceptance and commitment therapy is to practice mindfulness, accept situations, and cope healthily based on the values that are important to them.
Patients, for example, may undergo a consistent barrage of negative thought patterns. In ACT, thoughts like “I’m a hopeless case” are then sung to the tune of a Twinkle Twinkle Little Star. Repeated exercise helps people distance themselves from the meaning of their internal thoughts and helps build psychological flexibility. This can help them avoid black-and-white thinking that is only detrimental to their mental state.
The goal of acceptance and commitment therapy is to create the opportunity for patients to view their painful experiences in a different light. It’s not about putting a positive spin on the events but helping them objectively reassess their memories and reactions.
More specifically, ACT helps people:
- Identify avoidant behaviours
- Address emotional difficulties
- Identify actions that are in line with one’s values
When it comes to substance abuse, there are also other co-occurring mental health disorders like depression, anxiety, toxic shame, etc. And with ACT, the target is not substance abuse necessarily but the emotions from past experiences that influence substance abuse.
The Central Assumptions of Acceptance
and Commitment Therapy:
- People have the tendency to avoid negative experiences, and it’s only normal as it is part of human nature
- A clear set of personal values and commitment is key to behavioural change
- Instead of fighting the emotions that influence the behaviour, it is possible to observe the emotions objectively and not be influenced by them
The Six Core Principles of Acceptance
and Commitment Therapy:
Acceptance and Commitment therapy have six core principles that help patients build psychological flexibility in their thinking patterns, ultimately influencing their behaviours.
1. Acceptance
Part of ACT is the acceptance of negative emotions and thoughts wholly without resisting them. While this may be extremely difficult for most people, embracing unpleasant experiences helps build commitment to actions based on their inner values. In this case, people are encouraged to fully experience uncomfortable emotions, like feeling the breadth of your anxiety or pain. The goal is not to minimise the pain but to help people increase commitment to positive actions that contribute to their well-being and journey in recovery.
2. Cognitive diffusion
This principle centres on the act of distancing yourself from a thought or an emotion. It promotes psychological flexibility by having people not over identify with their thoughts and observe them mindfully. Detachment can help them experience thoughts, feelings, and experiences without necessarily being influenced by them. For example, one can think, “I’m not good enough”, and through cognitive defusion, they can instead reframe it into “I’m having thoughts that I am not good enough.” This, in turn, empowers people to avoid detrimental actions like substance abuse in response to thoughts and feelings that may potentially trigger them.
3. Being present
Substance abuse is driven by one’s need to escape the present in order to cope. In acceptance and commitment therapy, one of the principles is the complete opposite of substance abuse. Being attuned to the present moment and consciously engaging with life helps people act based on their values instead of getting caught up in the past or the future. This isn’t always easy; to do this, multiple mindfulness exercises promote presence.
4. Self as context
This part of ACT is all about self-awareness and detaching the “core self” from past experiences, thoughts, and emotions. The goal of self as context is to help people understand that whatever they are feeling or thinking at the moment doesn’t necessarily mean that that’s who they are. A common analogy in self as context is thinking of the self as the vast sky and the emotions and thoughts as the ever-changing weather. No matter the weather, the sky is still the sky, and nothing changes it.
5. Values
Every person has a different set of values, and mental health disorders like substance abuse may influence people to go against their values. ACT aims to help people make decisions and actions aligned with their values to foster a greater sense of self. Value-based actions are one of the end goals of acceptance and commitment therapy, which in turn helps most people suffering from substance abuse resist triggers.
6. Committing to action
Once a person has identified clearly the set of values they want to foster, the next part is committing action that aligns with it. In this part of ACT, people can finally have concrete goals after identifying their values, allowing for positive behavioural change.
These six core principles compose the foundation of acceptance and commitment therapy. Each principle builds on the subsequent principles, and as a person practices them all, they can achieve more psychological flexibility. With psychological flexibility, they have a more nonjudgmental view of their thoughts and emotions that can ultimately sever one’s inclination toward substance abuse.
What are the Origins of Acceptance
and Commitment Therapay?
ACT was first tested by Robert Zettle in the late 1980s and was conceptualised by Steven Hayes in 1982. Acceptance and commitment therapy were derived from the Relational Frame Theory. ACT is also considered the “third wave” of behavioural therapy, where the goal is to understand how people form inner thoughts concerning their behaviour.
Around the 2000s, this therapy approach was later used to treat substance abuse and focuses on minimising feelings of shame in people struggling with it. Jason Luoma’s works highlight this part of ACT and are later heavily adopted by medical professionals in treating substance abuse.
What Happens During Acceptance and Commitment Therapy?
Acceptance and commitment therapy is not only beneficial for people undergoing addiction treatment, but it also targets co-occurring mental health disorders. Below are some of the benefits of ACT as a treatment approach:
- Acceptance helps people deal with shame, anxiety, and other unpleasant thoughts and emotions by fully embracing them without judgment.
- Cognitive diffusion gives patients the tools to detach themselves from their negative thoughts, feelings, and experiences, which can significantly help in dealing with internal triggers related to substance abuse
- Being attuned to the present, thanks to ACT, can help people engage with their lives fully and encourage them not to hold on to escapist inclinations when faced with difficulty. This is particularly helpful for those who seek escape and have developed addiction problems.
- Commitment to action helps patients follow through with their values and build a better sense of self. This is practically the application of acceptance and commitment therapy, and through this, the patient can create lasting behavioural changes for their well-being.
- Last but not least, psychological flexibility is the end goal of ACT. This helps people deal with different facets of their lives healthily without derailing from detrimental coping patterns.
Through acceptance and commitment therapy, people can create action that aligns with their values and no longer feel the need to respond to every internal trigger that can lead them to another vicious cycle of substance abuse.
What lies behind us and what lies before us are
tiny matters compared to what lies within us
How ACT Can Help People in Recovery?
Sobriety is a long-term practice, and people will still be exposed to the same triggers that lead them to substance abuse after treatment. The key is fostering skills to help one healthily deal with unhealthy patterns.
Acceptance and commitment therapy aids these people in avoiding the pitfalls of substance abuse again through acceptance, detachment from emotions and thoughts, creating a better sense of agency, as well as following through with positive actions that align with their values.
The Role of Counselling in Cognitive Behavioural Therapy
When individuals begin their ACT treatment, counsellors will examine their specific needs and what mode of therapy they should attend. Most of the time, this can vary from weekly or bi-weekly sessions that last from 30 minutes to an hour.
During the sessions, both therapist and patient identify the problems and break them into components and how to address each. Both will collaborate in creating an actionable plan, which the patient will then apply and further assess as the treatment continues.
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