Make room for the feeling. Move toward what matters.
ACT (pronounced as one word, not the letters) is about psychological flexibility — the ability to hold difficult thoughts and feelings without being controlled by them, and to act on what you care about anyway.
Less fighting with your mind. More room to live.
ACT starts from an uncomfortable observation: trying to get rid of difficult thoughts and feelings often makes them stronger. The harder you push, the louder they get. ACT takes a different tack — accepting that some discomfort is part of being a person who cares about anything, and learning to act in line with your values even when the feelings are present.
Developed in the 1980s by psychologist Steven C. Hayes and colleagues at the University of Nevada, Reno, and articulated in book form by Hayes, Strosahl, and Wilson (1999), ACT grew out of the cognitive-behavioural tradition while drawing on mindfulness and a behavioural account of language called relational frame theory. The goal isn’t to feel better in the short term; it’s to live better — to do what matters even when your mind is throwing up obstacles.
Meta-analyses support ACT for anxiety, depression, chronic pain, substance use, and a range of transdiagnostic concerns (A-Tjak et al., 2015; Gloster et al., 2020).
When ACT fits.
- Anxiety
- Depression
- Chronic pain
- OCD
- Stress & burnout
- Life transitions
- Grief & loss
- Identity questions
- Self-esteem
- Perfectionism
- Substance use
ACT often pairs naturally with CBT (which it grew out of) or with mindfulness-based approaches. Our therapists choose what fits the person, not the textbook.
What ACT actually teaches.
Acceptance. Making room for difficult feelings instead of struggling against them.
Cognitive defusion. Noticing thoughts as thoughts — not orders or truths.
Present moment. Bringing attention to here, now, instead of the rumination loop.
Self-as-context. Recognising you’re the awareness behind the thoughts, not the thoughts themselves.
Values. Naming what matters most to you, even when it’s hard to live up to.
Committed action. Taking concrete steps in the direction of those values, regardless of how you feel about it.
Experiential, not just talky.
ACT sessions tend to use metaphors and exercises — not as gimmicks but because the work isn’t purely cognitive. You’ll often try things in session: brief mindfulness exercises, defusion experiments (saying a sticky thought out loud in a silly voice, or imagining it on a leaf floating by), values-clarification work that gets specific about what you actually want your life to be about.
Between sessions, you’ll usually have small experiments to run — not homework as such, but ways to test the skills in your actual life.
FP therapists trained in ACT.
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“Seeking support from caring others is a brave first step in dealing with hardship.”
“Your trust in me is a privilege, and I am here to support and guide you every step of the way.”
“I aim to create a caring space for you to feel seen, heard, and respected as we navigate your journey together.”
“Taking the step to start therapy is an act of courage and self-care — and I'm here to support you.”
“The therapeutic alliance is the core of therapy — it takes courage to bring up the most vulnerable aspects of life.”
A few things people ask first.
Is ACT the same as mindfulness therapy?
Related but distinct. ACT uses mindfulness skills as one of six core processes, but it goes further into values-clarification and behaviour change. Pure mindfulness-based therapies (MBCT, MBSR) emphasise meditation practice more centrally.
How is ACT different from CBT?
Classic CBT tries to change the content of unhelpful thoughts — replace the distorted thought with a more balanced one. ACT changes your relationship to the thought instead — you can have the thought and still do what matters. Both work for many things; the choice depends on the person and the problem.
Does ACT work for chronic pain?
Yes — this is one of the better-established applications of ACT, with multiple meta-analyses showing small-to-medium improvements in pain interference, functioning, depression, anxiety, and quality of life (Du et al., 2021; Ma et al., 2023). ACT doesn’t try to eliminate the pain; it helps you live a fuller life alongside it. For many chronic pain clients, that shift reduces the overall suffering even when the physical sensation doesn’t change much.
How long does ACT take?
Depends on what you’re working on. For a focused single concern, often 8–16 sessions. Complex or longstanding patterns are longer. Your therapist will be transparent about pacing.
References
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
Du, S., Dong, J., Zhang, H., Jin, S., Xu, G., Liu, Z., Chen, L., Yin, H., & Sun, Z. (2021). Acceptance and commitment therapy for chronic pain on functioning: A systematic review of randomized controlled trials. Neuroscience & Biobehavioral Reviews, 131, 59–76. https://doi.org/10.1016/j.neubiorev.2021.09.022
Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181–192. https://doi.org/10.1016/j.jcbs.2020.09.009
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
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
Ma, T.-W., Yuen, A. S.-K., & Yang, Z. (2023). The efficacy of acceptance and commitment therapy for chronic pain: A three-level meta-analysis and a trial sequential analysis of randomized controlled trials. Behaviour Research and Therapy, 165, 104308. https://doi.org/10.1016/j.brat.2023.104308
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