Patrick J. Hart Psy.D.
An Except from My Academic Coursework in Psychotherapy Research

Acceptance and Commitment Therapy:
            Get Out of Your Mind & Into Your Life!

Acceptance and Commitment Therapy (ACT) is a cognitive-behavioral model of psychotherapy that has gained considerable recognition in the psychological literature (Hayes, Jacobson, Follette, & Dougher, 1994; Hayes, Strosahl, & Wilson, 1999). Psychological acceptance and experiential avoidance represent constructs that have been well developed within the theoretical framework of this system of psychotherapy (Hayes et al., 1994; Hayes & Wilson, 1994). As theorized in ACT, the construct "psychological acceptance" is advanced as a functional, behaviorally productive, and life enhancing psychological process -- an elegant "coping skill" that is readily learned by clients undergoing Acceptance and Commitment Therapy. ACT  therapy is especially helpful for the treatment of depression, social anxiety, panic and anger management, post traumatic stress disorder and problems of addiction and substance abuse.

Psychological Acceptance: Acting Upon Your Valued Life.
An adaptive and clinically relevant coping mechanism, psychological acceptance can be learned through ACT-based psychotherapeutic interventions. Psychological acceptance involves a person’s willingness to tolerate the presence of distressing thoughts and emotions, while engaging in functional goal-directed behavior, without getting caught up in dysfunctional struggles to avoid or suppress disturbing and unwanted internal experiences. The increased visibility of acceptance-based treatment methods has largely been the consequence of conceptualizing various forms of psychopathology in terms of experiential avoidance (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). The goal of ACT is to treat experiential avoidance by enhancing the client’s capacity for psychological acceptance and commitment to goal directed behavior change.

Acceptance Based Therapeutic Methods:
A Nontraditional View of the Role of Emotions
The ACT literature reveals that this orientation involves a nontraditional view of the nature and role of “private events” in psychopathology. ACT theory maintains a functional perspective regarding the nature of human behavioral responding and personal adaptation. Dougher (1994) explained: If thoughts and feelings are seen as behaviors, then it is easier to understand that they too are the products of a particular history. That is, they are just something one does; they have no special status. They are neither the causes of suffering nor obstacles to change. This is often a startling discovery for clients who have been led to believe that their thoughts and feelings are somehow reflections of true reality and that the simple occurrence of negative thoughts and feelings is indicative of psychological disturbance. If, however, thoughts and feelings are understood as nothing more than the results of a particular history, then there is no need to fear them, react to them, struggle against them, control them or change them. They simply do not need to be modified in order to change behavior (p. 44).

Acceptance as a Therapeutic Psychological Resource
Mike Dougher (1994) highlighted acceptance as a functional and healthy psychological process, and noted an important point, “acceptance is not simply some kind of applied nihilism which seeks to have clients simply tolerate suffering” (p. 44). In acceptance theory a critical distinction is made between the occurrence of private events like thoughts or feelings, and an individual’s reaction to those thoughts or feelings. That is, “It is one thing to feel anxious, and quite another to react in a dysfunctional manner to that anxiety” (p. 44). Correspondingly, it is one thing to think “I’m bitter, ” or “I feel enraged,” and a different thing to behave maladaptively or with blind reactance to such thoughts. This is an important distinction, because from an acceptance perspective, it is one’s struggle with unwanted thoughts and feelings, not the thoughts and feelings themselves that enhances and maintains behavioral dysfunction. More specifically, it is the nonacceptance (i.e., experiential avoidance) of thoughts and feelings, and the struggle to control or rid oneself of them that is frequently the source of inordinate distress, exacerbated suffering, and dysfunctional coping strategies. It is possible, and this a primary outcome of acceptance based approaches, to have the thoughts and feelings attendant that result from living in the world, understand them for what they are, and get on [behaviorally] with the pursuit of the experiences which gives one’s life meaning and richness (Dougher, 1994, p. 44).

Theoretical Orientation of Cognitive Behavior Therapy
Although the theoretical orientations and clinical methods of various psychotherapies are quite divergent, ACT theorists maintain that the experiential avoidance construct can play an integral role in organizing data from various psychotherapeutic domains. As described here, experiential avoidance appears to be relevant to a wide range of presenting problems encountered in the context of psychotherapy. Acceptance methods are clearly gaining notoriety in the psychological literature, and the experiential avoidance construct has played a central role in shaping the zeitgeist of acceptance-based psychotherapeutic techniques.

The Nature of Psychological Acceptance
To illustrate the nature of psychological acceptance, imagine an individual who is willing to experience a full range of emotions, thoughts, memories, bodily states, and behavioral dispositions, including those that are negatively evaluated, without necessarily having to change, escape, avoid, or struggle to diminish the presence of such experiences. Such a person might respond to distressing, negative private events while refraining from any tendency to control, avoid, or get rid of such disturbing experiences. From an acceptance perspective this person would be viewed as manifesting a high level of the functional psychological process described here as acceptance. This individual’s attention and concern could remain focused upon valued and functional consequences of present actions and patterns of responding. Goal directed behavior is then embraced in the interest of living a vital and personally enriching life and increasing problem-solving strategies. In spite of an awareness of the presence of negative evaluations and unwanted cognitive content, this person would, in short, maintain the capacity to do what works, would be able to think and feel at the same time without dissociating, particularly in the long term, rather than getting caught up in distracting struggles with feeling good or not feeling bad. Dougher (1994) explained: Psychological acceptance involves not attempting to avoid, escape control, change or break contact with any element of the relevant contingencies operating at a particular time. Thus, occasioning events, the actions and reactions they engender, and the consequences that result [private or otherwise] are allowed to occur and no attempt is made to avoid, control or change them (p. 38).

Acceptance, Willingness and Tolerance
Psychologist C. McCurry (1994) noted that acceptance theory “defines acceptance as willingness to have certain experiences in the service of certain goals” (p. 143). The thrust of many acceptance interventions reflects this functional perspective, and a robust commitment to behavior change is emphasized as representing a life enhancing psychological resource. In the acceptance view, one must become “willing to have,” or make psychological contact with, a broad range of negatively evaluated, unwanted, inconvenient, and otherwise unsavory private experiences while simultaneously and deliberately acting upon valued behavioral outcomes. This capacity represents the functional clinical resource described here as psychological acceptance. In essence, this psychological resource lies in creating conditions whereby clients come to accept, and even actively experience aversive private events, in the service of functional actions aimed toward personally meaningful, clinically relevant, and value directed goals.

Acceptance methods are especially useful in therapy for depression, panic attack, social anxiety, substance abuse and anger management. An ACT idiom states, “If you are not willing to have it — you have got it — bad.” The capacity for psychological acceptance might be viewed as a behavioral barometer, a predictor, of individual functioning and psychological health.

Dr. Patrick J. Hart: Psychotherapist
The Hart Center: Private Behavior Change Practice

Acceptance and Commitment Therapy in Seattle

Acceptance and Commitment Therapy: Generalized Social Anxiety Disorder

Steven C. Hayes: ACT Foundation Professor & Clinical Psychologist

Acceptance and Commitment Therapy: As Defined by Wikpidia

The Association for Contextual Behavioral Science Community

Acceptance and Commitment Therapy: ACT Theory & Research

Relational Frame Theory: The Theoretical Research Base ACT

Acceptance and Commitment Therapy for Anxiety Disorders

ACT Mindfully: Training in Acceptance Commitment Therapy

Behavior Analysis: Behavior Analytic Foundations of ACT

Basis Principles of Accepting Reality: Willingness to ACT

Context Press: Behavior Analysis and Clinical Psychology

Post Traumatic Stress Disorder: ACT Workbook for PTSD

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy: Training

Seattle Psychotherapy and Mental Health Counseling
Dr. Patrick J. Hart:
Acceptance Commitment Therapy, ACT, is a cognitive behavioral therapy that is evidence based. Seattle private mental health counseling and psychotherapy private practice. Help for social anxiety, panic attack, depression and anger management.