Acceptance and Commitment Therapy: Definition & Exercises

By Charlie Huntington, M. A., Ph. D. Candidate
​Reviewed by Tchiki Davis, M.A., Ph.D.
Acceptance and Commitment Therapy helps us accept what we cannot change, but also change what we can. If that sounds helpful to you, read on to learn more and see some Acceptance and Commitment therapy exercises.
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As human beings, we trust our minds too much. I’m not just trying to be provocative when I say this – I promise you, my own mind is just as untrustworthy as anybody else’s. This is because our brains love to take shortcuts. Life would be exhausting if we questioned everything around us, so we make assumptions. While these assumptions might work at times, they often become problems for us over time.
A common assumption we make is, “this will never change.” Sometimes, there is truth behind this statement. Some things are permanently present in our lives, and we need to accept that. Other things that seem permanent may not be, or they can change more than we might believe. How do we handle this complex reality? One type of therapy, called Acceptance and Commitment Therapy, was designed to help us accept what we need to accept, while simultaneously staying committed to changing what we can. In this article, I will share the background and definition of Acceptance and Commitment Therapy and provide exercises and examples to help you understand how it might help you in your life.
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What Is Acceptance and Commitment Therapy? (A Definition)

Many psychotherapies set the goal of reducing or even eliminating mental pain. These therapies focus on building skills, such as learning how to restructure one’s thoughts, so that we can avoid or resolve situations that cause us distress. Acceptance and Commitment Therapy, often abbreviated as ACT, takes a slightly different stance on human suffering. Instead of focusing on eliminating all suffering, ACT operates from the reality that some suffering in our lives is inevitable.
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Rather than fighting that suffering – which tends to make it worse – ACT suggests that we can do three things to live a happier, more fulfilling life (Hayes et al., 2011): (1) become accepting, without judgment, of all experiences in our lives, especially those that are unpleasant or painful; (2) figure out what our personal values are; and (3) take action to change our lives so that we are living more in accordance with our values. ACT teaches that instead of resisting painful experiences, we can experience less pain when we accept those situations and maybe reduce that pain by making choices that match our values.

Most people I know have some initial resistance to the basic ideas of ACT. It sounds a little bit like just giving up, right? But I think with some simple reflection, we can easily see how inevitable discomfort and pain are in our lives. No amount of effort on my part will ever change the fact that the highway I commute on is crowded each day or that I look and feel older with each passing year. The ACT approach offers me a way to tolerate these ongoing challenges while also taking meaningful action to address them where possible.

For example, I feel a little better about the fact that I am (irreversibly and inevitably) ageing when I choose to get good exercise and sleep, eat nutritious food, wear lots of sunscreen, and do the physical therapy exercises that allow me to continue my long-distance running. Through these actions, and through acceptance of what I cannot change about ageing, I’m making the most of a fact of my life that might otherwise just cause me stress and worry.

Benefits of Acceptance and Commitment Therapy

Acceptance and Commitment Therapy, like many therapies related to Cognitive-Behavioral Therapy, has been thoroughly evaluated in research studies. A review of those studies by Gloster and colleagues (2020) shows that ACT is helpful for many mental health disorders, including depression, anxiety, substance use, pain, and for people with multiple mental health challenges. Some of the ways people benefit from ACT include having more psychological flexibility, more compassion for themselves, more mindfulness, and less psychological pain.

Values of Acceptance and Commitment Therapy

With Acceptance and Commitment Therapy, the word values takes on two meanings. First, there are the values of ACT itself – the principles by which it operates. Second, there is the fact that identifying each client’s values is a central component of this therapy, so ACT has a lot to say about the importance of values.
 
In the first sense, ACT places a high value on acceptance, self-compassion, flexibility, and mindfulness (Hayes et al., 2011). These are the goals to which ACT aspires in general, because when we exercise more acceptance, self-compassion, flexibility, and mindfulness, we are able to create more satisfying and less painful lives.
 
Within Acceptance and Commitment Therapy therapy itself, values are an essential concept. Therapists using ACT spend time with their clients asking them to identify what their values are and how much their lives and actions reflect their values. ACT therapists are careful to make sure clients think about values in a particular way. Values are not goals or feelings, but rather qualities of action that provide us with direction in making decisions (Hayes et al., 2011). In other words, they are not the consequences of our actions, but the principles that can guide how we move toward our goals (Robb, 2007).
 
For example, a common value for clients in Acceptance and Commitment Therapy is to be present. This does not mean that their ultimate goal is to become a master meditator (although it could be). Rather, it means that when living their life, this person tries to take actions that honor the fact that they value being present to one’s life. So instead of turning on Netflix when they feel sad and want a distraction, this person might make the values-based decision to take a walk and feel their feelings or text a friend about how they are feeling.​

Acceptance and Commitment Therapy Examples​

Acceptance and Commitment Therapy uses several techniques to promote acceptance and flexibility (Harris, 2006). Here are some examples of these techniques in action:
  • Defusion. A core skill in ACT is the defusing of the person and their thoughts and feelings. It can be very powerful to recognize that our thoughts and feelings, while they are happening to us, are not who we are. For example, saying to yourself, “I am having a feeling of sadness because my friend cancelled our plans,” can create some psychological distance between you and your sadness. Your sadness is a temporary experience that has come into your life.
  • Acceptance. To continue with the example above, an ACT therapist might then encourage you to say to yourself, “It makes sense that I am feeling this right now. This is an appropriate way to feel when somebody cancels plans that I was looking forward to.”
  • Contact with the present moment. ACT therapists try to ground clients in the present moment so that they fully experience their lives. In this scenario, your therapist might say, “Try to notice where in your body where you feel that sadness.”
  • The observing self. When we can observe ourselves without judgment, we may be able to change ourselves more effectively, and the things we don’t like about ourselves seem to sting less. For example, it is one thing to say, “I’m an idiot and I’ll never talk to that person again,” and quite another to say, “It was really important to me to make a good first impression, and it looks like I tried harder than I needed to as a result.”
  • Values. As discussed above, clarifying our personal values, and then discovering ways to live out those values more effectively are central tasks in ACT.
  • Committed action. On the other side of the equation from acceptance is committed action – clients in ACT commit to trying to live more into their values.

Acceptance and Commitment Therapy Exercises

Here is an exercise commonly used in Acceptance and Commitment Therapy (Engle & Follette, 2018):
 
  • First, try to come up with the values that are most important to you. You can ask yourself questions such as, “What kind of a person do I want to be?”, “What are the qualities I like in myself?”, “What sides of myself do I want to see more of?” “What matters most to me?” Make sure to think about who you are across all the different domains of your life, from work and hobbies to your closest relationships to how you practice self-care.​
  • Once you have written down seven or eight different values of yours, ask yourself how much you are living by each value. In fact, try to rate your success at living each value out on a scale from one to ten. This will help you target the values that you are integrating into your life the least. Once these are identified, you can start to think about how you might take committed action that is in accordance with these values.
 
An exercise like this can help you ultimately take action that aligns with your values (Engle & Follette, 2018). A while ago, I did a similar exercise and recognized that I had been prioritizing my value of working hard much more than I had been prioritizing my value of being connected to others. Gradually letting up on working hard and shifting toward making time for socializing has made me a happier and more fulfilled person.

Acceptance and Commitment Therapy for Anxiety

Acceptance and Commitment Therapy has been shown across many research studies to be an effective treatment for anxiety, especially because it seems to increase people’s psychological flexibility (Twohig & Levin, 2017). People with anxiety experience distress regarding things they cannot control, so it makes sense that a therapy that focuses on accepting what we cannot control would be helpful. By promoting mindfulness and flexibility, ACT gives people with anxiety more options than staying stuck in worry when anxious thoughts come up. ​

Acceptance and Commitment Therapy for Chronic Pain

Acceptance and Commitment Therapy is an especially effective psychotherapy for chronic pain (Wetherell et al., 2011), with people in chronic pain who receive ACT showing less interference from their pain in their lives, less worry about their pain, and less depression. Most people with chronic pain have tried many different treatments to reduce their pain, and many have to accept the reality that this pain will fluctuate over time, but in essence will remain a permanent fixture in their lives. ACT can help them with acceptance of this reality, followed by meaningful action to improve their lives in the ways that are possible.

Acceptance and Commitment Therapy for Trauma

Acceptance and Commitment Therapy has also been used successfully to treat people with Posttraumatic Stress Disorder (PTSD). People with PTSD often try to cope with the intrusive and unwanted memories and feelings they experience related to their traumas by avoiding certain situations or working very hard to control their environments. While this may help them not experience those intrusive symptoms in the short-term, it can make their overall symptoms worse in the long-term. Since ACT aims to help people face exactly the experiences that they know will be difficult, it is well-suited to helping people with PTSD both accept their symptoms and work on recovering (Orsillo & Batten, 2005). It is clear from the research literature that ACT works in just this way to effectively treat trauma (Bean et al., 2017).

Articles Related to Acceptance and Commitment Therapy

​Want to learn more? Check out these articles:

Books Related to Acceptance and Commitment Therapy

If you’d like to keep learning more, here are a few books that you might be interested in.

Final Thoughts on Acceptance and Commitment Therapy

I appreciate Acceptance and Commitment Therapy because I think it is an easier therapy to explain to people than many other treatments. That doesn’t mean it’s less sophisticated or effective – it just means that it’s the kind of help that intuitively makes sense (which I guess may make it easier to embrace, as a client). 
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I think it reflects some fundamental truths about human existence. For example, we can either accept or endlessly fight the true limitations in our lives; one option serves us a lot better than the other. And fighting reality makes it awfully hard to appreciate what is good in our realities – unless you’re a Buddhist monk or master meditator, you probably will benefit from more mindfulness in your life.

If you are intrigued by what you have learned about Acceptance and Commitment Therapy, I encourage you to look into the abundant worksheets and self-help books that utilize ACT. And if you would like some more concrete examples of what ACT looks like in action, I recommend watching the following video:​

Video: Here's What Acceptance and Commitment Therapy Looks Like

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