Acceptance and commitment therapy

Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of cognitive behavioral psychotherapy that uses mindfulness to recognize one's psychological responses and be open to one's experiences and accept them, and commitment to one's core values to create a meaningful life.

ACT was developed in the 1980s by Steven C. Hayes, taking a contextualistic and holistic approach to human behaviour, arguing that human suffering is created by human language (cognition), that is, the way we create and are entangled in our subjective world, and avoid certain unpleasant feelings.

Theoretically, ACT is rooted in B. F. Skinner's philosophy of radical behaviorism and in Hayes' post-Skinnerian functional contextualism. As a therapeutic practice, ACT takes a holistic approach borrowing aspects from "the human potential movement, Eastern traditions, behavior therapy, mystical traditions, and the like".

Origins and development

Steven C. Hayes developed ACT around 1982, elaborating on the cognitive therapy technique of cognitive distancing, the ability to take an objective stance towards thoughts and to investigate them as hypotheses rather than as confirmed truths. After analyzing the functionality of this concept, Hayes concluded that "thoughts alone cannot directly cause psychological distress or ineffective behavior," but that their impact depends on their context. According to Hayes, "distancing techniques establish a less literal context that can weaken the behavior regulatory impact of language," that is, cognition (pre-existing assumptions that regulate and shape the way we perceive and give meaning to the world). Hayes observed that this fit in with the restrictive "excessive regulation" which "verbal rules" can cause, and tried to find ways to reduce this impact, and create more room for "long-time contingencies" (unexpected events), by putting more emphasis on distancing and "confronting unworkable rules that we thought artificially sustained the behavior regulatory impact of private experiences by encouraging experiential avoidance." Hayes developed a treatment to test this model, first calling it comprehensive distancing.

The foundational concepts of ACT were formally introduced in Steven C. Hayes's 1987 article "A contextual approach to therapeutic change: Toward a functional analysis of human language," published in Behavior Therapy. He did not yet name the approach "Acceptance and Commitment Therapy." The term ACT began to appear in print in the early 1990s, as the model became more developed.