Within clinical psychology, there are a few types of psychological therapy that you hear about time and time again. These include cognitive behavioural therapy, interpersonal psychotherapy amongst others. As well as I often hear about Acceptance and Commitment Therapy but because this therapy isn’t really available on the National Health Service in the UK, we don’t really learn about it in any great depth. Therefore, in this psychology podcast episode, you’ll learn what is Acceptance and Commitment Therapy, how it works, when it used and more. If you enjoy learning about psychotherapy, clinical psychology and mental health then you’ll love today’s episode.
Note: as always absolutely nothing on this podcast is ever any sort of professional, medical or official advice.
Today’s podcast episode has been sponsored by Cognitive Psychology: A Guide To Neuroscience, Neuropsychology and Cognitive Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
What Is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy is a therapy stemming from the more traditional behavioural and cognitive behavioural therapies. Since Acceptance and Commitment Therapy is an action-oriented approach to therapy because it gets the client to stop denying, struggling and avoiding their inner emotions. Instead, the therapy gets the client to accept their deeper feelings as appropriate responses in a given situation that they shouldn’t prevent themselves from experiencing, because trying to stop these responses stops the client from moving forward in their lives.
As a result, Acceptance and Commitment Therapy gives the client an understanding that they need to begin accepting their mental health difficulties and commit to making the needed changes in their behaviour regardless of what’s going on in their lives and how they feel about it.
Personally, I really like the sound of Acceptance and Commitment Therapy because I think all therapies need a touch of this to be successful. Since if we take Cognitive Behavioural Therapy for example, we need a client to accept that their depression, anxiety, whatever can’t actually be cured. But if they commit to the therapy and have a capacity for change then they can develop adaptive coping mechanisms that will decrease their psychological distress and improve their lives.
So I could argue that the idea of acceptance and commitment is an undertone in all psychotherapies, but this therapy just focuses on it a lot more.
In addition, in the 1980s psychologist Steven C. Hayes from the University of Nevada developed Acceptance and Commitment Therapy based on his own experiences. Since the professor had a history of panic attacks and in the end, he promised himself he would no longer run from himself. Instead he would accept himself and his experiences.
How Does Acceptance and Commitment Therapy Work?
From a theoretical perspective, Acceptance and Commitment Therapy works because it is counterproductive for a client to try and control their painful emotions and their psychological experiences. As well as it is the suppression of these feelings that leads the client to experience even more distress.
As a result, Acceptance and Commitment Therapy proposes that a client needs to develop the belief system that there are valid alternatives trying to change the way they think. Including mindful behaviour, commitment to action and attention to personal values. This leads to taking steps to change their behaviour to decrease their psychological distress, but the client is still learning to accept their psychological experiences at the same level.
This eventually leads to a client changing their emotional states and attitudes.
What Should A Client Expect From Acceptance and Commitment Therapy?
Building upon this further, when a client works with a therapist for this type of psychotherapy, the client will learn to listen to their own self-talk and this includes how they talk about problematic relationships, traumatic events, physical limitations and other challenges. Then it is up to the client to decide if a problem requires any immediate action or a change, or if the problem can be accepted for what it is whilst the client learns to make the behavioural changes to modify the situation.
To do this a client might have to look at their past to see what has or hasn’t worked for them, and the therapist can help the client stop repeating the same thought patterns and behaviours as the past so they don’t cause more problems in the future.
Additionally, after a client has faced and accepted their current challenges, the client can make a commitment to stop fighting the past and their emotions. Instead, the client can start practicing more optimistic as well as confident behaviour based on their personal values and goals.
Ultimately, Acceptance and Commitment Therapy aims to develop a person’s psychological flexibility. A concept that encompasses emotional openness and the ability to adapt their behaviours and thoughts to better align with the client’s own values and goals.
Personally, I really like the idea of psychological flexibility and a lot of what Acceptance and Commitment Therapy aims to do. Since being flexible in the way we think and feel in a given situation is critical to our mental health. We can’t be strict and inflexible so we only feel a certain way in a given situation because this will make us feel awful and experience a lot of distress. Yet if start to explore other ways that make us feel slightly better then that will definitely improve our mental health over time if we accept and commit to changing our thoughts and behaviour.
A little personal example here is actually rather funny in a way, because I have a friend that I really want to date and everything, I asked them out and they said no. Fair enough, and we’re both really open about the fact that I like them. Yet whenever they talked about them dating or seeing someone, I used to feel like utter rubbish and I had some very bad thoughts towards myself but that wasn’t healthy. So over time I taught myself to think in other ways, accept how bad I felt and I have committed to take steps to change certain aspects of my life. Like, trying to meet other people. I know this isn’t like professional Acceptance and Commitment Therapy at all, but what I’m trying to say is that the concepts are useful even outside of therapy.
Moreover, there are six core processes used in Acceptance and Commitment Therapy to promote psychological flexibility:
· Acceptance
This core process involves the client acknowledging as well as embracing the full range of their emotions and thoughts rather than trying to deny, change or avoid them.
· Being Present
This core process comes from mindfulness in the sense that a client should try to be mindful in the present moment, so the client can observe their feelings and thoughts without judging them or trying to change them. instead, the client should experience events clearly and this can directly help them to promote behavioural change.
· Cognitive Defusion
Thirdly, cognitive defusion involves a client distancing themselves from their distressing thoughts and feelings as well as changing the way they react to them. This decreases their harmful effects. Also, some ways how this defusion is done include singing the thought, labelling the automatic response the client has to them and observing a thought without judgment.
· Values
Fourthly, values are important for developing psychological flexibility because this encompasses a client choosing personal values in different domains of their life, and trying as hard as they can to live according to these principles.
Now this is interesting because this is in direct contrast to when a client’s actions are being driven by their desire to avoid distress or to adhere to other people’s expectations.
· Self As Context
Penultimately, self as context is the idea that expands the notion of self and identity because it proposes that people are more than their feelings, experiences and thoughts.
Something I completely agree with, because it is true. All of us are way more than our past, our thoughts and how we feel in a given moment.
· Committed Action
Finally, committed action involves a client taking concrete steps to incorporate changes into their lives that will align with their values and lead to positive changes. For example, the client could do some goal setting, skill development or expose themselves to difficult thoughts and experiences.
When Is Acceptance and Commitment Therapy Used?
Lastly, Acceptance and Commitment Therapy is a useful therapy for a wide range of mental as well as physical conditions. For instance, depression, anxiety disorders, psychosis, eating disorders, workplace stress, chronic pain, substance use disorders and obsessive-compulsive disorder.
Clinical Psychology Conclusion
I have to admit that I have rather liked this podcast episode because I have heard a lot about Acceptance and Commitment Therapy over the years through my lectures, but it is only now that I have learnt about the therapy in any great depth. And I know I say this in a lot of these therapy-based podcast episodes, but I think a lot of these concepts can be transplanted into other therapies too.
For instance, the idea of getting your client to accept that their experiences aren’t something to be avoided, cured or ashamed of. That is nothing new and I know that is a large part of Cognitive Behavioural Therapy, which is where this therapy stems from in the first place.
Equally, getting a client to commit to taking actionable and concrete steps to improve their lives. Again, I don’t exactly think that is anything new because surely that is the same as a client having a capacity to change.
Therefore, if you like the idea of acceptance and commitment but you don’t practice Acceptance and Commitment Therapy, then maybe think about incorporating those concepts into your own practice in the future. It’s just an idea but I know it’s something interesting to think about.
What do you think?
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Cognitive Psychology: A Guide To Neuroscience, Neuropsychology and Cognitive Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Have a great day.
Clinical Psychology References
Blackledge, J. T., & Hayes, S. C. (2001). Emotion regulation in acceptance and commitment therapy. Journal of clinical psychology, 57(2), 243-255.
Brown, M., Glendenning, A., Hoon, A. E., & John, A. (2016). Effectiveness of web-delivered acceptance and commitment therapy in relation to mental health and well-being: a systematic review and meta-analysis. Journal of medical Internet research, 18(8), e221.
Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2007). A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior modification, 31(6), 772-799.
Harris, R. (2006). Embracing your demons: An overview of acceptance and commitment therapy. Psychotherapy in Australia, 12(4), 70-6.
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.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford press.
Hernández-López, M., Luciano, M. C., Bricker, J. B., Roales-Nieto, J. G., & Montesinos, F. (2009). Acceptance and commitment therapy for smoking cessation: a preliminary study of its effectiveness in comparison with cognitive behavioral therapy. Psychology of Addictive Behaviors, 23(4), 723.
Karlin, B. E., Walser, R. D., Yesavage, J., Zhang, A., Trockel, M., & Taylor, C. B. (2013). Effectiveness of acceptance and commitment therapy for depression: Comparison among older and younger veterans. Aging & mental health, 17(5), 555-563.
Livheim, F., Hayes, L., Ghaderi, A., Magnusdottir, T., Högfeldt, A., Rowse, J., ... & Tengström, A. (2015). The effectiveness of acceptance and commitment therapy for adolescent mental health: Swedish and Australian pilot outcomes. Journal of Child and Family Studies, 24, 1016-1030.
Pears, S., & Sutton, S. (2021). Effectiveness of Acceptance and Commitment Therapy (ACT) interventions for promoting physical activity: a systematic review and meta-analysis. Health psychology review, 15(1), 159-184.
Powers, M. B., Zum Vörde Sive Vörding, M. B., & Emmelkamp, P. M. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and psychosomatics, 78(2), 73-80.
Strosahl, K. D., Hayes, S. C., Bergan, J., & Romano, P. (1998). Assessing the field effectiveness of acceptance and commitment therapy: An example of the manipulated training research method. Behavior Therapy, 29(1), 35-63.
Twohig, M. P., & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: a review. Psychiatric clinics, 40(4), 751-770.
Wilson, K. G., & Murrell, A. R. (2004). Values work in acceptance and commitment therapy. Mindfulness and acceptance: Expanding the cognitive-behavioral tradition, 120-151.
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