Therapeutic Aproaches - Acceptance and Commitment Therapy (ACT)
You don’t have to get rid of hard thoughts to move forward
Acceptance and Commitment Therapy (ACT) is a research-backed approach that shifts the goal from eliminating painful thoughts and feelings to changing how you relate to them. The premise is that trying to suppress or avoid what’s uncomfortable often makes it worse. ACT teaches you to acknowledge what’s showing up without letting it run your life, and to focus your energy on the things that genuinely matter to you.
What this can feel like
People who benefit from ACT often describe:
- Anxiety and worry that keeps circling back no matter how much you try to manage it
- Depression, including feeling disconnected from meaning or motivation
- Chronic pain and the emotional toll it takes
- OCD and intrusive thoughts
- Stress, burnout, and overwhelm
- Life transitions and identity questions
- Relationship difficulties
- Trauma and grief
- Low self-esteem and self-criticism
Why this happens
Trying to suppress or avoid what’s uncomfortable often makes it worse. The struggle to control inner experience is often what creates and maintains suffering, not the thoughts and feelings themselves. When avoidance becomes the main coping strategy, it works just enough in the short term to keep you doing it, but over time it tends to narrow your world rather than expand it.
How acceptance and commitment therapy can help
ACT is built around six core processes that work together to build psychological flexibility, the ability to be present with your experience and still act in line with your values.
- Acceptance: Allowing difficult thoughts and feelings to exist without fighting them
- Defusion: Learning to step back from thoughts rather than being swept away by them
- Present-moment awareness: Paying attention to what’s actually happening now instead of living in your head
- Self-as-context: Recognizing that you are not your thoughts, you’re the person who notices them
- Values clarification: Identifying what genuinely matters to you, not what you think should matter
- Committed action: Taking steps toward the life you want, even when discomfort is present
Sessions may include mindfulness exercises, reflection on your personal values, and practical skill-building between appointments. Your therapist might invite you to notice what shows up when you try to push a thought away and explore what happens when you let it be there instead. It’s collaborative and practical. You won’t be told what to think. You’ll be supported in finding a different relationship with your own mind.
How Ellie makes support more accessible
- Therapist matching: We connect you with a therapist experienced in ACT and the areas you’re working through
- Insurance support: We help you understand your coverage before your first session
- In-person and telehealth: Sessions available in clinic or virtually, depending on what works for your life
- Flexible scheduling: We work around real schedules, not ideal ones
- No pressure: You can come in not knowing much about ACT — your therapist will walk you through it
Frequently Asked Questions for Acceptance and Commitment Therapy (ACT)
Not sure what to expect? These are the questions people ask us before they get started.
ACT incorporates mindfulness as a core component, but it goes further. Mindfulness in ACT is a tool in service of values-based action — not just present-moment awareness for its own sake. ACT also includes specific work around defusion, acceptance, and committed action that distinguish it from mindfulness-based approaches alone.
CBT focuses on identifying and changing unhelpful thought patterns. ACT takes a different angle — rather than trying to change the content of your thoughts, it works on changing your relationship to them. Both have strong evidence; some people find ACT more helpful when traditional thought-challenging hasn’t stuck.
It depends on what you’re working through. Some people see meaningful shifts in a matter of months. Others engage in longer-term work. Your therapist will help you set goals and check in on progress along the way.
Not exactly — but you do need to be open to trying things that might feel counterintuitive at first, like moving toward discomfort rather than away from it. Your therapist will explain the rationale and go at a pace that makes sense for you.
Yes. ACT has a strong evidence base for anxiety, and many people find it helpful precisely because it offers a different approach than what they’ve tried before. The goal isn’t to stop feeling anxious — it’s to stop letting anxiety run the show.
ACT has been adapted for children and adolescents and can be effective for younger clients depending on the therapist’s approach and the specific situation. Ask about this when you reach out and we can help you find the right fit.