Guide
ACT (acceptance and commitment therapy) is one of the third-wave CBT approaches. Its aim isn’t to make difficult thoughts or emotions disappear, but to help you live a life that matters to you, even when they are there.
The central idea: psychological flexibility
When we suffer, we tend to fight what we feel or avoid it. In the moment it brings relief; in the long run, life shrinks. ACT offers another way: being in contact with the present moment, making room for what is there and acting according to your values. This is what is called psychological flexibility.
A little theory · Psychological flexibility is the ability to stay in contact with the present moment, including what is unpleasant, and to change or maintain your behaviour according to what matters to you (Hayes et al., 2006). It isn’t a fixed trait: it can be trained.
Six ways to develop it
- Being present: coming back to what is happening here and now, instead of being carried away by the past or the future.
- Accepting: making room for difficult emotions and sensations instead of fighting them.
- Stepping back from your thoughts (defusion): seeing thoughts as thoughts, not as facts or orders.
- The observing self: noticing that there is a part of you that observes your experiences without being reduced to them.
- Values: knowing what matters to you, the direction you want to give your life.
- Committed action: taking small, concrete steps in that direction, even with discomfort.
To keep it simple, the six processes can be grouped into three: being open, being present and being engaged.
A little theory · ACT has been studied in hundreds of controlled trials. Reviews of meta-analyses show useful effects on anxiety, depression, chronic pain and substance use, often comparable to those of other forms of CBT (A-Tjak et al., 2015; Gloster et al., 2020).
What ACT is not
It isn’t “positive thinking”, resignation, or putting up with anything. Accepting your emotions doesn’t mean accepting an unfair situation: it means stopping an exhausting inner struggle, so that you keep your energy for acting.
What a session looks like
We start from your concrete situation: what you avoid, what you find hard, what matters to you. We practise with short exercises (mindfulness, metaphors, small experiments) and decide together on a small step for the week. It isn’t a lecture: it is practice.
How to start
Choose one of the worksheets below, depending on what speaks to you most. If you are in therapy, your psychologist can tell you which one to start with.
Watch: short videos
- The Choice Point, by Russ Harris: the “choice point” of worksheet 35.
The videos open on YouTube. They complement this guide and are no substitute for support.
Worksheets to practise
- 26 · Thank you, mind · Thanking your mind and naming its stories (defusion)
- 29 · Dropping the rope · Stopping the tug-of-war with the anxiety monster (acceptance)
- 31 · The sky and the weather · Discovering you are bigger than your thoughts and emotions (observing self)
- 34 · The values target · Measuring the gap between values and life, area by area
- 35 · The choice point · Noticing whether I am moving towards or away from what matters to me
- 36 · The ACT matrix · A four-box map to find your bearings (matrix)
Sources
Hayes, S. C., Strosahl, K. D. & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford.
Harris, R. (2019). ACT Made Simple: An Easy-to-Read Primer on Acceptance and Commitment Therapy (2nd ed.). New Harbinger.
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.
A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J. & Emmelkamp, P. M. G. (2015). A meta-analysis of the efficacy of Acceptance and Commitment Therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30-36.
Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P. & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181-192.
These worksheets do not replace therapy. If you are in distress or having suicidal thoughts, call your local emergency number (112 in Europe; 3114 in France, free, 24/7).
