Acceptance and Commitment Therapy (ACT)

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Acceptance and Commitment Therapy (ACT)

Evidence Status: Evidence-supported

Medically reviewed · Dr. Sarah Whitfield, PsyD · Sunday, 16 August 2026

A therapy that combines acceptance and mindfulness strategies with commitment to behavior change guided by a person’s core values.

What Is Acceptance and Commitment Therapy (ACT)?

Acceptance and commitment therapy (ACT) is a form of psychotherapy that encourages psychological flexibility by helping people accept difficult thoughts and feelings rather than struggling against them, while committing to actions aligned with their personal values. It differs from therapies focused primarily on directly changing thought content by emphasizing one’s relationship to thoughts and feelings.

How It Works

ACT is based on the idea that psychological suffering often stems from experiential avoidance and rigid attachment to unhelpful thoughts. Therapists use mindfulness-based exercises, values clarification, and behavioral commitment strategies to help clients respond to internal experiences with greater openness while pursuing meaningful goals. This description reflects general ACT principles using original language.

What Happens During Therapy?

Sessions often include exercises to build present-moment awareness, defusion techniques for stepping back from unhelpful thoughts, and exploration of personal values to guide goal-setting. Clients may be given practice exercises to build acceptance and value-based action between sessions.

Evidence and Effectiveness

Research supports ACT for a range of conditions, including depression, anxiety disorders, and chronic pain, with evidence generally comparable to other established psychotherapies such as CBT. Evidence for some applications, such as psychosis and certain physical health conditions, is more emerging and continues to develop.

Who May Benefit?

ACT may be considered as part of an individualized treatment plan for people experiencing anxiety, depression, chronic pain, or difficulty tolerating distressing internal experiences, particularly those drawn to a values-based, mindfulness-oriented approach.

Limitations and Considerations

ACT involves abstract concepts, such as psychological flexibility and cognitive defusion, that may take time to understand and apply. Availability of ACT-trained clinicians can vary by region, and evidence strength differs across specific conditions.

Finding a Qualified Therapist

ACT is practiced by psychologists, licensed clinical social workers, licensed mental health counselors, and other mental health professionals with training in ACT-specific techniques. Asking about specific ACT training and experience can help identify a well-suited provider.

How Long Does Therapy Take?

ACT can be delivered in both brief and longer-term formats; some studies use protocols of around 8 to 16 sessions, but treatment length varies according to the person, condition, severity, goals, clinician, and treatment setting.

Therapy vs. Medication

For conditions such as depression and anxiety, ACT and medication are not necessarily competing options. Depending on the condition, ACT may be used alone, medication may be used alone, or both may be combined; decisions should be made with a qualified healthcare professional.

What Conditions Is It Used For?

Generalized Anxiety Disorder

A persistent pattern of excessive, difficult-to-control worry about everyday events and activities.

Major Depressive Disorder

A mood disorder involving persistent sadness or loss of interest that interferes with daily life for at least two weeks.

Social Anxiety Disorder

A condition involving marked fear or anxiety about social situations in which a person may be scrutinized or judged by others.

Related Therapy Types

Cognitive Behavioral Therapy (CBT)

A structured, time-limited psychotherapy that helps people identify and change unhelpful thought patterns and behaviors that contribute to emotional distress.

Mindfulness-Based Cognitive Therapy (MBCT)

A structured group therapy combining mindfulness meditation practices with cognitive therapy techniques, primarily used to prevent depression relapse.

Compassion-Focused Therapy (CFT)

A therapy that helps people develop self-compassion and reduce shame and self-criticism using techniques drawn from evolutionary psychology and mindfulness.

Medical Information Disclaimer

Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.

References

  • American Psychological Association. Clinical Practice Guidelines.
  • American Psychiatric Association. Practice Guidelines.
  • National Institute of Mental Health. Psychotherapies.