ACCEPTANCE & COMMITMENT THERAPY

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Acceptance and Commitment Therapy (ACT said as a word) is one of the so-called Third Wave Behaviour Therapies, along with Dialectical Behaviour Therapy (DBT), Mindfulness-Based Cognitive Therapy and others.  ACT is unique amongst these developments because it is the direct clinical application of a solid theoretical foundation that has considerable empirical and experimental support.

David Barlow, famous for his work on anxiety, and developing the scientist-practitioner model, writes of ACT

“Once in a while, there is a unique contribution to psychotherapy.  Even more rare is the grounding of that contribution in sound philosophy, on the one hand, and firm data on the other.  Acceptance and Commitment Therapy represents such an effort.  In a truly creative leap forward, the authors present a new approach to behaviour change that is “must” for everyone in the field of psychotherapy….. Challenging the assumptions and methods of cognitive therapy, this is amongst the most significant new approaches to behaviour change of the past three decades.”

 ACT uses metaphor, paradox, mindfulness, acceptance skills and experiential exercises to undermine the power of destructive cognitive, emotive and behavioural processes.  It helps clients create a rich, full and meaningful life, to take action guided by their deepest values, and to free themselves from the grip of self-limiting thoughts, painful memories, negative emotions and painful bodily experiences. 

The Contextual Psychology website is the key repository for information on ACT.  Take some time to explore this site.  

 Hayes, Wilson, et al. on Experiential Avoidance (PDF document, 29 pages)  Destined to be a citation classic, this paper describes a key concept in ACT.  Experiential Avoidance is the human tendency to try to avoid (control) unwelcome internal experiences such as distressing memories, images, negative emotions, body sensations, etc.  Such attempts may meet with short term success (e.g., drinking, distractions, dissociation, behavioural, cognitive and emotional  avoidance) but such 'solutions' often magnify problems in the longer term. 

A study  which demonstrates the power of ACT describes a brief (4 hour) intervention which reduced subsequent re-hospitalisation of psychotic patients rates by 50%.  To read this paper in full, see  Bach & Hayes (2002) (PDF, 11 pages).

Another recent study is that of Dahl, Wilson & Nilsson (Behavior Therapy, 2004)  who compared a brief (4 x 1 hour) ACT treatment with a conventional multi-disciplinary treatment for nurses at risk of going on long term sick leave due to work related injury.  Mean number for sick days taken in the 6 month period post-intervention was 0.5 for the ACT group, 56 for the treatment as usual group.  That is not a typo error, it really was 0.5 vs 56.