ACCEPTANCE and COMMITMENT THERAPY
"We teach what we practice, we practice what we teach."
Page last updated 19 October 2012. Click your browser's Refresh button to ensuer you get the latest information.
Therapist Training brought Kelly Wilson and Robyn Walser to Australia to conduct the first ACT trainings here. Since then there have been more Australian workshops teaching Acceptance and Commitment Therapy (ACT) than any other approach to therapy. Of concern to us has been feedback from many people we have met whilst presenting other workshops around the country that in many cases ACT has been presented in an excessively "evangelical" manner. ACT is not the be all and end all of therapy, indeed it's developers caution against seeing it as such. We must not forget that much good therapy was done before ACT came along. You don't have to abandon that base when you do ACT, you can build on it. It's about promoting therapist flexibility, not therapist rigidity.
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.
ACT is one of the so called "Third Wave" behavioural therapies. A 2006 paper by Hayes et al. summarises the ACT model, processess and outcomes of ACT. We will expand these themes throughout the workshop. Read this paper thoroughly.
Experiential Avoidance is a key concept in ACT. It refers to the normal human tendency to try to avoid or control unwelcome internal experiences such as distressing memories, images, limiting or negative thoughts, distressing 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. You should read this paper, a citation classic in the field, before attending the workshop: Hayes, Wilson, et al. on Experiential Avoidance
The Contextual Psychology website is the key repository for information on ACT. Take some time to explore this site. You can join the Association for Contextual Behavioural Science for a nominal amount, and get access to a huge range of resources.
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 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.