ACT Therapy Mental Health Benefits: How Acceptance and Commitment Training Transforms Anxiety and Depression

The majority of mental health therapies are based on symptom reduction. Acceptance and commitment therapy works differently. Instead of trying to get rid of anxiety, depression, or challenging thoughts, ACT helps develop the psychological ability to experience them without them dominating, and to act on what is important without worrying about what the mind is doing. The mental health benefits of the ACT therapy that have been reported in hundreds of clinical trials are not of a symptom reduction type, although in most cases, such is the result.

What Is Acceptance and Commitment Therapy and How Does It Work?

Acceptance and commitment therapy is a third-wave cognitive behavioral therapy based on six processes: acceptance, defusion, present moment awareness, self-as-context, values, and committed action. The Association of Contextual Behavioral Science (ACBS) identifies a single umbrella mechanism of psychological flexibility that generates mental health benefits of ACT therapy: the ability to be completely present in the present experience, the ability to observe internal events without being dictated by them, and the ability to act in service of what matters instead of what the mind is urging.

The Core Principles Behind Psychological Flexibility

The six processes of psychological flexibility in ACT are based on interlocking processes:

• Acceptance. Willingly experiencing painful thoughts and emotions without trying to change, avoid, or suppress them.
• Cognitive defusion. Viewing thoughts as mental states, and not facts, lessens their influence on behavior.
• Present moment awareness. Full and flexible attention to what is happening now, as opposed to living mainly in the realm of mental time.
• Self-as-context. Viewing experience in a non-turbulent point of view that is not characterized by a specific thought, feeling, or role.
• Values clarification. What really counts and what path of life exemplifies the values.
• Committed action. Taking concrete steps aligned with values and goals despite difficult internal experiences.

ACT Therapy for Anxiety Disorders: Breaking the Cycle of Avoidance

Avoidance is the primary mechanism of maintaining anxiety disorders: the behavioral approach of minimizing exposure to feared internal and external stimuli that short-term relieves but increases the anxiety in the long-term. The mental health benefits of ACT therapy for anxiety act by altering the attachment to the anxiety and avoidance, which sustains it. The American Psychological Association (APA) reports that ACT has similar results to CBT on anxiety disorders and can be beneficial to individuals whose anxiety is mainly in the form of experiential avoidance, rather than in the form of distorted beliefs, especially when the anxiety is of an internal nature such as physical sensation, emotions, or thoughts, as opposed to an external situational nature.

Managing Depression Through Values-Based Living and Commitment

Behavioral withdrawal sustains depression: the progressive withdrawal of involvement in activity that once brought meaning, attachment, and positive reinforcement. The mental health benefits of ACT therapy on depression do not attempt to improve the mood, but rather seek to determine what the person values and take committed action to that value, independent of the mood.

Mindfulness Techniques and Present-Moment Awareness in Treatment

The mental strategies in ACT are actually designed to develop psychological flexibility as opposed to relaxation or optimal performance. Contact with the present moment exercises and defusion exercises, which make current experience fully engaged and believable, respectively, and self-as-context practices, which develop the stable observing perspective with which all ACT work is done, are the practices of ACT mindfulness.

Building Emotional Regulation Skills Through Acceptance Practices

The paradoxical approach of diminishing the secondary suffering caused by fighting emotions establishes emotional regulation capacity by acceptance practices in ACT. As soon as a person ceases his/her fighting with a painful emotional condition, the emotional condition reaches its peak and passes more quickly than when it is actively opposed.

The Role of Cognitive Defusion in Reducing Anxious Thoughts

One of the most unique and clinically beneficial ACT therapy mental health advantages is cognitive defusion.

The ACT therapy mental health benefits toolkit includes defusion techniques such as:

• Naming the process. Having the thought that I am going to fail, instead of identifying with the thought as a fact.
• Thanking the mind. Momentarily recognizing a repetitive, unhelpful thought and refusing to participate in the thought anymore.
• Physicalization. Putting the thought in the form of shape, color, and texture to feel it as an object, but not a reality.

Psychological Flexibility as the Foundation for Mental Health Recovery

All the ACT therapy mental health benefits are mediated by psychological flexibility, and the main objective of ACT treatment is to increase psychological flexibility. The following table illustrates the contribution of each of the six ACT processes to psychological flexibility and the appearance of the lack of one of them in a clinical picture:

Personalized Mental Health Treatment Plans at Kentucky Wellness

Kentucky Wellness offers acceptance and commitment therapy, which is a part of a holistic and individualized approach to mental health treatment. Our clinicians are trained in ACT and apply its fundamental processes to an individual treatment plan that is aligned with the individual presentation, goals, and values of each person. Mental health benefits of ACT therapy are best when administered by a clinician who is capable of tailoring the interventions to the patient and not using a general protocol for a diagnosis tag.

Contact Kentucky Wellness to speak with a care specialist about ACT therapy, mental health benefits, and personalized treatment options.

FAQs

1. Can ACT therapy treat anxiety without focusing solely on symptom elimination?

Yes, and this is one of the most valuable ACT therapy mental health benefits to people whose anxiety has not been responsive to symptom-focused therapies: ACT treats anxiety by developing the ability to experience anxiety without its control and to act in values-congruent ways despite its existence; symptom reduction may occur as a byproduct, but it is not the treatment target. The studies indicate that ACT has similar effects to CBT in the treatment of anxiety disorders and that it accomplishes the same using a radically different mechanism.

2. How quickly does psychological flexibility improve emotional regulation in depression treatment?

Significant gains in psychological flexibility can be expected to be noticed in four to six weeks of regular ACT exercises, with the defuse and acceptance portions having the quickest initial impact by decreasing the struggle with depression that worsens its severity. The elements of values clarification and committed action require more time to gain momentum but have the greatest long-term benefits, and follow-up studies indicate that the gains of values-based living continue to improve once the therapy ends, as values-based living becomes more entrenched.

3. What makes cognitive defusion more effective than traditional thought-stopping techniques?

The thought-stopping methods aim to stop or reduce unwanted thoughts, but actually cause more and more of them to occur, due to the rebound effect: the conscious effort not to think a particular thought leads to more and more frequent occurrences of that thought. Cognitive defusion does not attempt to eliminate thoughts but to alter their association with behavior, where they are less controlling but do not have to be stopped. This method can be said to work in harmony with the brain’s natural thought generation instead of counteracting it, resulting in a sustainable reduction of the effect of anxious thought without the counteracting effects of suppression.

4. Does mindfulness in ACT differ from standard meditation practices?

The development of psychological flexibility processes of defusion, present moment awareness, and self-as-context is specifically created to achieve mindfulness in ACT, unlike a wellness practice or a relaxation technique. The ACT mindfulness practices are explicitly associated with values and action taken in commitment, and as such, they are instrumentally directed to the type of life that the individual wishes to establish and not to the meditative state.

5. How do values-based commitments create lasting mental health improvements?

Values-based commitments provide enduring psychological health gains by providing psychological flexibility with something to serve, instead of being a set of neutral skills to be applied or discarded depending on the level of symptoms. Once an individual is clear about what they desire in their lives and has developed behavioral patterns that lead to those values, the personal drive to keep the psychological work going despite the tough times that are bound to come will be maintained, thereby preventing relapse. This is due to the fact that ACT therapy mental health benefits at long-term follow-up tend to be greater in comparison to those at the end of treatment.