Overview
What is it?
Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that combines acceptance and mindfulness strategies with commitment and behavior-change techniques. It aims to help individuals increase their psychological flexibility, allowing them to accept unavoidable negative thoughts and feelings while committing to actions that align with their personal values and goals. ACT is not naturally occurring but is a structured therapeutic approach developed within the framework of cognitive-behavioral therapy (CBT) .
How does it work?
ACT works by encouraging individuals to embrace their thoughts and feelings rather than fighting or feeling guilty for them. It focuses on six core processes: acceptance, cognitive defusion, being present, self-as-context, values, and committed action. By practicing mindfulness and acceptance, individuals learn to reduce the impact of negative thoughts and emotions, allowing them to focus on meaningful actions that improve their quality of life. This approach helps alleviate depression by reducing the struggle with negative emotions and promoting actions that align with personal values .
What are the benefits?
ACT has been shown to reduce symptoms of depression by promoting acceptance of negative thoughts and feelings and encouraging actions that align with personal values. Research indicates that ACT is effective in managing depression, with studies showing significant reductions in depressive symptoms compared to control groups. It also improves psychological flexibility, which is the ability to adapt to difficult situations and maintain focus on long-term goals. Additionally, ACT has been found to be as effective as traditional CBT in treating depression, making it a valuable alternative for those who may not respond well to other therapies .
Effectiveness
What does the research say?
Research supports the efficacy of ACT for managing depression. A meta-analysis of 36 randomized controlled trials (RCTs) found that ACT is more effective than waitlist conditions and treatment-as-usual, with effects comparable to traditional CBT. ACT has been shown to reduce depressive symptoms significantly, with improvements in psychological flexibility being a key factor in its success. Studies also indicate that ACT can be particularly beneficial for individuals with chronic conditions, such as chronic pain or cancer, where depression often co-occurs .
Side Effects
Rare adverse events
Serious adverse events are rare, with only one reported case (bypass surgery) in an ACT group, which was unlikely related to the intervention .
Minor discomfort during mindfulness exercises
Some individuals may experience minor discomfort or frustration when practicing mindfulness exercises, especially if they are new to these techniques .
Emotional distress when confronting difficult thoughts
Confronting difficult thoughts and emotions during therapy can sometimes lead to temporary emotional distress, but this is typically part of the therapeutic process and resolves over time .
Evidence
Clinical Studies & Trials
[1] Mindfulness-Based Cognitive Therapy, Acceptance and Commitment Therapy, and Positive Psychotherapy for Major Depression
This review synthesizes evidence for mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and positive psychotherapy (PPT) in treating major depression.
View study[2] Comparative efficacy of 11 non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for informal caregivers of people with dementia: A systematic review and network meta-analysis
This study evaluates the effectiveness of non-pharmacological interventions, including ACT, for depression and anxiety in informal caregivers of people with dementia.
View study[3] Acceptance and Commitment Therapy as a Treatment for Anxiety and Depression: A Review
This article reviews the core features of ACT and its efficacy in treating depression and anxiety, summarizing 36 RCTs.
View study[4] [Acceptance and commitment therapy]
This paper discusses ACT as a third-generation cognitive-behavioral therapy, focusing on improving psychological flexibility.
View study[5] Acceptance and Commitment Therapy (ACT) for Chronic Pain: A Systematic Review and Meta-Analyses
This review examines the effectiveness of ACT for chronic pain, including its impact on depression and anxiety.
View study[6] Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy for Depressive Disorders
This paper explores the role of mindfulness-based therapies, including ACT, in treating depressive disorders.
View study[7] Acceptance and commitment therapy versus mindfulness-based stress reduction for newly diagnosed head and neck cancer patients: A randomized controlled trial assessing efficacy for positive psychology, depression, anxiety, and quality of life
This study compares ACT and mindfulness-based stress reduction (MBSR) for depression and anxiety in cancer patients.
View study[8] Effects of group Acceptance and Commitment Therapy (ACT) on anxiety and depressive symptoms in adults: A meta-analysis
This meta-analysis examines the effects of group ACT on anxiety and depressive symptoms in adults.
View study[9] Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review
This review evaluates the effectiveness of ACT and other mindfulness-based interventions for chronic pain, including their impact on depression.
View study[10] Acceptance and Commitment Therapy for Chronic Pain: An Overview of Systematic Reviews with Meta-Analysis of Randomized Clinical Trials
This overview summarizes evidence from systematic reviews and meta-analyses on the efficacy of ACT for chronic pain, including its effects on depression.
View study[11] The Efficacy of Acceptance and Commitment Therapy for Chronic Pain: A Systematic Review and Meta-analysis
This systematic review and meta-analysis investigates the efficacy of ACT for chronic pain, including its impact on depression.
View study[12] A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders
This meta-analysis evaluates the effectiveness of ACT and other mindfulness-based interventions for anxiety disorders, including their impact on depression.
View study[13] Management of Anxiety and Depression in Adult Survivors of Cancer: ASCO Guideline Update
This guideline update discusses the management of anxiety and depression in cancer survivors, including the use of ACT.
View study