Types of Psychotherapy: Acceptance and Commitment Therapy

When learning about modern psychotherapy approaches you will often come across the term mindfulness, which can be summarized as the practice of observing what is happening without judging those observations.

Over the last 50 years, the western world has increasingly incorporated the idea of mindfulness into various psychotherapy approaches. The spirit behind this change has been to introduce new, less deprecatory, ways for patients to think about their mental health challenges and the approaches to navigating them.

Acceptance and Commitment Therapy (ACT) is a modality where the therapist first helps guide someone through using mindfulness to recognize, without judgement, their thoughts and behaviors. Likewise, time can be spent on learning to observe, without judgement, patterns of thoughts and behaviors.

Once this skill is established, sessions are spent introducing the idea that a patient's energy should not be spent on labelling thoughts or behaviors as "good" or "bad", nor on attempting to extinguish them. Rather, now that the patient can forthrightly discuss what they are experiencing, their energy should be spent on how to choose a direction moving forward that aligns with their goals and values.

One criticism of ACT is that the modality uses skills and approaches that are shared amongst many other modalities. For instance, both dialectical behavioral therapy (DBT) and cognitive behavioral therapy (CBT) introduce and frequently utilize mindfulness techniques while helping a patient develop a psychotherapeutic treatment plan.

In my opinion, cleanly delivered ACT dedicates considerably more time and emphasis to the patient being comfortable and skilled at observing their own thoughts and behaviors accurately and nonjudgmentally. There is less focus on moving towards changes in behavior quickly, since any planning by the patient must be based on accurate observations to be helpful. Therefore, choosing ACT as the correct modality for a particular patient may only be a reflection of where skills development needs to be initially focused.