Acceptance & Commitment Therapy (ACT)

Susie McAfee, Ph.D.


I'm glad you came.

There are two versions of the ACT model. One displaying adaptive human traits (above) and the flip side (below), where behaviour becomes less functional and problematic. The hexaflex, as its lovingly known, describes both the healthy and unhealthy self, as well as providing an intervention road map! ACT has been evaluated in thousands of randomized controlled trials demonstrating its efficacy with almost every known psychiatric and behavioural problem from smoking cessation to schizophrenia. ACT is trans-diagnostic, meaning you don't need a label to benefit from the approach but it still works if you have a diagnosis. It also means that ACT therapists will help you focus on what matters most in your life rather than on the symptoms that hold you back. In the ACT world we like to say "how are you living?" not "how are you feeling?" because we know when you're living well, you feel better and if you wait to feel better you may never get to the living better.

ACT therapy focuses on 6 specific processes that interact with one another so we're really working on more than one at a time in each session. The ability to jump fluidly around the model makes ACT therapy much more dynamic and creative than other types of psychotherapy. It's not surprising that the process of therapy itself is quite flexible with ACT because "PSYCHOLOGICAL FLEXIBILITY" is the skill ACT therapist are trying to help our clients (and ourselves) cultivate. Psychological flexibility allows us to be increasingly aware of the environment around us and within us so that we can use what we have noticed in order to come up with behavioural responses. Most of use respond to situations with a small number of fairly automatic responses that we have learned over time. ACT allows us to enhance our mindful awareness so that we can generate more options and more unique ideas in everyday situations. By responding in new ways we begin to change our interactions with the world around us and with our own internal world. Once you begin this process you will find new and unexpected opportunities present themselves leading to the next step. There really are no boundaries! However, sometimes it takes a while to get there. If you are very stuck in negative patterns or carry a lot of pain from the past ACT is an excellent choice of therapy because we work on releasing the grip of difficult thoughts and emotions through acceptance and defusion work. For those who are less burdened we can start with values and committed action work. That being said sometimes the most "stuck" client moves through it quickly with a bit of values work and some who just came to move forward with action discover emotional wounds buried beneath the surface and a need to slow down into the acceptance work. You just never know but the beauty of ACT is that it is flexible!!!