Gary DeVine’s Blog on Faith-Based Therapy

What is Acceptance and Commitment Therapy?

Written by: Gary DeVine

August 23, 2023

We at DeVine Interventions Group combine different therapeutic approaches to help people heal. Our primary approach is Acceptance and Commitment Therapy (ACT). ACT practitioners call it third-wave behaviorism, the second wave being Cognitive Behavioral Therapy (CBT). Many CBT therapists themselves add ACT methods to their repertoire. Over 1,000 randomized controlled trials have demonstrated the efficacy of ACT in relieving psychological problems such as substance abuse, anxiety disorders, and chronic pain.

ACT therapists believe psychological inflexibility is the primary cause of psychological suffering. Psychological inflexibility is when psychological reactions dictate our actions instead of us making choices based on our values. These reactions are a dysfunctional attempt to protect the person from psychological suffering.

Six basic processes cause psychological inflexibility: another type of inflexibility (attentional, emotional, or cognitive), faulty perspective, lack of values, and perpetual inability to live according to our values. To address these, ACT identified six processes to promote psychological flexibility. We will briefly explore each process, but first, we need to know more about Acceptance and Commitment Therapy.

ACT is a form of behaviorism that integrates human language and cognition with behavior. The theory of language and cognition is called Relational Frame Theory (RFT). RFT is difficult to understand, and it is unnecessary to explain it here. Instead, we will use a simplified example.  

Imagine my 5-year-old son sees a cat and tries to pet it, but the cat scratches him. His brain will “frame” the cat with pain. Psychological inflexibility occurs if my son now frames all cats with pain.

My son would have a phobia of cats because he is psychologically inflexible in core psychological processes. We cannot undo phobias and other inflexible processes; instead, we must replace them with more flexible processes.

The ACT therapist provides tools to increase the six core processes, which will increase psychological flexibility:

  • Values: Some call these morals, such as honesty, love, faith, or loyalty. The therapist helps their client clarify their values.
  • Committed Action: Committed action creates a clear goal based on the client’s values. It is helpful for clients who express their values moment-to-moment rather than achieving them.
  • Acceptance: We all have painful feelings, memories, or other internal events that we wish we could forget. Acceptance and Commitment Therapy teaches us to embrace inner pain actively. Rather than complacency, acceptance is an active willingness to allow because avoidance or resistance only creates more problems.
  • Cognitive Defusion: Remember the story about my son and the cat? When my son frames the cat with pain, he fuses the two. ACT teaches us methods to defuse because the fusion creates problems for us.
  • Being Present: Think of the contemporary adage “Be here now.” Present-moment awareness is the alternative to multitasking, regretting the past, or worrying about the future. We sometimes need to multitask, plan for our futures, or reminisce. However, present-moment awareness is healthier for your brain and relationships and increases cognitive flexibility.
  • Self as Context: We typically live in relational frames, such as I vs. you, now vs. then, or here vs. there. Your sense of self includes perspective-taking, which causes this relational experience. In ACT, the self is the context, not the content, of perspective. 
    • In practice, this means being aware of your experiences in a detached manner that decreases your investment in said experiences. Detached awareness fosters acceptance and defusion.
    • Self as context is incompatible with my beliefs and the beliefs of many of my clients. As a Buddhist belief, it may be helpful for other clients. Therefore, I use mindfulness exercises, metaphors, and other self as context practices that do not require you to believe it. These methods increase aspects of spirituality, such as transcendence, sense of self, and empathy, while fostering acceptance and defusion.  

Most of my clients identify as Christian or are culturally Christian if they are non-religious. For this reason, DeVine Interventions Group takes a Christian approach to ACT. You can learn more about that HERE.