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Acceptance and commitment therapy

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Acceptance and commitment therapy

Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of psychotherapy, as well as a branch of clinical behavior analysis. It is an empirically-based psychological intervention that uses acceptance and mindfulness strategies along with commitment and behavior-change strategies to increase psychological flexibility.

This approach was first called comprehensive distancing. Steven C. Hayes developed it around 1982 to integrate features of cognitive therapy and behavior analysis, especially behavior analytic data on the often negative effects of verbal rules and how they might be ameliorated.

The foundational concepts of ACT were formally introduced in Steven C. Hayes’s 1987 article “A contextual approach to therapeutic change: Toward a functional analysis of human language,” published in Behavior Therapy. He did not yet name the approach “Acceptance and Commitment Therapy.” The term ACT began to appear in print in the early 1990s, as the model became more developed. The first major use in a formal publication was in the 1999 book: Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change.

ACT protocols vary with the target behavior and the setting. For example, in behavioral health, a brief version of ACT is focused acceptance and commitment therapy (FACT).

The goal of ACT is not to eliminate difficult feelings but to be present with what life brings and to "move toward valued behavior". Acceptance and commitment therapy invites people to open up to unpleasant feelings, not to overreact to them, and not to avoid situations that cause them.

Its therapeutic effect aims to be a positive spiral, in which more understanding of one's emotions leads to a better understanding of the truth. In ACT, "truth" is measured through the concept of "workability", or what works to take another step toward what matters (e.g., values, meaning).

ACT is developed within a pragmatic philosophy, functional contextualism. ACT is based on relational frame theory (RFT), a comprehensive theory of language and cognition that is derived from behavior analysis. Both ACT and RFT are based on B. F. Skinner's philosophy of radical behaviorism.

ACT differs from some kinds of cognitive behavioral therapy (CBT) in that, rather than try to teach people to control their thoughts, feelings, sensations, memories, and other private events, ACT teaches them to "just notice", accept, and embrace their private events, especially previously unwanted ones. ACT helps the individual get in contact with a transcendent sense of self, "self-as-context"—the one who is always there observing and experiencing and yet distinct from one's thoughts, feelings, sensations, and memories. ACT tries to help the individual clarify values and then use them as the basis for action, bringing more vitality and meaning to life in the process, while increasing psychological flexibility.

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