Acceptance and commitment therapy

Domain II · Behavioural & cognitive · Hayes, Strosahl, Wilson · 1999

What it is

Acceptance and commitment therapy (ACT) is a behavioural therapy, built on functional contextualism and relational frame theory (RFT), that aims to increase psychological flexibility: contacting the present moment fully and changing or persisting in behaviour when that serves chosen values. ACT is…

Format

• Classic sequence (1999 book / "Complete ACT" 12-session depression protocol; weekly 60-min individual sessions):
• The excerpt of the protocol ended in session 7; content of sessions 8–12 above is taken from the 1999 book's Willingness and Commitment chapter summaries, not from the protocol itself. A mid-programme assessment followed session 6 in the protocol, and depression and automatic-thought questionnaires…

Who practises it, and how they are trained or regulated

• Follow-up visits: purposes are named as a training topic but not described in the sources.: review the experiment with the CAN-DO checklist idea (did they do it, what happened, what was learned), re-rate, adjust the plan.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• non-completion; see Section 5.
• faster, more neutral labelling over time.
• do not use real heights; a step or a book is enough.
• over-reliance on one pillar (e.g. high insight, low engagement).
• the client reporting less dirty discomfort as willingness rises.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.