Acceptance and Commitment Therapy

What is Acceptance and Commitment Therapy (ACT)?

Acceptance and Commitment Therapy (ACT) is a relatively new type of therapy first developed by Professor Steven Hayes and colleagues in the late 1980’s. Although ACT is quite young, it is already delivering outstanding results for adults and children alike. It utilises cognitive and behavioural techniques to navigate towards a more meaningful life.

ACT encourages us to accept what is out of our personal control, and commit to engaging in actions that improve life. There is a strong emphasis on exploring one's personal values. In so doing, ACT aims to maximise our potential for a full and meaningful life. 

Jodie is the co-writer of Mindtrain, a ten-session manual for psychologists working with anxious children using the principles of Acceptance and Commitment Therapy. 

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Acceptance Commitment Therapy for Anxiety

Anxiety in children can be very debilitating for the child and in turn the family. Anxiety can show up in many forms including shyness, worry, anger, social problems, obsessions and disruptive behaviour. Identifying and addressing the cause of anxiety is important in any treatment program. Early intervention creates remarkable results in anxiety reduction.

Acceptance and Commitment Therapy (ACT), aims to work on addressing individual issues as well as providing generalised techniques for accepting and managing the natural flow of anxiety we all experience. Through ACT, children are taught to notice uncomfortable thoughts and feelings; a technique widely used in many cognitive behaviour therapies for children. In ACT, however, we do not try to control or get rid of the worry, we work on accepting it as a natural state and allow it to be there. Whilst traditional therapy is undoubtedly beneficial for many types of anxiety, its premise often depends on controlling unwanted feelings. Children we might define as those real worry warts use control as one of their best-loved techniques for avoiding feared situations. Excessive control, however, only increases the anxiety in the long term, so we need to find ways to help these children manage their anxiety outside of control-based techniques. ACT teaches us to accept and tolerate uncomfortable feelings, rather than trying to get rid of them. In this sense, we focus on our relationship with our thoughts, rather than the content of them. By learning about the process of worry and using mindfulness to tolerate anxiety, we can become better able to handle the new worries as they emerge. Through accepting and living with the worry, rather than struggling with it, the worry begins to dissipate.

Outside of sessions, ACT includes the regular practice of mindfulness- a technique that has enormous benefits for overall well-being, particularly anxiety. Results tend to be even better when a family member also commits to mindfulness practice. The practice can be as little as one minute per day.

Acceptance and Commitment Therapy for Autism Spectrum Conditions

Acceptance and Commitment Therapy (ACT) is uniquely placed in its ability to assist young people with ASD. Many people with ASD report that they feel misunderstood and not listened to. Left unaddressed, this can lead to behaviour difficulties, social problems and eventually depression. ACT has its foundations in acceptance and compassion, which brings success to therapy very quickly as the young person feels heard and understood from the outset. 

Psychological flexibility is one of the key aims of ACT. Most people with ASD like to do things in a very particular way so when things don't go as planned, they can become very stuck and give up or act out. Furthermore, many with ASD struggle with looking at a situation from another person’s perspective. In essence, they are lacking the skill of psychological flexibility. Through ACT, we now know that it is a skill that can be taught.  The ACT principle of Self As Context teaches us to look at ourselves through the eyes of an observer. This can also be transferred to understanding the thoughts and feeling of others- a key to developing perspective taking.

ACT additionally emphasises the importance of Mindfulness, a skill that requires a person to be highly focused on only one part of their experience. We know that people with ASD are already skilled at noticing one part of their experience and many are very successful in an area of special interest as well as in mindfulness. However, this can also work to disadvantage. For example, a person might become caught up in their thoughts to the exclusion of everything else in their environment. This can have troubling outcomes socially but also personally, particularly if those thoughts are distressing. ACT assists young people with ASD to steer their natural ability for mindfulness in a direction that can be helpful. This is also a skill that can be taught and developed to assist with emotion regulation.

Jodie is President of the International ACT and Autism ACBS group.

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