Treatment Approaches

ACT for anxiety

Acceptance and Commitment Therapy (ACT) is a unique approach to therapy that aims to help people struggling with anxiety by encouraging them to accept their thoughts and feelings while also committing to actions that align with their values. It’s a shift away from traditional methods that focus on controlling or reducing anxiety. ACT is considered a “third-wave” behaviour therapy.

Here’s a breakdown of how to explain ACT for anxiety:

  • It’s not about getting rid of anxiety. Instead, ACT teaches that it’s okay to have unwanted thoughts and feelings, and that struggling against them can make things worse. The goal is to change your relationship with these internal experiences.
  • Anxiety is a normal human experience. ACT acknowledges that suffering is a normal part of life, not a disorder. It views mental health problems as stemming from normal processes that have become unworkable.
  • The problem is often how we respond to anxiety. When people try to avoid or control their anxious feelings, it can lead to a more rigid way of living. For example, they might avoid social situations or become overly focused on managing their symptoms, which can interfere with what they really care about in life.
  • ACT focuses on psychological flexibility. This means being open to your present experience, voluntarily shifting attention to where it is needed, and developing habits that move your life in the direction of your most cherished values.
  • Key processes of ACT include acceptance of thoughts and feelings, defusion from thoughts, being present in the moment, connecting with the “observing self,” identifying values, and taking committed action.
  • ACT uses techniques such as mindfulness and experiential exercises to help people relate differently to their thoughts and feelings. Metaphors and analogies are also used.

Why Therapists are Using ACT

  • Limitations of traditional CBT: Traditional Cognitive Behavioural Therapy (CBT) often focuses on symptom reduction by challenging negative thoughts and teaching coping skills. However, it may not be as effective for long-term recovery or relapse prevention.
  • Traditional approaches can reinforce the struggle with anxiety: Traditional therapies may unintentionally reinforce the idea that anxiety itself is the problem by focusing on controlling or managing it.
  • ACT addresses the root of the problem: ACT helps people recognise that their attempts to control thoughts and feelings are often what perpetuates the cycle of anxiety. Instead of targeting symptoms, ACT targets the underlying processes of experiential avoidance and cognitive entanglement.
  • Broader focus: ACT is not just about anxiety, it is about enriching human life and undermining destructive patterns that get in the way of living. ACT therapists help their clients move towards living a life that is consistent with what matters to them, rather than just reducing their anxiety.
  • Emphasis on values: ACT helps people identify their core values and make choices in accordance with them, rather than being driven by their anxiety. This gives them a larger reason to engage with difficult situations or uncomfortable feelings.
  • Focus on ‘broadband outcomes’: The focus is on helping the client move in life directions that they truly care about, rather than simply alleviating anxiety symptoms.
  • ACT is an approach, not just a set of techniques. It is flexible, and therapists can adapt techniques based on the unique circumstances of the client.
  • ACT can be used with other therapies. ACT can complement other therapies by providing a new perspective that supports the use of traditional techniques such as exposure therapy. Exposure therapy within ACT is recontextualized as an opportunity to be with and not act upon the urge to avoid and escape anxiety.

In summary, ACT offers a different way of working with anxiety by focusing on acceptance, values, and committed action. It recognizes that anxiety is a part of life and helps people move toward a more meaningful life despite it, rather than struggling against it. Therapists are now using ACT because it offers a more holistic and effective way to deal with anxiety and its underlying causes.

John Nolan

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