Acceptance and Commitment Therapy (ACT) has two major primary goals when treating anxiety disorders: (1) fostering acceptance of unwanted thoughts and feelings whose occurrence or disappearance clients cannot control, and (2) commitment and action toward living a life that they value. This means that ACT aims to help clients both accept their internal experiences and actively pursue a meaningful life despite these experiences.
- ACT aims to help the client become better at living a full, rich, and meaningful life, rather than becoming better at feeling good (i.e., being symptom-free) in an attempt to have such a life. The focus shifts from an avoidance goal (recovery from anxiety) to an approach goal (what clients want to have instead of anxiety).
- The primary goal of ACT is to increase psychological flexibility, which is defined as the ability to be open to present experience, voluntarily shift attention, and develop habits that move life in the direction of cherished values. Psychological rigidity, marked by attempts to escape pain, is seen as a predictive factor in anxiety.
- ACT teaches clients to just notice, accept, and embrace their thoughts, feelings, sensations, memories, and other events, especially unwanted ones. It encourages clients to relate to these internal experiences as experiences to be had, rather than struggling with them.
- A key goal is to undermine experiential avoidance, which refers to attempts to avoid, suppress, or alter negatively evaluated private events like bodily sensations, emotions, thoughts, worries, and memories. ACT views this avoidance as a core toxic process driving disordered anxiety.
- ACT-style exposure is always done in the service of client values and life goals, not as a means to reduce or get a handle on symptoms. The goal is not primarily to extinguish and reduce anxiety, but to help clients live a valued life. Therefore, exposure exercises within ACT are framed to foster greater psychological flexibility, experiential willingness, and openness. They are about growth and are always done in the service of client values and goals.
- ACT encourages clients to identify their own values while committing to put those values into freely chosen action. This involves helping clients clarify how they wish to live their lives and helping them to do just that. Actions that get in the way of value-driven choices are viewed as barriers to living.
- While symptom alleviation may occur as a by-product of ACT, it is not an explicit goal or a requirement for living life as a complete, fully functioning, capable human being. ACT does not focus on symptom reduction.
- ACT challenges the notion that anxious thoughts and feelings are problems that warrant elimination. Instead, it focuses on changing the pathological functions those thoughts and emotions might have.
In contrast to traditional Cognitive Behavioural Therapy (CBT), which often focuses on symptom alleviation and controlling anxiety, ACT prioritises living well even in the presence of anxiety. ACT reframes the clinical context to focus on a life lived well, not living to feel well. It views attempts to control anxiety as the problem, not the solution.