The act approach to anxiety represents a significant shift in how anxiety disorders are understood and treated. It moves away from traditional methods focused on symptom reduction and control, instead emphasising acceptance, mindfulness, values, and committed action. This approach aims to help individuals live full, rich, and meaningful lives, even in the presence of anxiety.
Why the ACT Approach to Anxiety Was Developed
Traditional psychotherapies often focus on reducing negative affect and distress, whereas the act approach to anxiety aims to increase positive affect to help clients make their lives better. Many cognitive behavioural therapies (CBT) for anxiety are predicated on the idea that changing anxious thoughts and feelings will naturally foster a more vital life. However, these approaches often fall short in achieving long-term recovery and preventing relapse. Despite short-term gains with cognitive behavioural interventions, there’s a lack of agreement on critical variables and the best way to approach anxiety-related problems.
The act approach to anxiety was developed to address the limitations of earlier therapies by targeting experiential and emotional avoidance. It recognises that attempts to control or eliminate anxiety can paradoxically perpetuate suffering. The key problem for most people with anxiety disorders is not their intense fear or pervasive anxiety, but the avoidance of experiencing these feelings.
How is ACT Superior to Older Therapies and Techniques?
- Focus on Processes, Not Content: Unlike traditional cognitive therapies that focus on changing the content of thoughts, ACT targets the processes that turn normal anxiety into disordered experiences.
- Acceptance vs. Control: ACT encourages acceptance of unwanted thoughts and feelings rather than struggling against them. This reduces the energy spent on control efforts and opens space for valued actions.
- Values-Driven Action: ACT emphasizes identifying and committing to actions aligned with personal values. This provides a sense of purpose and meaning, making the hard work of therapy worthwhile.
- Mindfulness and Presence: ACT uses mindfulness techniques to help individuals experience anxiety without trying to fix it, promoting a better ability to feel on the path to living better.
- Psychological Flexibility: ACT aims to increase psychological flexibility—the ability to be open to experiences, focus attention, and act in line with values.
Eifert and Forsyth suggest that ACT has revolutionised anxiety disorder treatment by examining the core psychological processes that make anxiety disordered, moving beyond the disease model that CBT has been stuck in.
How the ACT Approach to Anxiety Helps People Change Their Understanding and Approach
- Redefining the Problem: ACT redefines the problem from the presence of particular thoughts or emotions to the constriction of a human life. The solution is not the removal of difficult private events but living a valued life.
- Understanding Experiential Avoidance: ACT highlights how efforts to avoid, suppress, or alter negative thoughts, feelings, and sensations contribute to anxiety disorders. By recognising this, clients can begin to change their relationship with anxiety.
- Promoting Willingness: ACT fosters willingness to experience thoughts and feelings for what they are, which helps develop greater psychological flexibility and openness. Clients learn to observe rather than react to their anxiety.
- Values Clarification: ACT assists clients in identifying what is truly important to them, providing motivation to engage in difficult work. This helps them shift from fighting anxiety to pursuing a meaningful existence.
- Committed Action: Clients commit to actions that lead them in valued directions, even in the face of anxiety. This helps them break free from the cycle of avoidance and control.
Why ACT is a More Long-Term Solution
- Addresses Core Processes: ACT targets the fundamental processes that underlie disordered anxiety, such as experiential avoidance and cognitive fusion, rather than just managing symptoms.
- Promotes Psychological Flexibility: By increasing psychological flexibility, ACT equips individuals with skills to handle a wide range of life challenges, not just anxiety.
- Focuses on Value-Guided Living: ACT emphasises living in accordance with personal values, providing a sustainable source of motivation and resilience.
- Undermines the Struggle with Anxiety: ACT breaks the cycle of avoidance and control that perpetuates anxiety, leading to a more fundamental and lasting change in how individuals relate to their thoughts and feelings.
The Evidence
- Empirical Support: ACT has a solid empirical base focused on human language and cognition, built upon behavioural principles guided by functional contextualism and relational frame theory.
- Outcome Studies: Clinical outcome studies show ACT is effective for various clinical problems, from depression and substance abuse to chronic pain and eating disorders.
- Anxiety-Related Problems: ACT has proven effective for anxiety-related problems such as OCD and trichotillomania. Studies have also shown that ACT produces rapid and significant decreases in the believability of negative or unwanted thoughts.
- Process Studies: Studies examining core processes of ACT, such as acceptance, defusion, and willingness, have been done in the anxiety area, with all published tests of ACT components showing positive results.
- Component Testing: It has been possible to test ACT components such as acceptance and defusion, with several studies done in the anxiety area.
Hayes points out that, despite impressive short-term gains in anxiety treatment, there is still a need for better long-term recovery and relapse prevention, which ACT aims to address.
The act approach to anxiety offers a transformative path by shifting focus from symptom control to embracing life’s fullness. By fostering acceptance, clarifying values, and promoting committed action, ACT empowers individuals to break free from the anxiety trap and live richer, more meaningful lives. Supported by a growing body of evidence, ACT provides a long-term solution by addressing core processes and enhancing psychological flexibility, equipping individuals with lasting resilience.
ACT, Anxiety Relief, Psychological Flexibility, Acceptance, Values, Committed Action, Mindfulness, Experiential Avoidance, Long-Term Solution, Mental Health.