Comparing ACT with CBT and its value in brief therapy.

Acceptance and Commitment Therapy (ACT) and Cognitive Behavioural Therapy (CBT) are both evidence-based approaches to therapy, but they differ in their underlying philosophies, techniques, and goals.

CBT

• Focus on symptom reduction: CBT primarily aims to reduce symptoms by targeting and changing maladaptive thoughts and behaviours. It seeks to identify and correct irrational or unhelpful thoughts.
• Cognitive restructuring: A core technique in CBT involves challenging and disputing negative or irrational thoughts, replacing them with more rational ones.
• Behavioural techniques: CBT utilizes exposure techniques to help clients confront their fears gradually.
• Emphasis on control: CBT often focuses on managing or controlling anxiety by using coping strategies and techniques to alleviate symptoms.
• Narrowband outcomes: CBT typically focuses on symptom reduction and alleviation as the main goals of therapy.
• Three minute therapy: CBT is considered a relatively simple, easily applied, and time limited therapy that can be self-administered.
• Goal oriented: CBT is methodical, reflective, evidence-based and time-limited.

ACT

• Focus on psychological flexibility: ACT aims to increase psychological flexibility rather than directly targeting symptom reduction. This involves being open to present experiences, shifting attention voluntarily, and committing to actions aligned with values.
• Acceptance rather than disputation: Instead of challenging thoughts, ACT teaches clients to accept thoughts and feelings as they are, without needing to change them. It emphasizes defusion, which involves recognizing thoughts as just thoughts rather than getting caught up in them.
• Experiential approach: ACT is an experiential approach that involves active engagement in behavioural experiments and the use of metaphors and analogies.
• Emphasis on values: ACT helps clients clarify their values and encourages them to make choices based on these values, rather than being driven by anxiety or avoidance.
• Acceptance and mindfulness: ACT uses acceptance and mindfulness processes to help clients relate differently to distressing thoughts and feelings.
• Broadband outcomes: While symptom reduction may occur, ACT focuses on helping clients move in the direction of a meaningful life, as defined by their values.
• Challenges the dominance of language and rules: ACT questions the power of language and rules, particularly when they are unhelpful.
• An approach, not just techniques: ACT is considered to be an approach to therapy, and not a collection of techniques.
• Not about eliminating anxiety: ACT is not about eliminating anxiety but helping clients create a life worth living, even with anxiety.

Benefits of ACT for Brief Therapy

• Addresses the root of the problem: ACT addresses the underlying processes that contribute to anxiety and psychological inflexibility, rather than solely focusing on symptoms. It targets experiential avoidance and cognitive entanglement.
• Faster symptom improvement: Some studies suggest that clients of therapists trained in ACT have shown better symptom improvement than those trained in CBT.
• Reduced struggle with anxiety: ACT moves away from the idea that anxiety must be controlled or eliminated. By accepting their thoughts and feelings, clients reduce the struggle with anxiety, which in turn reduces anxiety.
• Focus on values: By identifying and connecting with their values, clients can find a greater purpose in their actions, which makes the therapy more meaningful and motivating.
• More flexible treatment goals: The focus of ACT is not just on symptom reduction, but on moving towards a life that the client values. This takes the pressure off clients and therapists.
• Applicable across a wide range of issues: ACT can be applied to a broad range of topics and populations. It is considered a “full-service” therapy that can be used in individual, couples and group therapy, as well as in other contexts outside of therapy.
• Combines well with other therapies: ACT can be combined with other therapies to enhance their effectiveness by providing a framework for acceptance of difficult thoughts and feelings. ACT provides a new perspective that supports the use of traditional techniques like exposure therapy.
• Reduces dropouts: Studies have indicated that using an acceptance-based approach in therapy can prevent premature dropouts.

Key Differences Summarized

In conclusion, while both ACT and CBT are effective for addressing anxiety, ACT offers a unique approach by emphasizing acceptance, values, and committed action. This can be particularly beneficial in brief therapy, as it addresses the underlying processes that contribute to anxiety and helps clients move towards a more meaningful and fulfilling life, even in the presence of anxiety.