Acceptance and Commitment Therapy (ACT) explained

Acceptance and Commitment Therapy is a contemporary behavioural intervention with a substantial evidence base for anxiety, depression, chronic stress and comorbid presentations. It is often used in the context of trauma recovery, either as a stand-alone approach or alongside trauma-focused work.

ACT is built around the concept of psychological flexibility: the capacity to remain present with difficult internal experiences while continuing to act in line with what matters to you. Rather than trying to eliminate unwanted thoughts and feelings, ACT teaches skills for changing the relationship with them, so that they exert less control over behaviour.

Treatment addresses six interrelated processes. Acceptance involves making room for painful thoughts, feelings and sensations without struggling against them. Defusion is the practice of noticing thoughts as mental events rather than literal truths. Present-moment awareness supports contact with what is actually occurring, in contrast with rumination about the past or worry about the future. Self-as-context refers to a stable sense of self that can observe experience without being defined by it. Values clarification identifies the qualities of action that matter to the person. Committed action translates those values into specific, workable behavioural steps.

In sessions, these processes are explored through structured exercises, guided experiential work, metaphors and behavioural experiments. Between sessions, clients are typically asked to notice patterns of avoidance, practise brief mindfulness exercises, and take small values-consistent actions in daily life.

For clients recovering from crime-related trauma, ACT can be useful in reducing the impact of intrusive thoughts and hyperarousal, in re-engaging with meaningful activity, and in addressing depression, social withdrawal or chronic pain that often co-occur with post-traumatic presentations. It can be sequenced with trauma-focused interventions such as EMDR or trauma-focused CBT where clinically indicated.

Telehealth is a good fit for ACT. Experiential exercises and worksheets translate well to a video format, and between-session practice is central to the model regardless of setting.

If you have a Victims Services approval and want to discuss whether ACT is appropriate for your situation, submit an enquiry through the contact form.