Clinically reviewed by Bülent Ada, BSc.(Psychol.)(Hons.), MAPS · Updated August 2025

Most people who seek psychological support want to feel less anxious, less sad, or less distressed. That’s a completely understandable goal. But what if the pursuit of feeling better was itself part of what was keeping you stuck?

That’s the somewhat counterintuitive starting point of Acceptance and Commitment Therapy — ACT (pronounced as one word, not three letters). ACT doesn’t aim to eliminate difficult thoughts and feelings. Instead, it aims to change your relationship with them, so that they have less power to control your behaviour and limit your life.

It is one of the most extensively researched psychological therapies of the past two decades, and it is now among the most widely used approaches in Australian clinical practice.

The Core Idea Behind ACT

Traditional Cognitive Behavioural Therapy (CBT) works largely by identifying and modifying unhelpful thoughts. The goal is to replace irrational or distorted thoughts with more balanced, accurate ones.

ACT takes a different approach. Rather than trying to change the content of thoughts, ACT aims to change how you relate to them.

In ACT, the problem is not that you have anxious thoughts, painful memories, or difficult emotions. The problem is that you are fused with them — caught up in them, treating them as facts, and organising your life around avoiding them. This process of avoidance — technically called experiential avoidance — is what ACT identifies as the primary driver of psychological suffering.

When we work to avoid thoughts and feelings, we tend to:

• Narrow our lives (not going to places, people, or situations that might trigger distress)
• Lose contact with our values (not doing what matters most because it might cause discomfort)
• Spend enormous mental energy on a struggle that often makes difficult thoughts more persistent, not less

ACT offers an alternative: not surrender, not indifference, but psychological flexibility — the ability to have difficult inner experiences and still choose to move toward what matters.

The Six Core Processes of ACT

ACT is built around six interconnected processes. Together, they form what ACT theorists call the psychological flexibility model, sometimes called the “hexaflex.”

1. Cognitive Defusion

Defusion means stepping back from your thoughts — noticing them as thoughts rather than facts or commands.

If you have the thought “I’m a failure,” fusion means experiencing that as a truth about who you are. Defusion means noticing that you are having the thought “I’m a failure” — observing it, labelling it, and choosing not to act on it as if it were true.

A common defusion exercise: instead of “I’m a failure,” say to yourself “I’m having the thought that I’m a failure.” Or: “My mind is telling me I’m a failure.” This small linguistic shift can create significant psychological distance.

2. Acceptance

Acceptance in ACT does not mean liking or approving of difficult experiences. It means making room for them — allowing them to be present without fighting them or being controlled by them.

This is the opposite of resignation. It’s more like putting down a heavy tug-of-war rope: you stop fighting the anxiety, and suddenly you have energy for everything else.

A widely used ACT metaphor: think of difficult emotions as waves. You can exhaust yourself fighting them, or you can practise surfing — staying balanced while they rise and pass.

3. Present-Moment Awareness

Much psychological suffering involves being stuck in the past (rumination) or worried about the future (anxiety). Present-moment awareness — closely related to mindfulness — is the practice of bringing your attention to the here and now with curiosity and openness.

In ACT, present-moment awareness is a skill, not a state. It is practised through meditation, breathing exercises, and in-the-moment attentional techniques.

4. Self-as-Context (The Observing Self)

ACT distinguishes between the thinking self (the continuous stream of thoughts, memories, and judgments we identify with) and the observing self — the part of us that notices what we are thinking and feeling without being defined by it.

Connecting with the observing self creates a sense of stability and continuity, even when thoughts and feelings are chaotic. A useful metaphor: you are the sky. Thoughts and feelings are weather. Weather changes. The sky remains.

5. Values Clarification

Values in ACT are not goals — they are directions, not destinations. A goal is “run a marathon.” A value is “living a healthy and active life.” Goals can be achieved (and then it’s over); values are ongoing.

Clarifying your values — what truly matters to you in relationships, work, health, community — provides a compass for action that isn’t dependent on how you feel in any given moment.

6. Committed Action

The final process is taking action in the service of your values, even when difficult thoughts and feelings show up. This often involves gradual exposure to previously avoided situations — but with a crucial difference from traditional exposure: the purpose is not to reduce anxiety, but to live more fully in alignment with what matters.

What ACT Looks Like in Practice

An ACT session might involve:

• Exploring the ways you have been struggling with or avoiding difficult inner experiences
• Identifying what you most care about (values work)
• Learning defusion and acceptance techniques
• Mindfulness practices (often brief, practical exercises rather than long meditations)
• Setting committed action steps tied to your values
• Reviewing what worked and what got in the way

ACT sessions can be structured and skills-based, or more exploratory depending on the individual and the issues being addressed. Many people find ACT more intuitive than they expected — it resonates quickly because it describes something many people have felt but haven’t had a framework for.

Who Does ACT Help?

ACT has a strong evidence base across a wide range of conditions, including:

• Anxiety disorders (generalised anxiety, social anxiety, health anxiety, panic disorder)
• Depression and persistent low mood
• Chronic pain — ACT is among the most researched psychological approaches for pain management
• OCD — ACT’s defusion and acceptance techniques complement Exposure and Response Prevention
• Eating disorders — particularly where emotional avoidance and values disconnection are central
• Workplace stress and burnout
• Grief and loss
• Substance use disorders — as part of a broader treatment approach

ACT may be particularly valuable for people who have tried traditional CBT and found that challenging or restructuring thoughts didn’t help much — or for people who feel that their internal experience has become the main battleground of their life.

Is ACT Right for You?

If you are seeking psychological support, your psychologist will work with you to identify the approach (or combination of approaches) most suited to your situation and goals. ACT is often used alongside other methods — CBT, schema therapy, EMDR, DBT — rather than as a standalone treatment.

If you are curious about whether ACT might be helpful for you, it is worth raising with a psychologist or GP when seeking a referral.

Frequently Asked Questions

What is Acceptance and Commitment Therapy?

ACT (said as one word) is an evidence-based therapy that helps you change your relationship with difficult thoughts and feelings rather than trying to remove them. It targets experiential avoidance, the struggle to escape inner experiences, which often keeps people stuck. The aim is psychological flexibility: the ability to hold difficult experiences while still choosing actions aligned with your values.

How is ACT different from CBT?

Traditional CBT largely works by identifying and modifying unhelpful thoughts, aiming to make thinking more balanced. ACT instead changes how you relate to thoughts, treating them as mental events rather than facts or commands. It may particularly suit people who have tried challenging their thoughts in CBT without much benefit. In practice the two approaches are often combined.

What are the six core processes of ACT?

ACT is built on six interconnected processes: cognitive defusion (stepping back from thoughts), acceptance (making room for difficult feelings), present-moment awareness, self-as-context (the observing self), values clarification, and committed action. Together they form the psychological flexibility model. The goal is to act in line with what matters to you, even when uncomfortable thoughts and feelings are present.

Who can ACT help?

ACT has a strong evidence base across anxiety disorders, depression, chronic pain, OCD, eating disorders, workplace stress and burnout, grief, and substance use as part of broader treatment. It can be especially valuable for people who found that challenging or restructuring thoughts in traditional CBT did not help much, or whose inner experience has become the main battleground of their life.

What does an ACT session look like?

A session might involve exploring how you have been struggling with or avoiding difficult experiences, identifying what you most care about, learning defusion and acceptance techniques, brief mindfulness practices, and setting committed-action steps tied to your values. Sessions can be structured and skills-based or more exploratory. Many people find ACT more intuitive than they expected.

Related reading

• ACT services
• How CBT compares
• ACT and OCD treatment

About the author: Bülent Ada is the Principal Psychologist and Founding Director of Mind Health Associates in Parramatta, Sydney. With over 20 years of clinical experience, Bülent integrates ACT with other evidence-based approaches to support individuals through anxiety, depression, trauma, and life transitions. Learn more about Bülent.

This article is for informational purposes only and is not a substitute for professional mental health advice.

Ready to take the next step? Mind Health Associates offers evidence-based psychological therapy in Parramatta and via telehealth across Australia. Contact us to enquire about appointments or learn about our services.