Academic journal article Journal of Mental Health Counseling

Acceptance and Commitment Therapy: Part of the "Third Wave" in the Behavioral Tradition

Academic journal article Journal of Mental Health Counseling

Acceptance and Commitment Therapy: Part of the "Third Wave" in the Behavioral Tradition

Article excerpt

As described by Hayes, Strosahl, and Wilson (1999), Acceptance and Commitment Therapy (ACT) is one of several methods for integrating mindfulness concepts into mental health treatment. Unlike many counseling approaches, ACT does not assume that the goal of treatment is to better control thoughts, feelings, or other private events. Individuals are taught to notice phenomena and take a nonjudgmental stance toward them rather than trying to control, avoid, or otherwise minimize them. Although relatively new, ACT has increasing support for its effectiveness in addressing a variety of problems (Pull, 2009). This article addresses the theoretical foundation and basic principles of ACT, reviews the research, presents a case study to illustrate how it can be applied, and discusses the counseling implications.

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Hayes (2004) described Acceptance and Commitment Therapy (ACT) as belonging to a category of treatments he characterized as the "third wave" in the behavioral tradition, such as Dialectical Behavior Therapy (Linehan, 1993); Functional Analytic Psychotherapy (Kohlenberg & Tsai, 1991); Integrative Behavioral Couples Therapy (Christianson & Jacobsen, 1998); and Mindfulness-Based Cognitive Therapy (Segal, Williams & Teasdale, 2002). These approaches, he said, all emphasize issues like "acceptance, mindfulness, cognitive delusion, dialectics, values, spirituality and relationship" (p. 640). One key difference between an ACT approach and a "second wave" approach like traditional cognitive behavioral is the latter's assumption that clinical improvement depends on changing cognitions. Instead, ACT teaches individuals to notice their thoughts from a neutral perspective without engaging with them or defining themselves by them.

While some have argued that ACT and other mindfulness approaches are simply variations that fit well with the cognitive behavior therapy (CBT) paradigm (Hofmann & Asmundson, 2008; Hofmann, Sawyer & Fang, 2010), there seems to be agreement that ACT and traditional CBT do differ; the distinction is like the comparison of the martial arts of tae kwon do (loosely: "to strike or break with foot or fist"); aikido ("the way of the harmonious spirit"); and jiujitsu ("a gentle or yielding art-form"). All may be martial arts initially developed in Asia, but tae kwon do emphasizes force meeting force while aikido and jiujitsu emphasize blending with the opponent and redirecting or neutralizing the attack. In counseling, a CBT approach might work to "change" maladaptive thoughts by directly challenging them, with the expectation that unpleasant emotions will be reduced or eliminated; an ACT approach would focus on learning to be aware of maladaptive thoughts but not necessarily trying to change them, and allowing emotions that may be subjectively experienced as unpleasant to "blend in" with the overall emotional experience.

BASIC CONCEPTS OF ACT

Instead of starting, like other perspectives in Western psychology, from the assumption that psychological health is the normal state for humans, ACT posits that normal psychological processes often result in suffering because "the logical mind is being asked to do what it was not designed to do" (Hayes & Smith, 2005, p.2). Hayes and Smith argued that the human mind evolved to increase flexibility (and hence adaptability) in coping with the external environment. The abilities to plan for contingencies and make environmental conditions more favorable have evolved in humans to a high degree of complexity, especially with the emergence of language and the ability to think symbolically. However, although these capabilities can be quite effective when dealing with external situations, they are much less effective in dealing with internal issues. Attempts to exert control over these inner experiences by using strategies that are generally effective in exerting control over the external environment is an all-to-common maladaptive human strategy that may explain the apparent ubiquitousness of human suffering (Hayes and Smith, 2005). …

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