ACT — Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT, pronounced as the word "act") is a third-wave CBT approach that proposes a different relationship with painful thoughts and emotions: instead of trying to eliminate or control negative thoughts (as classic CBT emphasizes), the goal is to change one's relationship with them — cognitive defusion, acceptance, and commitment to actions grounded in personal values.
The six core processes of ACT: (1) Acceptance — making room for difficult internal experiences instead of fighting them; (2) Cognitive defusion — seeing thoughts as thoughts, not as facts; (3) Contact with the present moment — mindfulness; (4) Self-as-context — the observer perspective; (5) Values — clarity about what truly matters; (6) Committed action — acting in line with your values even amid suffering.
In depression, ACT helps reduce the struggle against depressed mood (which often makes things worse) and helps a person move toward a meaningful life even while depressed. It has evidence comparable to CBT for mood and anxiety disorders.
Practical example
Carolina learned in ACT that trying to "just not think about sad things" was fueling her rumination. Her therapist taught her defusion: "I'm having the thought that I'm a failure" instead of "I am a failure." That small shift created distance from the thought. Combined with identifying her values (being a good mother, building connections), she began acting in that direction even while depressed.
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