Acceptance and Commitment Therapy (ACT): Principles and Characteristics

the Acceptance and Commitment Therapy (ACT) is a type of therapy that falls under the so-called third generation therapies, which appeared between the 80s and 90s in the United States and which are part of behavioral and cognitive therapeutic models.

While first and second generation therapies have focused and (focus) on combating automatic or uncomfortable thoughts and replacing them with supposedly more adaptive thoughts, third generation therapies emphasize dialogue and functional context and seek acceptance and the non-judgmental attitude as a means of finding well-being.

    What are first and second generation therapies

    Third generation or third wave therapies belong to behavioral therapies. To understand what these therapies are, I will first talk about first and second generation therapies.

    The first generation therapies (1960s) are therapies that arose with the aim of overcoming the limitations of psychoanalytic therapy, which was dominant at that time. When we talk about first generation therapies, we are talking about Watson’s Classic Conditioning and Skinner’s Operant Conditioning. These therapies were useful in treating, for example, fears or phobias, and were based on the principles of conditioning and learning.

    However, neither Watson’s characteristic associationist learning model and stimulus-response paradigm, nor even Skinner’s experimental breakthrough was effective in dealing with certain psychological problems presented by some people. Next are the second generation therapies (1970s), which are primarily cognitive behavioral therapies (CBT) such as Rational Emotional Therapy (TREC) by Albert Ellis and Cognitive Therapy by Aaron Beck., Which consider thinking or cognition as the main cause of man. behavior and therefore psychological disorders.

    However, the second wave of behavioral therapy continued (and continues) to use first generation techniques and procedures and therefore focuses on modifying, eliminating, avoiding and ultimately modifying private events (thoughts, beliefs, emotions, feelings and even one’s own bodily sensations.).

    In other words, these forms of therapy revolve around the idea that if the motive for the behavior is the private event, it must be changed to change the behavior. This premise is widely accepted today, which at present leads to what is socially established as normal and correct behavior or as mental illness. Something that fits perfectly into a medico-psychiatric and even pharmacological model.

    What characterizes third generation therapies

    Third generation therapies appeared in the 1990s, And differ from the latter in that they approach the disorders from a contextualist, functional point of view, and their main objective is not to reduce the symptoms presented by the patient, but to educate him and reorient his life in a more holistic perspective. They are based on the idea that causes him discomfort or anxiety, it is not the events, but the way we relate the emotions to them and the way we relate to them. It is not about avoiding what makes us suffer, as it can have a rebound effect (as indicated by a lot of research), but the ideal situation is to accept our own mental and psychological experience, and thus reduce the intensity of symptoms.

    Sometimes it can be strange to work on this type of therapy, which invites the person to see, through different techniques (experiential exercises, metaphors, paradoxes, etc.), that what is socially or culturally accepted brings him an attempt to control over their private events, which in itself is problematic. This control is not the solution, but the cause of the problem.

      The importance of functional contextualism

      A remarkable aspect of third generation therapies is that they are based on a functional and contextual perspective of pathologies, Which is called functional contextualism. In other words, the behavior of the individual is analyzed from the context in which it occurs, because if it is decontextualized, it is not possible to discover its functionality.

      On the one hand, it is interesting how the person relates to the context based on their history and current circumstances, always taking into account verbal behavior and value clarification. Verbal behavior is what the patient says to himself and to others, but it is not important for the content but for its function. A patient may say that he feels complex and is very embarrassed when he has to speak in public. The important thing is not whether you are embarrassed or complex, the point is whether this way of thinking is good or bad for you.

      In addition, in third generation therapies, no distinction is made between observable behavior and private behavior, the latter also being valued from the point of view of functionality.

      Acceptance and Commitment Therapy

      Without a doubt, one of the most well-known third-generation therapies is Acceptance and Commitment Therapy (ACT), which it aims to create a rich and meaningful life for the patient, accepting the pain that inevitably accompanies it.

      ACT is touted as an alternative to traditional psychology and is a model of psychotherapy that is scientifically supported and uses different techniques: paradoxes, experimental exercises, metaphors, working with personal values, and even mindfulness training. It has its bases in the Relational Framework Theory (RFT)So it fits into the new theory of language and cognition.

      Human language can transform us, but it can also create psychological suffering. This is why it is necessary to work with the meanings of language, its functions and its relation to private events (emotions, thoughts, memories …). Outraged, self-discovery and clarification of values ​​are essential elements in this type of therapy, In which the patient has to ask and question the kind of person he wants to be, what is really valuable in his life and from what beliefs and values ​​he acts.

      Commitment to our values

      If we look around, it seems clear that much of our suffering is determined by our beliefs about what is right or wrong, Beliefs that are acquired culturally and that are anchored in the values ​​that Western society promotes. While most therapies view suffering as something abnormal, ACT understands that suffering is a part of life itself. This is why ACT is said to challenge social ideology and models of healthy normality, in which happiness is understood as the absence of pain, anxiety or worry.

      ACT, which means “to act” in English, emphasizes effective actions guided by our deepest values, in which we are fully present and committed.

      Principles of this type of therapy

      ACT uses certain principles that allow patients to develop the mental flexibility necessary to improve their emotional well-being.

      These are six:

      1. Acceptance

      Acceptance means recognizing and approving our emotional experience, Our thoughts or feelings. It is about treating us with affection and compassion even if we are not perfect. We must not fight or run away from our private events.

      In fact, acceptance of the present situation helps many aspects of our life that we perceive as problems cease to be so, thereby decreasing the level of anxiety and the associated discomfort factors.

      2.Cognitive diffusion

      It is about observing our thoughts and cognitions as they are., Pieces of language, words, images, etc. Just watch and let go without judging them. In this way, a distant and more rational view of things is adopted.

      3. Current experience

      The present is the only time we can live. Being in the here and now with an open mind and full awareness, participating fully with due attention to what is happening to us and our environment is key to our well-being.

      4. The “Observer I”

      It means detaching from the conceptualized egoThat is, affection for our own stories. From the point of view of the ego as an observer, we see things from a non-judgmental point of view.

      5. Clarity of values

      ACT requires a work of self-knowledge that allows us to clarify our values ​​deep within the soul. What is really valuable to us? Where do we really want to be or go? These are some of the questions that need to be answered. Of course, always with honesty.

      6. Action initiated

      The direction we take should always be determined by our own values and not by social charges. We need to get involved in meaningful actions for ourselves. This way we are much more likely to engage in our projects and move them forward at the pace we want.

      Bibliographical references:

      • Hayes, SC (2004). Acceptance and Commitment Therapy, Relational Framework Theory and Third Wave of Behavioral and Cognitive Therapies. Behavioral therapy, 35, 639-665.
      • Luciano, MC and Valdivia, MS (2006). Acceptance and Commitment Therapy (ACT): Fundamentals, Characteristics and Evidence. Papers of the Psychologist, 27, 79-91.

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