What is ACT?
Acceptance and Commitment Therapy (ACT) is a form of cognitive behavioral therapy that helps you deal differently with difficult thoughts, feelings, and memories.
Where many therapies focus on reducing symptoms, ACT emphasizes something else: learning to make space for what you experience, so that it dictates your life less.
ACT is based on the idea that pain and discomfort are inevitable, but that the fight against them often causes extra suffering. By letting go of that fight step by step, space is created.
Within ACT, you work on six core processes:
Acceptance: make room for what you feel
Cognitive defusion: distancing oneself from thoughts
Connection to the here and now: being present in the moment
Even as context: realize that you are more than just your thoughts and feelings
Committed action: take steps in that direction
Working on cognitive flexibility
Together, the six core processes of ACT strengthen what is also known as your psychological flexibility. This is the ability to remain present with what is (acceptance), while still making choices that are right for you (commitment). In this way, it also increases your resilience.
What is Trauma-Focused ACT (TF-ACT)?
Trauma-Focused ACT (also known as trauma-informed ACT) is not a specific protocol or treatment, but a way of working in which ACT is explicitly tailored to people with trauma.
That primarily means there is extra attention given to the potential role of trauma in many different psychological symptoms, and the impact of trauma on the body, brain, and nervous system. There is also extra attention given to self-compassion and how to grow this.Â
Within Trauma-Focused ACT, work is primarily carried out in three areas:
- Living in the Presentyou learn to ground yourself and focus your attention on the here and now.
- Healing the pastyou examine how the past has shaped your current thoughts and behavior, and work on trauma-related beliefs that still go along with this.
- Building a future: You set value-based goals and explore post-traumatic growth.
The goal of Trauma-Focused ACT is not to relive traumatic experiences, but to learn to cope with them in a different way, so that they have less of an impact on your daily life.
What does an ACT session look like?
You can take an ACT session either individually or in a group setting. It usually consists of a combination of conversation and experiential exercises.
You can expect the following elements:
- Exploring your symptoms and patterns: Together, you map out what you are struggling with, such as recurring thoughts, avoidance, or overwhelming feelings.
- Mindfulness exercises: You'll learn to pause and reflect on what's happening in your body and mind, without reacting immediately or passing judgment.
- Learning to deal with thoughts differently: You'll explore how thoughts work and how you can gain a little more distance from them. Thoughts don't always have to be in control.
- Making space for feelings: In small steps, you learn to allow feelings without them overwhelming you.
- Working with values: You reflect on what is important to you. What gives direction to your life, apart from your symptoms?
- Take concrete steps: You look at what you can still do in line with your values despite complaints such as anxiety or tension.
Sometimes you also get exercises to take home, so you can continue practicing between sessions.
With what symptoms can ACT help?
ACT is used for many different complaints. Think of:
- Fear and panic
- Depressive symptoms
- Post-traumatic stress symptoms (PTSS)
- Overthinking and stuck in thoughts
- Shame and guilt
- Stress and burnout
- Chronic pain or physical symptoms
In trauma, ACT can be especially helpful when you notice that you:
- Thinking very strictly or negatively about yourself
- Suffering from intrusive thoughts
- Having trouble experiencing direction or meaning in your daily life again
- Getting stuck in patterns that were once protective, but now hold you back
- avoiding many things, such as situations, feelings, and memories, and wanting to learn how to deal with this differently
Where can I take ACT?
ACT is offered in many places in the Netherlands, both within mental healthcare institutions and by independent coaches and therapists.Â
Sometimes ACT is offered as an independent treatment, sometimes as part of a broader trajectory. You can also get started with ACT independently using a workbook of online assignments.
It is good to know that ACT therapist is not a protected title. When you are looking for a coach or therapist to follow ACT with, it can be helpful to ask about someone's experience in working with trauma.Â
Where can I read more about ACT?
Books
- Inner work (workbook) – Denise Matthijsen
- ACT with head and heartÂ
- TF-ACT in practice – Russ Harris
Website
Reading tip
Inner work (workbook)
Denise Matthijssen
In collaboration with
Ingrid Pénzes
Art therapist, psychologist, and PhD in social sciences. She received her doctorate on the relationship between visual arts and mental health and, based on that, ArTA developed. She offers schooling about arts therapies and trauma and writes blogs about experiential therapy and trauma.
