What it is
Acceptance and commitment therapy (ACT) is a type of cognitive-behavioral approach that focuses less on changing or arguing with difficult thoughts and more on changing your relationship to them. The goal is often described as psychological flexibility — the ability to stay present and act on your values even when uncomfortable feelings show up.
ACT therapists frequently use tools like cognitive defusion, which helps people notice thoughts as passing mental events rather than literal truths or commands. Another core piece is values work, where you clarify what genuinely matters to you so your actions can line up with those priorities.
People commonly bring topics like anxiety, chronic pain and a sense of being stuck or disconnected from their goals. ACT does not promise to erase hard experiences; instead, it explores how to carry them differently so they take up less room in your life.
How it’s traditionally been approached
Historically, many approaches to distress focused on reducing or eliminating unwanted symptoms directly — challenging anxious thoughts, for example, or trying to make pain go away. These strategies have helped many people and remain widely used today.
ACT emerged from the broader cognitive and behavioral tradition but shifted the emphasis. Rather than treating difficult internal experiences as problems to be fixed, it grew out of the idea that struggling against them can sometimes add to suffering, and that acceptance paired with committed action may open up more room to live fully.
Today, ACT is used by licensed therapists across a range of concerns and is often considered part of the family of evidence-based cognitive and behavioral approaches. Different therapists may blend ACT with other methods depending on a person's needs and goals.
How a therapist may help
Working with a licensed ACT therapist generally starts with getting to know you — what you're struggling with, what you've tried, and what a meaningful life would look like for you. From there, sessions often explore your values and the ways certain patterns of avoidance or struggle may be pulling you off course.
In session, an ACT therapist may help you practice noticing thoughts and feelings with more openness and less automatic reaction. Rather than following a rigid script, the work is usually collaborative and tailored, drawing on tools like cognitive defusion and values clarification in ways that fit your situation.
People exploring ACT for anxiety, chronic pain or a desire to live by their values sometimes find they can move toward important actions even while discomfort is present. This is framed as a possibility, not a guarantee — outcomes vary from person to person, and a licensed therapist can help you set realistic expectations.
Where mind meets body
Thoughts, emotions and the body's stress response are deeply connected. Anxiety can show up as a racing heart or tight chest, and chronic pain can shape mood and thinking, which is part of why a whole-person view can be useful. ACT already invites people to notice bodily sensations as part of staying present with experience.
Because the mind and body influence each other, some people pair thinking-based work like ACT with body-based (somatic) practices that focus more directly on the nervous system and physical sensations. If you'd like to learn about those options, Somatic Experiences is a place to explore body-based approaches. Neither path is better than the other — many people find value in combining them.
Explore on Somatic Experiences: body reconnection →Explore on Somatic Experiences: meditation →Explore on Somatic Experiences: chronic pain →
Keep in mind
- ACT is one approach among many; what works best often depends on the individual and the concern.
- Licensed professionals should guide care, especially where trauma, self-harm, suicidal thoughts, psychosis, eating disorders or substance use are involved.
- In a crisis, people in the US can call or text 988 or call 911.
- Any decisions about medication are made with a licensed prescriber, separate from the therapy work itself.
Therapists
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Frequently asked questions
What is an ACT therapist?
An ACT therapist is a licensed professional who uses acceptance and commitment therapy, a cognitive-behavioral approach. They help people make room for difficult thoughts and feelings while taking action toward their values. Sessions often include tools like cognitive defusion and values work.
What does ACT help with?
People often explore ACT for anxiety, chronic pain and a desire to live more in line with their values. ACT focuses on building psychological flexibility rather than eliminating difficult experiences. Results vary from person to person, so a licensed therapist can help you understand what to expect.
How is ACT different from traditional CBT?
ACT and CBT both come from the cognitive-behavioral tradition, but they emphasize different things. Traditional CBT often works to examine and change unhelpful thoughts, while ACT focuses more on changing your relationship to thoughts and feelings so you can act on your values. Many therapists draw on both.
What is cognitive defusion in ACT?
Cognitive defusion is an ACT concept that involves noticing thoughts as passing mental events rather than literal facts or commands. The aim is to create a little distance so thoughts have less automatic pull over your actions. An ACT therapist can explain how this fits your goals.
Can ACT help with chronic pain?
Many people explore ACT as a way to relate differently to chronic pain, focusing on living meaningfully rather than only on reducing pain. ACT does not promise to remove pain, and physical symptoms should also be evaluated by appropriate medical providers. A licensed therapist can help you think through a whole-person approach.
How do I find a qualified ACT therapist?
Look for a licensed therapist who lists training or experience in acceptance and commitment therapy. It can help to ask how they use ACT and whether their style fits your goals, such as working with anxiety or living by your values. Directories like Therapists.plus can help you start your search.
Educational resource. Therapists.plus shares general information and connects people with independent therapists, coaches and groups. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health. In a crisis in the US, call or text 988 or call 911.
