Acceptance & Commitment Therapy (ACT): Living with Meaning

Life offers joy, connection, and purpose—but it also brings pain, stress, and challenges. Acceptance and Commitment Therapy (ACT) is a modern, evidence-based approach to psychological counselling that helps us find new ways of responding to life’s difficulties. Instead of trying to “get rid of” painful thoughts and feelings, ACT teaches us how to make room for them—while still moving toward the things that matter most.

At its heart, ACT is about developing psychological flexibility: the ability to adapt when challenges arise, stay connected to the present moment, and keep choosing actions that align with our values. Success in ACT isn’t measured by “feeling good all the time.” Instead, it’s about whether we can continue to take steps toward a rich, full, and meaningful life—even in the presence of discomfort.

The Six Core Skills of ACT

ACT uses six evidence-based processes to build flexibility and resilience:

1. Cognitive Defusion (Unhooking) – Learning to step back from unhelpful thoughts so they don’t automatically dictate behaviour. Thoughts are noticed as passing events in the mind, not absolute truths.

2. Acceptance – Allowing thoughts, feelings, and urges to be present without struggling against them. It’s often the battle with inner experiences, rather than the experiences themselves, that causes the most suffering.

3. Contact with the Present Moment – Cultivating mindfulness by paying attention with openness and curiosity, instead of zoning out, avoiding, or being swept away by worries.

4. The Observing Self – Developing a steady awareness that notices thoughts and feelings without being defined by them—like watching a play from the audience rather than being lost in the performance.

5. Values – Clarifying what truly matters: the qualities we want to embody, the kind of person we want to be, and what gives our life meaning.

6. Committed Action – Taking practical steps guided by values, even when it feels uncomfortable or difficult. These choices gradually create a life that feels purposeful and authentic.

Everyday Examples of ACT in Action

Anxiety

Before a presentation, your mind says, “I’m going to mess this up.” Rather than trying to silence the thought (which often makes it louder), ACT encourages you to notice: “Here’s my anxious mind again.” By grounding yourself and reconnecting to your value of sharing knowledge, you can give the presentation anyway. Anxiety may still be there—but it no longer runs the show.

Depression

Depression often whispers: “What’s the point? I can’t do anything right.” ACT helps you see this as a thought—not a fact. Even when motivation is low, you can take one small, values-guided step, such as calling a friend or going for a short walk. These small actions accumulate, gently building momentum toward a more meaningful life.

Trauma

Traumatic experiences can leave us avoiding reminders of pain. ACT doesn’t try to erase these memories, but teaches us to hold them more lightly while staying anchored in the present. For example, grounding exercises and reconnecting to values like safety or connection help people gently re-engage with the world instead of withdrawing from it.

Relationships

Conflict often triggers thoughts like “They never listen to me” or urges to lash out. ACT teaches us to pause, notice these inner reactions, and then check in with values—perhaps kindness or honesty. Guided by those values, we can choose a “towards move” (an action that leads us closer to our values and the kind of relationships we want), such as calmly expressing feelings, listening openly, or setting a healthy boundary.

The Struggle Switch

Dr. Russ Harris describes the struggle switch:

• Pain + struggle = suffering

• Pain + willingness = growth

Pain is part of being human. But when we fight with our thoughts and feelings, pain turns into suffering. ACT helps us “turn off” the struggle switch—not by eliminating pain, but by learning to hold our experiences with compassion and space.

Try This Now: A Simple ACT Exercise

The Choice Point

1. Think of a stressful situation today.

2. Ask: What are my thoughts and feelings pushing me to do? (e.g., avoid, lash out). These are away moves (actions driven by discomfort that pull us further from our values).

3. Then ask: What action would take me closer to the kind of person I want to be? (e.g., reach out, take a step, speak calmly). These are towards moves.

4. Choose one small towards move today.

This practice helps us notice the crossroads we face and choose actions guided by values—not automatic reactions.

Does ACT Work? The Research

ACT is one of the most widely researched therapies today, with evidence supporting its effectiveness across many areas:

• Anxiety disorders – reduces worry and avoidance, improves quality of life (Arch et al., 2012; Swain et al., 2013).

• Depression – significantly reduces depressive symptoms (Bai et al., 2020; Forman et al., 2012).

• Trauma & PTSD – helps survivors reduce avoidance and reconnect with valued living (Walser & Westrup, 2007; Twohig, 2012).

• OCD – reduces obsessions and compulsions, particularly when combined with exposure therapy (Twohig et al., 2010, 2018).

• Substance use & addictions – reduces relapse and supports recovery (Lee et al., 2015; Bricker et al., 2020).

• Chronic pain & health conditions – improves functioning and wellbeing even when symptoms remain (Veehof et al., 2016).

• Psychosis – supports flexible responding to distressing thoughts and voices, sometimes lowering hospital readmissions (Bach & Hayes, 2002).

Across dozens of meta-analyses, ACT consistently improves wellbeing and functioning. It doesn’t promise a life without pain—but it provides tools to live more fully and meaningfully alongside it.

Final Thoughts

ACT offers a practical, compassionate framework for living well—with more awareness, more freedom, and greater alignment with your values. It’s not about eliminating pain, but about learning to carry it differently so you can create a life that truly matters.

For a friendly introduction, see Dr. Russ Harris’s article Embracing Your Demons: An Overview of Acceptance and Commitment Therapy, and explore more free resources at www.actmindfully.com.au.

References (selected)

• Arch, J. J., et al. (2012). ACT vs CBT for mixed anxiety disorders. J. Consulting & Clinical Psychology.

• Bai, Z., et al. (2020). ACT for depressive disorders: Meta-analysis. Journal of Affective Disorders.

• Gloster, A. T., et al. (2020). The empirical status of ACT: Review of meta-analyses. Journal of Contextual Behavioral Science.

• Twohig, M. P., et al. (2010, 2018). ACT trials for OCD. J. Consulting & Clinical Psychology; Behaviour Research & Therapy.

• Veehof, M. M., et al. (2016). Acceptance-based interventions for chronic pain: Meta-analysis. Journal of Pain.

• Bach, P., & Hayes, S. C. (2002). ACT for psychosis: RCT. J. Consulting & Clinical Psychology.

• Bricker, J. B., et al. (2020). ACT-based smoking cessation app (iCanQuit). JAMA Internal Medicine.