Acceptance and commitment therapy: altering the verbal support for experiential avoidance
Open accessAbstract
Acceptance and Commitment Therapy (ACT) is a behavior-analytically-based psychotherapy approach that attempts to undermine emotional avoidance and increase the capacity for behavior change. An overview of this approach is given, followed by several specific examples of the techniques used within ACT. In each instance the behavioral rationale of these techniques is described. A contemporary view of verbal relations provides the basis for new approaches to adult outpatient psychotherapy.
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ACT does not include meditation and rarely uses the term 'mindfulness', but its therapeutic strategies are practically identical to mindfulness skills as described in this review.
“ACT does not include meditation practices, and rarely uses the term ‘mindfulness’ in its treatment protocol, but the therapeutic strategies of ACT are practically identical to mindfulness skills as described in this review.”
From Mindfulness-Based Interventions for Anxiety and Depression (2017) · cites this paper as [26]
The sections on establishing self as context and letting go of the struggle describe observing thoughts and experiencing feelings without trying to change or escape them, supporting a resemblance to mindfulness skills. But the paper does not compare ACT with the skills in the citing review, establish that its strategies are practically identical to them, or substantiate claims about meditation and use of the word ‘mindfulness’ in the full treatment protocol. The Examples of Specific ACT Techniques section says that protocol is a book-length document and offers only a sample of its procedures (page numbers unavailable). (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe aim of ACT is to improve daily functioning and quality of life (QOL) by cultivating psychological flexibility.
“The aim of ACT is to improve daily functioning and QOL by cultivating psychological flexibility [54, 55].”
From Effectiveness of a videoconferencing group-based dyad acceptance and commitment therapy on the quality of life of chronic heart failure patients and their family caregivers: A study protocol for a randomized controlled trial (2024) · cites this paper as [55]
The Synopsis of ACT (Table 1; page unavailable) describes reducing avoidance that inhibits life functioning and helping clients act in directions they value. Commitment and Behavior Change likewise focuses on effective behavior change. These passages support the aim of improving functioning, but our copy does not state a quality-of-life aim or describe the mechanism as cultivating psychological flexibility. (LLM, conf=0.83)
Experimental — accuracy not yet measuredPrevious literature suggested that the relation between mindfulness and mental health outcomes could be a function of the effect of mindfulness on cognitive fusion.
“Previous literature suggested that the relation between mindfulness and mental health outcomes could be a function of the effect of mindfulness on cognitive fusion [17,59].”
From Cognitive fusion mediates the relationship between dispositional mindfulness and negative affects: A study in a sample of spanish children and adolescent school students (2019) · cites this paper as [59]
In “Reactions as Barriers” (page not provided), the paper describes ACT clients learning to notice thoughts as thoughts and reports reduced believability of depressive thoughts alongside treatment outcomes. This is consistent with the proposed role of reduced cognitive fusion, but the paper discusses ACT rather than establishing that mindfulness affects mental health outcomes through cognitive fusion. (LLM, conf=0.78)
Experimental — accuracy not yet measuredAcceptance and commitment therapy (ACT) has consistently demonstrated robust efficacy in addressing psychological distress.
“Acceptance and commitment therapy (ACT), an evolving cognitive behavioral intervention that has consistently demonstrated robust efficacy in addressing psychological distress,21,22,23 targets psychological inflexibility”
From Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions: A Systematic Review and Meta-Analysis (2023) · cites this paper as [21]
In “Reactions as Barriers,” the paper reports favorable outcomes for depression and anxiety, supporting some efficacy. But it also says outcome data were limited, the empirical analysis was in its infancy, and ACT’s comparative benefit was unclear. Those qualifications do not support the claim that robust efficacy had been consistently demonstrated. Page numbers are not provided in the excerpts. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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- Authors
- Hayes, S. C., & Wilson, K. G.
- Affiliations
- University of Nevada, Reno (US)
- Venue
- The Behavior Analyst
- Published
- 1994-10
- Volume
- 17
- Issue
- 2
- Pages
- 289-303
- ISSN
- 0738-6729 (ISSN-L)
- 2196-8918
- PMC
- PMC2733476
- OpenAlex
- W87747734
- Cited by
- 354
- References
- 27
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 24 · 2023: 19 · 2022: 15 · 2021: 27 · 2020: 30 · 2019: 13 · 2018: 15 · 2017: 13 · 2016: 16 · 2015: 15 · 2014: 15 · 2013: 15 · 2012: 8
- FWCI
- 10.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Behavior Analyst (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy, experiential avoidance, emotional avoidance, verbal support, psychotherapeutic interventions
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