Introduction

In this blog I aim to give you a brief overview of Acceptance and Commitment Therapy/Training (ACT), outline why I believe it is very compatible with Positive Psychology (PP) and look at how the two approaches might complement each other.

 

What is ACT?

ACT is a process-based model for understanding and developing psychological flexibility. Thus, it is relevant to people with or without mental health issues, even though it was originally developed from a therapeutic perspective. It can be used in coaching or organisational level interventions as well as applied across a range of psychological disorders. ACT was pioneered by Stephen Hayes in the 1980s and is one of the “third wave” of cognitive behavioural therapies (CBT) and has been described as an existential, humanistic cognitive behavioural therapy. The ACT model is very similar to Susan David’s (2016) conceptualisation of emotional agility within PP.

 

Aims of ACT

The goal of ACT is to help people create a rich and meaningful life rather than “treat” problems. (Does this sound like eudaimonic wellbeing to you?) This is seen as involving experiencing the full range of human emotions because life inevitably has periods of challenge and our emotions have important messages for us about what is going well and what isn’t (Second Wave PP). The avoidance of or struggle with difficult emotions or experiences is considered a key factor in becoming psychologically stuck. We all use a certain amount of experiential avoidance to help us cope at times, the odd glass of wine or chocolate to help us feel better is not an issue, however, when we rely on these strategies to excess it can result in us losing out on parts of our life that are important to us in our futile attempts to “control” our painful thoughts and feelings. This clearly undermines wellbeing. In ACT the thoughts and feelings themselves are not considered the problem, how we relate to them and what we do, as a result, are.

 

Functional Contextualism, Workability and Mindfulness

The function of behaviours (external and internal) in context and their level of “workability” is key in this model. This is in contrast to traditional CBT which spends time looking at whether the thoughts we have in response to challenges are true and logical. In ACT all that matters is whether thoughts, feelings and our responses to them are helpful or not. ACT  uses mindfulness techniques to help us be in contact with our thoughts and feelings and what is actually going on in the moment (presence). We allow feelings to be there (acceptance) rather than resisting them, we step back from being overidentified with our thoughts (defusion) so that we can choose how to respond to them rather than reacting in rigid and inflexible ways. We use perspective to see our issues and narrative about ourselves in context (self as context) so that we have time to connect with what really matters (values) and act purposefully in line with what we truly care about (committed action). This focus on personal values and taking committed action towards living them resonates with the PP concepts of intrinsic motivation, authenticity, meaning and purpose. The six key processes of psychological flexibility in the ACT model are shown in figure 1.

ACT is also an evidence-based intervention based on coherent psychological theory (Relational Frame Theory, RFT) and consistent with client-centred Rogerian values which are key in PP interventions.

Figure 1

ACT Processes of Psychological Flexibility (The Hexaflex)

 

 

 

Compassion and Self-Compassion

Compassion and self-compassion are foundational tenets of ACT seen as underlying any intervention, as is a focus on experiential and embodied work during therapy. You can’t just talk about ACT, you have to live it. It takes us out of our heads and into connecting with what it is actually like to truly live a values congruent life. Does that sound like the PP principle of “the first intervention is ourselves?”  Cognitive behavioural principles are drawn on to follow intention through to action and evaluation, which echoes Snyder’s (2002) Hope model from PP.

 

ACT and PP

I hope this brief introduction to ACT has shown how well it resonates with PP. If you would like to know more about ACT I recommend “The Happiness Trap” by Russ Harris or the companion website https://thehappinesstrap.com/ or “A Liberated Mind” by Stephen Hayes. For me as a therapist who had become very disillusioned with traditional CBT, I felt the same sense of “coming home” when I discovered ACT as I had previously when I found PP.

So what can PP offer ACT? To my mind, a good deal. ACT is fundamentally a mindfulness-based intervention and although PP can’t lay claim to the mindfulness movement, it has done much to further research in this area and these links need to be fostered. Likewise, the study of Compassion and Self-Compassion and the work of Kristin Neff (2003) and Paul Gilbert (2014) has much to add to both ACT congruent techniques, research and models to aid psychoeducation. Even though I have a background in CBT I don’t think I would fully “get” ACT without the mindfulness and compassion training I have undertaken as part of my PP work.

Additionally, the work on strengths in PP could supplement values work in ACT. In my previous blogs, I have described strengths as the tools that sit between values and goals. I find a strength assessment can be useful with clients in addition to values and goals work. Sometimes this seems more tangible than values alone and helps produce a shift to a positive mindset and strengths-based language. You can have a strength of humour and use it in the service of a value of connection or misuse it to cause harm. The idea of the “golden mean” in strengths work is similar to the workability concept in ACT. Looking at ways of integrating the approaches might be a useful line of research.

PP also provides models and research around wellbeing and creating a rich and meaningful life which can be useful to discuss with clients who say they don’t know what they want. Likewise, the work on the evolutionary functions of emotions and the Broaden and Build Theory of Positive Emotions (Fredrickson 2004) can provide an explicit focus and rationale for building positive emotions as part of action. I find it helpful to discuss this with clients along with the concept of hedonic adaptation. Lifespan development models from within PP also have something to offer around the “context” of individual clients which could be a helpful adjunct to ACT.

Concepts and research around resilience are also highly relevant to the psychological flexibility that ACT promotes, as is work on courage and vulnerability. It takes both of these things to try and live a values-oriented life.

I am still new to practising ACT and have a lot to learn, but it seems to me it is a process-oriented approach to change that is wholly consistent with PP and I hope to continue to explore ways that these paradigms might complement one another.

 

 

References

David, S. (2016). Emotional Agility: Get unstuck, embrace change and thrive in work and life. Penguin.

Fredrickson, B.L. (2004). The broaden-and-build theory of positive emotions. Phil. Trans. R. Soc. Lond. B, 359, 1367-1377.

Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53, 6-41.

Harris, R. (2008) .The happiness trap. Robinson (Second edition due out in paperback April 2022)

Hayes, S. (2019). A liberated mind. Penguin, Random House Publishing.

Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity: The Journal of the International Society for Self and Identity, 2, 223–250.

Snyder, C.R. (2002). Hope Theory: Rainbows in the Mind. Psychological Inquiry, 13(4), 249-275.

 

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