In this article, I discuss how using the tools of acceptance and commitment therapy (ACT) is easier if combined with using skills from cognitive behavioural therapy (CBT).

Estimated reading time: 3 minutes.

A recently influential form of therapy is acceptance and commitment therapy (ACT). Its focus is on helping people to accept thoughts and feelings—both pleasant and unpleasant—while focusing on the present moment, connecting with one’s values and taking committed action in the direction of one’s values.

My experience has been that the ‘acceptance’ part of ACT is easier to implement if the person uses skills from another influential form of therapy which has been around much longer than ACT. This perspective is cognitive behavioural therapy (CBT).

In the following sections, I will discuss how implementing ACT’s fundamental strategy of accepting difficult thoughts and feelings is easier when using CBT skills to manage one’s thoughts and feelings.

The ABC’s of ACT

The focus of acceptance and commitment therapy is on helping people to accept thoughts and feelings—both pleasant and unpleasant—while connecting to the present moment, connecting with one’s values and taking committed action in the direction of one’s values. Accepting unpleasant thoughts and feelings results in their being less likely to interfere with connecting to the present moment and acting consistently with your values. The reason is that accepting such thoughts and feelings takes the focus off them and allows you to turn to connecting to the present moment and acting consistently with your values.

In contrast, struggling against such thoughts and feelings turns your focus away from connecting with the present and from acting consistently with your values. Such struggling not only takes your focus away from connecting with the present and from acting consistently with your values, it also paradoxically results in these thoughts and feelings being your focus much longer than were you to accept them. The saying, ‘that which you resists, persists’ and the analogy of fighting to escape quicksand causing you to sink into it captures the importance of accepting thoughts and feelings.

But, you may point out, accepting unpleasant thoughts and feelings is easier said than done when your natural reaction is to resist them and to try to make them go away. Later in this article, I will discuss how you can overcome this obstacle by using skills from CBT which will make it easier for you to accept unpleasant thoughts and feelings. But first I will discuss the basic skills used in CBT for this purpose.

The ABC’s of CBT

The focus of CBT is on helping people to make changes in their thinking (that is, cognitions–the C in CBT) and their behaviours (the B in CBT) in order to have good effects on their emotions. Using this approach, CBT has been found to be effective in helping people address many issues in which dealing with difficult emotions is the problem. These issues include depression, various anxiety issues (generalized anxiety disorder, social anxiety, phobias, health anxiety, panic disorder, and obsessive compulsive disorder), and anger management along with other issues in which dealing with difficult emotions typically plays an important role such as post-traumatic stress disorder, eating issues like bulimia and binge eating as well as substance use issues.

CBT helps people address these issues by giving them skills to help them change how they feel by changing the way they think and behave. Among the many CBT skills are cognitive strategies like thought records which help people to moderate their emotional reactions to manageable levels by changing negatively distorted ‘hot thoughts’ into more accurate ‘balanced thoughts’. Behavioural strategies from CBT are often used in combination with cognitive strategies to bring one’s emotional reactions from very uncomfortable and even overwhelming levels down to somewhat unpleasant but manageable levels.

How using the ABC’s of CBT can help you use the ABC’s of ACT

ACT’s goal of  helping people accept unpleasant thoughts and feelings so that they can connect with the present and act consistently with their values is much easier to achieve if people have skills to help them reduce the unpleasantness of their thoughts and feelings from very uncomfortable or overwhelming levels to somewhat unpleasant and manageable levels.

As I discussed in the previous section, CBT provides people with these skills. Therefore, practising CBT skills to implement the ‘acceptance’ element of ACT makes it easier then to execute the ‘commitment’ element of ACT.

May you use CBT to help you get results from using ACT,

Dr. Pat