Acceptance and Commitment Therapy Exercises

Acceptance and Commitment Therapy (ACT) is a form of behavioural therapy that works on how a person relates to their thoughts and feelings, rather than on arguing with the content of those thoughts. It sits alongside other approaches rather than replacing them, and it may be worth reading about if you have not found relief in other forms of therapy.

ACT is not only talking over problems. It teaches skills for noticing thoughts and feelings without being directed by them, clarifying what matters to you, and taking action in line with those values, including at times when the feelings are painful.

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Understanding the Basics of ACT

At its core, Acceptance and Commitment Therapy (ACT) aims to build psychological flexibility: the capacity to stay in contact with the present moment and to act on your values even when unwanted thoughts and feelings are present [2].
Here are the six processes ACT works with:

Cognitive Defusion

This involves learning to perceive your thoughts and feelings as passing events in your mind rather than as directives that must be acted upon. For example, instead of getting entangled in a thought like "I must be perfect," you can learn to see it as a string of words in your mind that does not control your actions.

Acceptance

Instead of fighting or feeling bad about having certain thoughts or feelings, with ACT you learn to allow these thoughts or feelings as part of your human experience. This does not mean resignation: it is about facing what you feel without unnecessary struggle.

Being Present

This means bringing your full awareness to the here and now, engaging fully with your current activities, rather than dwelling on the past or rehearsing the future.

Self as Context

Often referred to as the 'observing self', this is the understanding that you are not merely your thoughts or feelings. Instead, you are the context in which these internal experiences happen. This perspective supports a different relationship to thoughts and feelings.

Values Clarification

ACT involves identifying what truly matters to you, that is, your values. These are chosen qualities of purposive action that you can bring to many situations, such as being caring, creative, or courageous.

Committed Action

Finally, ACT encourages you to take action based on your values, even when it is difficult or uncomfortable to do so. This might mean pursuing a career path that aligns more closely with your interests, or engaging in a relationship in a more open way.

Why Consider ACT?

ACT is distinct in that it does not set out to reduce or dispute unwanted thoughts and feelings directly. It works instead on your relationship to them, and on what you do next.

The aim is to be able to engage with life more fully alongside the inevitable ups and downs: meeting your thoughts and emotions with openness, and taking steps that align with your values.

Core ACT Exercises for Self-Help

ACT provides several practical exercises that can help you apply its principles in daily life. Here are a few you might find useful:

1. Cognitive Defusion Techniques

• Thought Labelling: This technique involves recognising thoughts simply as thoughts, rather than truths. When a distressing thought arises, mentally note it as "thinking" and allow it to pass without further engagement. The aim is to see thoughts as temporary events rather than as facts to be settled.
  
• Physicalising Thoughts: Picture your thoughts as objects placed on a conveyor belt, or as leaves floating down a stream. This is a standard defusion practice: it gives you a way of observing thoughts as separate from yourself instead of being carried along by them.

2. Acceptance Practices

• Expansion Exercise: This involves making room for unpleasant feelings by picturing your body opening around them, giving them space to exist rather than pushing them away. The point is to feel them fully without letting them dictate your actions.
  
• Willingness and Turning Towards: This exercise encourages you to turn towards emotional discomfort and open up to it with curiosity rather than avoidance. It works from the position that discomfort and pain are part of life, and that avoiding them often adds to the difficulty.

3. Mindfulness and Being Present

• Mindful Breathing: Concentrate on your breathing, noticing the sensation of air entering and leaving your nostrils. The practice is intended to anchor you in the present moment when your attention has run ahead of you.
  
• Mindful Observation: Choose an object from your immediate environment and focus your attention on it. Observe it without judgement, noticing its colour, shape, texture, and other qualities. This is practice in staying present and engaged.

4. Values Clarification

• Values Card Sort: A physical or digital card sort in which you prioritise different values such as family, health, education, and career. This helps you to clarify what is most important to you and informs your decisions.
  
• Values Journalling: Regularly write about how you have lived according to your values each day. This keeps the values in view rather than leaving them as an abstraction.

5. Committed Action

• Goal Setting: Based on your clarified values, set specific, measurable, achievable, relevant, and time-bound (SMART) goals. This focuses your efforts on concrete steps that align with your values.
  
• Action Planning: Develop a plan for when and how you will take those actions. Include what you will do, when you will do it, and how you will track your progress.

Integrating ACT into Your Daily Routine

To make ACT a regular part of your life, start small by taking on one or two exercises. Set reminders to practise them during breaks in your day, or in response to specific triggers. Regular practice is how the skills develop; how quickly, and how far, differs from person to person.

These tools offer practical ways to work on psychological flexibility, mindfulness, and values-based action. They are commonly used alongside therapy for stress, anxiety, and other difficulties, and are not a substitute for it.

Challenges and Solutions in Practising ACT

ACT comes with its own difficulties, as any therapeutic approach does. Here are some common ones and what can help:

1. Overwhelm with Negative Emotions

• Solution: Use the expansion exercise from the acceptance practices to allow your emotions to be present. If the distress stays high after the exercise ends, stop and speak to a clinician rather than pushing on alone.

2. Difficulty Staying Present

• Solution: Increase the frequency of the mindfulness exercises. Short, consistent practice through the day is usually more workable than occasional long sessions.

3. Sticking to Committed Actions

• Solution: Break the actions into smaller steps and mark the ones you complete. Smaller steps are easier to start, and starting is usually the hard part.

Staying Motivated with ACT

Some strategies that help:

Set Realistic Expectations

Change takes time, and setbacks are part of the process. Realistic goals make frustration and disappointment less likely.

Note Small Gains

Recognise what you have managed, however small it seems. Managing a stressful moment slightly better than before, or practising mindfulness consistently for a week, is worth noting.

Connect with Your Values

Remind yourself regularly why you are doing this. Linking the practice to your values gives it a reason that holds when it becomes difficult.

Integrating ACT Practices into Family and Social Life

ACT is not only for individual therapy. Its principles can also be used in your interactions with family and friends:

Shared Mindfulness

Take up mindfulness exercises together with your family or friends. Activities such as mindful walking or eating can be done as a group.

Open Communication

Use the openness cultivated through ACT in your relationships. Express your thoughts and feelings openly and hear others' perspectives without judgement.

Group Values Exercise

Discuss and explore shared values with your family or social group, which can bring collective actions towards common goals. In addition to ACT, systemic therapy approaches also emphasise the importance of shared goals and values in fostering healthy relationships and resolving conflicts within groups.

Resources for Deepening Your ACT Practice

To read further on ACT and extend your practice, these are useful places to start:

Books and Articles

"The Happiness Trap" by Russ Harris and "Get Out of Your Mind and Into Your Life" by Steven C. Hayes both set out ACT principles and practices for a general reader.

Online Courses

Platforms such as Coursera and Udemy carry courses on ACT and mindfulness that you can work through at home. Check who has written the course and what their clinical training is before you commit to it.

Workshops and Seminars

Look for local or online workshops run by a qualified practitioner, where the exercises are done with guidance rather than alone.

Supporting Your ACT Practice

A few things that make the practice easier to sustain:

Seek Professional Guidance

Self-help tools have their uses, but working with a therapist trained in ACT gives you guidance suited to your own situation.

Join a Support Group

Many communities and online platforms run ACT groups where people share their experiences and strategies.

Keep a Practice Journal

Writing down what you tried, what was difficult, and what shifted gives you something concrete to review, on your own or with a clinician.

If ACT exercises do not suit you, look at the different therapy techniques and tools available to find an approach that fits.

Conclusion

Acceptance and Commitment Therapy is more than a set of techniques. It is a way of approaching difficulty in which the aim is not to remove painful thoughts and feelings, but to act on what matters while they are present. What that yields differs from person to person, and for many people it is worked out with a therapist rather than alone.

Key Takeaways

• ACT Targets Psychological Flexibility: Defusion, acceptance, mindfulness, and committed action are all aimed at the same capacity, which is acting on your values while difficult thoughts and feelings are present.
• Regular Practice Matters: These are skills, and skills develop with repetition. The pace and the result differ from person to person.
• Values Drive Action: Clarifying your values gives you something to steer decisions by when feelings alone would not.
• Support is Available: Whether through professional counselling or support groups, you do not have to do this alone.
• Progress is Personal: Everyone's experience of ACT is different. Be patient with the parts that are hard.
• Change is Gradual: Building psychological flexibility takes time and practice.
• Small Steps Count: Short, regular practice is usually more workable than occasional long sessions.

FAQ

How do I start incorporating ACT into my busy schedule?

Begin with short mindfulness exercises at moments of transition through your day, such as after sending emails or before starting your car.

What if I can't seem to detach from my thoughts?

Keep practising the cognitive defusion techniques. It is a skill that develops over time with repetition.

Can ACT help with serious mental health issues?

A 2020 review of 20 meta-analyses, covering 12,477 participants, found ACT more effective than no treatment, placebo, or usual care across conditions including anxiety, depression, substance use, and chronic pain. It was not found superior to cognitive behavioural therapy [1]. That review did not establish ACT for post-traumatic stress disorder. Where a difficulty is severe or long-standing, self-guided exercises are not a substitute for working with a clinician.

How long before I see changes from practising ACT?

This varies. Some people notice something in a single exercise; more durable change usually takes consistent practice over weeks or months, and for some people it does not come from self-guided work alone.

What's the best way to learn more about ACT?

Books, workshops, and sessions with an ACT therapist. A therapist can tell you which parts apply to your situation, which a book cannot.

How can I tell whether I'm practising ACT correctly?

Feedback from a therapist or an ACT practice group is the usual way. Working entirely alone, it is difficult to tell whether you are doing an exercise or avoiding through it.

Are there any risks associated with practising ACT?

Turning towards difficult feelings can raise distress, sometimes sharply. Stop the exercise and speak to a clinician if the distress stays high after you finish, if it brings up traumatic memories, or if you find yourself thinking about harming yourself. If you are in immediate danger, contact your local emergency or crisis service.

How can I handle resistance from within myself while practising ACT?

Recognise the resistance as a normal reaction, observe it without judgement, and return to the practice. Persistent resistance is worth raising with a clinician rather than overriding.

Can ACT techniques be harmful if done incorrectly?

Misapplied exposure to uncomfortable emotions can increase distress. This is the main reason to learn the techniques under a qualified practitioner rather than from a text alone.

What if my family doesn't support my practice?

Focus on what is within your control, which is your own actions and your commitment to your values, and seek support elsewhere if you need it.

How can I restart my practice when it feels stale?

Try different ACT exercises, revisit your goals, or work through it with a therapist.

Is there a community of ACT practitioners I can join?

There are online forums, social media groups, and local meetups where you can connect with others practising ACT.

How do I balance between accepting emotions and taking action?

Use your values as the guide. Acceptance is what allows the action; it is not an alternative to it.

Where can I find a certified ACT therapist?

Check professional directories such as the Association for Contextual Behavioural Science (ACBS), or consult your local psychological association.

References

1. Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181-192. https://doi.org/10.1016/j.jcbs.2020.09.009
2. Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25. https://doi.org/10.1016/j.brat.2005.06.006