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As described by Hayes, Strosahl, and Wilson (1999), Acceptance and Commitment Therapy (ACT) is one of several methods for integrating mindfulness concepts into mental health treatment. Unlike many counseling approaches, ACT does not assume that the goal of treatment is to better control thoughts, feelings, or other private events. Individuals are taught to notice phenomena and take a nonjudgmental stance toward them rather than trying to control, avoid, or otherwise minimize them. Although relatively new, ACT has increasing support for its effectiveness in addressing a variety of problems (Pull, 2009). This article addresses the theoretical foundation and basic principles of ACT, reviews the research, presents a case study to illustrate how it can be applied, and discusses the counseling implications.
Hayes (2004) described Acceptance and Commitment Therapy (ACT) as belonging to a category of treatments he characterized as the "third wave" in the behavioral tradition, such as Dialectical Behavior Therapy (Linchan, 1993); Functional Analytic Psychotherapy (Kohlenberg & Tsai, 1991); Integrative Behavioral Couples Therapy (Christianson & Jacobsen, 1998); and Mindfiilness-Based Cognitive Therapy (Segal, Williams & Teasdale, 2002). These approaches, he said, all emphasize issues like "acceptance, mindfulness, cognitive defusion, dialectics, values, spirituality and relationship" (p. 640). One key difference between an ACT approach and a "second wave" approach like traditional cognitive behavioral is the latter's assumption that clinical improvement depends on changing cognitions. Instead, ACT teaches individuals to notice their thoughts from a neutral perspective without engaging with them or defining themselves by them.
While some have argued that ACT and other mindfulness approaches are simply variations that fit well with the cognitive behavior therapy (CBT) paradigm (Hofmann & Asmundson, 2008; Hofmann, Sawyer & Fang, 2010), there seems to be agreement that ACT and traditional CBT do differ; the distinction is like the comparison of the martial arts of tae kwon do (loosely: "to strike or break with foot or fist"); aikido ("the way of the harmonious spirit"); and jiujitsu ("a gentle or yielding art-form"). All may be martial arts initially developed in Asia, but tae kwon do emphasizes force meeting force while aikido and jiujitsu emphasize blending with the opponent and redirecting or neutralizing the attack. In counseling, a CBT approach might work to "change" maladaptive thoughts by directly challenging them, with the expectation...