​What Is Acceptance and Commitment Therapy (ACT)?

Acceptance and Commitment Therapy — commonly known as ACT (pronounced as the word "act," not as initials) — is one of the most well-researched therapeutic approaches of the last 40 years. Developed in the 1980s by psychologist Steven C. Hayes, ACT belongs to the "third wave" of cognitive-behavioural therapies, which means it builds on traditional CBT but takes a fundamentally different direction.

Where older therapies often focus on reducing or eliminating difficult thoughts and feelings, ACT takes a different stance: it teaches you to make space for those thoughts and feelings, while choosing to live in alignment with what truly matters to you.

The core idea sounds almost counterintuitive at first — stop fighting your pain, and you'll suffer less. But the research consistently backs it up.

The Problem ACT Was Designed to Solve

Most of us spend enormous energy trying to feel better: avoiding difficult conversations, numbing emotions, staying busy so we don't have to sit with discomfort. It's understandable. Pain feels like something to be solved.

But this strategy — sometimes called experiential avoidance — often creates a second layer of suffering. When we run from our emotions, we also run away from our lives. We pull back from relationships, avoid meaningful work, and slowly disconnect from who we really are.

ACT was developed to address exactly this pattern. Instead of teaching you to think more positively or eliminate anxiety, it helps you build a different relationship with your inner experience — one rooted in awareness, acceptance, and intentional action.

The Six Core Processes of ACT

ACT works through six interconnected psychological processes, all of which build toward psychological flexibility — the ability to be present, open, and to do what matters even when it's hard.

1. Acceptance

Acceptance in ACT does not mean resignation. It does not mean you have to like your pain or agree with your difficult thoughts. It means making room for them — choosing to stop fighting what cannot immediately be changed, so your energy can go toward living.

2. Cognitive Defusion

Our minds produce thousands of thoughts a day, and we tend to get tangled in them, treating every thought as a fact or a command. Defusion techniques help you observe your thoughts from a distance — to notice "I'm having the thought that I'm not enough" rather than believing "I am not enough." This small shift can be profoundly freeing.

3. Present-Moment Awareness (Mindfulness)

Much of our suffering happens in the past (rumination) or the future (anxiety). ACT incorporates mindfulness practices to help you come back to the present — not to empty your mind, but to be fully alive to your actual experience right now.

4. Self-as-Context

This process helps you connect with the part of you that is always observing — the steady witness behind your changing thoughts, emotions, and roles. You are not your anxiety. You are not your depression. You are the person noticing those experiences.

5. Values Clarification

One of ACT's most distinctive and powerful elements is its focus on values — not goals, but the deep qualities of how you want to live. What kind of partner do you want to be? What does meaningful work look like for you? What matters most? When you know your values, they become a compass even through painful terrain.

6. Committed Action

Knowing your values isn't enough. ACT supports you in taking concrete, deliberate steps toward a life that reflects them — even when those steps feel uncomfortable, uncertain, or imperfect.

These six processes are often visualised as a "hexaflex," a model that shows how they interconnect to build psychological flexibility — the central outcome ACT works toward.

What Does Psychological Flexibility Actually Mean?

Psychological flexibility is ACT's central concept, and it's worth unpacking because it's often misunderstood.

It doesn't mean being unaffected by difficulty. It means being able to:

  • Feel fear, and still take the step that matters
  • Experience grief, and still show up for the people you love
  • Sit with uncertainty, and still make a decision aligned with your values
  • Notice self-critical thoughts, without being controlled by them

Research shows that higher psychological flexibility is linked to reduced anxiety and depression, better relationships, greater work satisfaction, and improved wellbeing overall. It's not about having fewer problems. It's about having more capacity to live fully despite them.

What Conditions Does ACT Help With?

ACT is one of the most extensively studied therapeutic models available. It has been shown to be effective for a wide range of challenges, including:

  • Anxiety disorders — including generalised anxiety, social anxiety, panic, and health anxiety
  • Depression — particularly for preventing relapse and treating chronic low mood
  • Burnout — especially relevant for high-achieving women and professionals who have lost connection with meaning in their work
  • Chronic stress — helping people respond to ongoing pressure rather than simply react to it
  • Relationship difficulties — ACT principles apply beautifully to couples work, particularly around communication, vulnerability, and values alignment
  • Trauma and PTSD — often used alongside or within trauma-informed approaches
  • Grief and loss — helping people honour their pain while remaining connected to life
  • Chronic pain and illness — ACT has a strong evidence base for physical conditions where acceptance is part of the treatment

It is also increasingly used in high-performance contexts — sport, business, leadership — precisely because it doesn't aim to eliminate pressure but to help people perform and live well within it.

ACT vs. CBT: What's the Difference?

A common question is how ACT differs from traditional Cognitive Behavioural Therapy (CBT).

In CBT, the primary goal is often to identify and challenge unhelpful thoughts — to replace distorted thinking with more balanced thinking. This is genuinely useful for many people.

ACT operates from a slightly different premise: that the problem is not the content of your thoughts but your relationship to them. Rather than arguing with a thought like "I'm a failure," ACT asks: what if you simply didn't have to obey that thought? What if you could notice it, name it, and still choose to act from your values regardless?

This distinction makes ACT particularly well-suited for people who have tried CBT and found that identifying cognitive distortions was helpful intellectually but didn't quite get to the root of what they were struggling with.

That said, these approaches are not opposites — many skilled therapists integrate principles from both.

What Does an ACT Session Look Like?

An ACT session with a holistic psychologist won't feel like being handed a workbook and told to complete exercises. Done well, ACT is deeply experiential — it invites you into direct contact with your inner world.

In sessions, you might:

  • Use metaphors and imagery — ACT is rich with vivid metaphors that illuminate how the mind works (the passenger on the bus, the chessboard, the hands in front of your face)
  • Try mindfulness and body-based practices — because ACT recognises that the body is part of the story, not just the mind
  • Explore your values — through reflection, conversation, and sometimes creative exercises
  • Identify avoidance patterns — gently noticing where you've been pulling back from life, and what that's costing you
  • Practice defusion techniques — learning to step back from thoughts rather than being swept away by them
  • Plan committed actions — small, concrete steps toward a life that feels meaningful

Sessions are collaborative, curious, and warm. ACT is not about the therapist telling you what your values should be or how you should feel. It's about helping you come into clearer contact with your own inner compass.

ACT and the Body: The Holistic Dimension

One of the reasons I find ACT so compatible with holistic psychology is that it doesn't treat the mind and body as separate systems. The body holds our experiences — tension, bracing, collapse — and learning to notice and work with somatic responses is a natural extension of ACT's mindfulness principles.

In my work with clients, I often weave ACT techniques with body-aware practices, creating a therapeutic space where you can be met as a whole person — not just a collection of thoughts and symptoms.

This is particularly relevant for women navigating life transitions, burnout, or relationship challenges, where the disconnection between mind and body is often part of what needs healing.

Is ACT Right for You?

ACT tends to be a good fit if:

  • You feel stuck despite already knowing a lot about yourself intellectually
  • You've tried to "think your way out" of difficult emotions and found it only takes you so far
  • You're going through a significant life transition and need support clarifying what you actually want
  • You want therapy that's collaborative, reflective, and values-centred rather than purely symptom-focused
  • You're curious about mindfulness but want more structure than a meditation app can offer
  • You feel disconnected from what makes life feel meaningful

It may be less suitable as a standalone approach if you are in acute crisis, require stabilisation first, or have specific conditions that respond better to more structured protocols — in those cases, a skilled therapist will adapt accordingly.

Frequently Asked Questions About ACT

How long does ACT therapy take? This varies depending on the person and the presenting issues. Some people see meaningful shifts in 8–12 sessions. Others engage in longer-term work, especially when exploring deeper life questions, relationship patterns, or complex histories. This is something to discuss openly with your therapist from the beginning.

Can ACT be done online? Yes. ACT translates very well to online sessions. Many of the core techniques — mindfulness practices, defusion exercises, values exploration — work effectively in a video therapy setting.

Is ACT the same as mindfulness? Mindfulness is one of six core processes within ACT, not the whole of it. ACT uses mindfulness practices as a tool within a broader framework that also includes values work and committed action.

Do I need to be in crisis to benefit from ACT? Not at all. Many people come to ACT not because something is acutely wrong, but because they want to live more intentionally, reconnect with meaning, or work through a transition. You don't need to hit a wall before therapy becomes valuable.

Is ACT evidence-based? Yes. ACT has one of the strongest evidence bases in contemporary psychotherapy, with hundreds of peer-reviewed studies supporting its effectiveness across a wide range of conditions. It is included in clinical guidelines in the US, UK, and Europe.

Working with ACT in Athens

If you're based in Athens or Greece and looking for an English-speaking therapist who works with ACT principles, you don't need to choose between cultural sensitivity and clinical quality.

In my practice, I work with high-achieving women and bicultural couples navigating stress, transition, and the particular challenges of building a meaningful life across cultures. ACT's emphasis on values and committed action makes it a natural fit for people who are redefining what they want — from their work, their relationships, and themselves.

Sessions are available in English, Greek, and Swedish, both in person and online.

If you're curious about whether ACT could be helpful for you, I offer a free introductory call to explore this together.

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Melina Linden is a holistic psychologist based in Athens, Greece. She works with individuals and couples using an integrative approach that draws on ACT, Imago Therapy, and somatic psychology. Melina holds advanced training in Acceptance and Commitment Therapy and offers sessions in English, Greek, and Swedish.