Acceptance and Commitment Therapy in Kent

The short version

Acceptance and Commitment Therapy — said as the word "act", not spelled out — is a well-established form of behavioural therapy developed from the late 1980s onwards. It rests on an observation most people recognise immediately once it is said out loud: the harder you fight an unwanted thought or feeling, the more of your life it takes up.

Try not to think about a white bear. Try not to notice a craving. Try to make yourself stop worrying. The effort is the problem. So ACT changes the target. Instead of working to feel differently, you work to live differently while the feeling is present.

The six things you actually learn

ACT is usually described as six connected skills. In practice they overlap, and we would not go through them in order like a syllabus — but here is what they mean in plain English.

1. Defusion — putting a bit of daylight between you and your thoughts. "I am worthless" is a sentence your mind produced. It is not a measurement. Learning to hear it as a sentence rather than a verdict changes what you do next.
2. Acceptance — making room for the feeling instead of wrestling it. Not liking it. Not approving of it. Just stopping the fight, which is where most of the exhaustion comes from.
3. Present-moment contact — being here rather than in the replay. Most anxiety lives in the future and most shame lives in the past. Neither is where you can actually do anything.
4. The observing self — noticing that you are the one noticing. You have had thousands of thoughts and feelings across your life and you are still here. You are the sky, not the weather.
5. Values — working out what you actually want to stand for. Not goals. Goals can be completed and ticked off. Values are directions you can keep moving in: being someone your children can rely on, doing work you respect, being honest with the person you live with.
6. Committed action — small, real steps in that direction. Starting today, at the size you can actually manage, with the difficult feeling still in the room.

What it looks like in a session

Less talking about your feelings, more doing something with them. Expect short practical exercises — noticing where a craving sits in your body and watching it change, saying a stuck thought out loud until it loses its grip, mapping what you have given up to keep avoiding something. Some of it feels odd the first time. Most of it makes immediate sense once you have done it.

You will also do things between sessions. Small, specific, testable things — not worksheets for the sake of it.

What ACT is good for

• Addiction and compulsive behaviour — where ACT is particularly well suited, because urges are exactly the kind of internal experience it teaches you to hold rather than obey. This is the bulk of my work.
• Anxiety, worry and panic — especially where avoidance has quietly shrunk your life.
• Low mood, particularly the kind that has become a long-running withdrawal from things you used to care about.
• Stress and burnout.
• Long-term health conditions and chronic pain, where the difficulty is not going to disappear and the question becomes how to have a life alongside it.
• Shame — which is often the real engine underneath addiction, and which responds badly to being argued with and well to being brought into the open.

What it is not

ACT is not positive thinking, and it is not resignation. "Acceptance" does not mean accepting a situation you can change — if the problem is a job that is destroying you, the answer may well be a different job. Acceptance applies to what is already here and cannot be wished away: the feeling, the memory, the urge, the fact of what happened.

It is also not a quick fix. It is a set of skills, and skills take practice.

Does it work?

ACT has been researched extensively over three decades, with randomised controlled trials across anxiety, depression, chronic pain and substance use, and it is recognised as an evidence-based approach in the UK and internationally. For substance use specifically, the evidence base is real but still smaller than for standard CBT — which is worth knowing, and is why I use both.

What no research can tell you is whether it will work for you. That is what the first few sessions are for, and I would rather find out honestly than sell you a certainty that does not exist.