Acceptance and Commitment Therapy (ACT) is an evidence-based therapy that helps you build psychological flexibility — the ability to stay present, make room for difficult thoughts and feelings, and take action guided by what actually matters to you, rather than waiting for anxiety or stress to go away first.
If you're still deciding whether therapy is worth exploring at all, our guide on Do I Need Therapy? is a good starting point. This article assumes you're ready to understand the "how" — what the approach we use actually involves.
The Core Idea: Psychological Flexibility
Most people come to therapy hoping to get rid of anxiety, low mood, or stress altogether. ACT takes a different starting point: rather than treating difficult thoughts and feelings as problems to eliminate, it treats your relationship with them as the thing that can change.
That shift matters because a lot of struggle comes not from anxiety itself, but from the fight against it — the avoidance, the mental effort spent trying to control or suppress feelings, and the way life gets smaller as a result. ACT works on loosening that fight, so you can move toward a fuller life even when difficult feelings are present.
How ACT Differs from Traditional CBT
ACT sits within the broader CBT family, and shares its evidence-based foundations, but the emphasis is different. Traditional CBT often works by identifying and challenging unhelpful thoughts directly. ACT instead teaches you to notice thoughts without needing to fight, fix, or believe them automatically — a skill called cognitive defusion — and to focus energy on values-driven action instead.
In practice, many psychologists (including our team) draw on both approaches flexibly, depending on what's most useful for the person in front of them.
What an ACT Session Actually Looks Like
Sessions are collaborative and practical, not just talking in the abstract. Depending on what you're working on, a session might involve:
- Noticing and naming patterns of avoidance that have been keeping life smaller than you'd like
- Practising mindfulness-based skills for making room for difficult feelings, rather than suppressing them
- Clarifying what actually matters to you — your values — as a compass for decisions, separate from what anxiety is telling you to do
- Building specific, workable steps (committed action) toward the life you want, even while difficult feelings are present
What ACT Can Help With
ACT has a strong evidence base across a wide range of presentations, including generalised anxiety, social anxiety, panic, OCD, stress and burnout, and chronic pain. It's a flexible approach rather than a narrow protocol for one condition — which is part of why it can be tailored closely to your specific situation.
Frequently Asked Questions
Is ACT evidence-based?
Yes. ACT has a substantial and growing evidence base across anxiety, depression, chronic pain, and stress-related conditions, and is recognised as an evidence-based therapy under Medicare's Better Access initiative.
How many sessions does ACT usually take?
This varies by person and presentation, but many people notice meaningful shifts within the first several sessions, with ongoing work building psychological flexibility over a broader course of therapy.
Can ACT be combined with medication?
Yes, ACT is commonly used alongside medication prescribed by a GP or psychiatrist. Your psychologist and prescriber can work together as part of your overall care.
Is ACT the same as mindfulness?
Mindfulness is one ingredient within ACT, not the whole approach. ACT combines mindfulness-based skills with values clarification and committed action, aimed at helping you live well alongside difficult thoughts and feelings, rather than only calming the mind.
General information only. Treatment approaches are tailored to the individual, and outcomes vary based on personal circumstances. This article does not constitute clinical advice.
