Acceptance and Commitment Therapy (ACT)
At Contemporary CBT, we provide Acceptance and Commitment Therapy (ACT) for children, teens, adults, couples, and families. ACT is an evidence-based therapy approach that helps people relate differently to difficult thoughts and feelings while taking meaningful action based on their values. We offer in-person ACT at our offices in Chicago (Lakeview) and Skokie, as well as virtual therapy for clients located in Illinois, Florida, South Carolina, Michigan, and Wisconsin.
What is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy, often called ACT, is a type of therapy that helps people build psychological flexibility. Psychological flexibility means being able to make room for uncomfortable thoughts and feelings while still moving toward the life you want to live.
ACT is not about giving up, ignoring problems, or accepting harmful situations. Instead, ACT helps clients notice painful thoughts and emotions without letting those experiences control every decision. The goal is to spend less energy fighting internal discomfort and more energy building a life that feels meaningful.
What Can Acceptance and Commitment Therapy Help with?
ACT can be used for many mental health concerns, especially when people feel stuck trying to control, avoid, or eliminate difficult emotions.
ACT may help with:
Anxiety and excessive worry
OCD-related distress
Depression and low motivation
Perfectionism
Stress and burnout
Social anxiety
Health anxiety
Chronic self-criticism
Emotional avoidance
Life transitions
Grief and loss
Relationship stress
Parent-child conflict
Identity and values questions
School or work pressure
Difficulty making decisions
Feeling stuck or disconnected
ACT can also be combined with other evidence-based approaches, including Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), Dialectical Behavior Therapy (DBT).
How Does Acceptance and Commitment Therapy Work?
ACT is a mindfulness-based approach that focuses on helping clients change their relationship with thoughts and feelings rather than trying to control every uncomfortable internal experience.
Many people come to therapy because they feel trapped by anxiety, sadness, intrusive thoughts, guilt, shame, fear, or self-doubt. ACT helps clients learn how to notice these experiences, make space for them, and choose actions that align with their values.
In ACT, your therapist may help you:
Identify what matters most to you
Notice thoughts without automatically believing them
Make room for uncomfortable emotions
Reduce avoidance and escape behaviors
Practice mindfulness and present-moment awareness
Separate yourself from harsh self-criticism
Take small steps toward meaningful goals
Build a life guided by values instead of fear
Respond more flexibly to stress, uncertainty, and discomfort
ACT is active, compassionate, and practical. It helps clients develop skills they can use outside of therapy in real-life situations.
Acceptance: Learning how to make room for difficult emotions, sensations, and urges instead of constantly fighting or avoiding them.
Cognitive Defusion: Learning how to step back from thoughts so they feel less powerful. For example, instead of treating the thought “I’m going to fail” as a fact, you may learn to notice, “I’m having the thought that I’m going to fail.”
Core Ideas in ACT
Present-Moment Awareness: Practicing attention to the here and now, rather than getting pulled into the past, future, or repeated mental loops.
Self-as-Context: Connecting with the part of yourself that can observe thoughts, emotions, and experiences without being fully defined or controlled by them.
Values: Clarifying what matters most to you, such as connection, honesty, learning, health, family, creativity, courage, or independence.
Committed Action: Taking realistic steps toward your values, even when difficult thoughts or feelings show up.
Learn More
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ACT can be helpful for anxiety because anxiety often pushes people toward avoidance. Avoidance may feel better in the short term, but it can make life smaller over time.
In ACT for anxiety, clients practice noticing anxious thoughts and bodily sensations without letting anxiety make every decision. Therapy may focus on tolerating uncertainty, reducing avoidance, and taking values-based steps even when anxiety is present.
For example, someone with social anxiety may work on showing up to meaningful social situations, even if anxious thoughts are present. Someone with generalized anxiety may practice making decisions without needing complete certainty first.
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ACT can also support clients with OCD, especially when intrusive thoughts, uncertainty, guilt, or fear feel overwhelming. ACT does not try to prove that intrusive thoughts are “true” or “not true.” Instead, it helps clients relate to thoughts differently and choose actions based on values rather than compulsions.
ACT may be used alongside Exposure and Response Prevention (ERP) to help clients tolerate uncertainty, reduce compulsions, and practice living according to what matters most.
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Depression often pulls people away from the activities, relationships, and routines that give life meaning. ACT can help clients reconnect with values and take small, manageable steps toward those values, even when motivation is low.
ACT for depression may focus on reducing avoidance, responding differently to self-critical thoughts, rebuilding routines, and creating moments of connection, purpose, or accomplishment.
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ACT can be adapted for children and teens in a practical and age-appropriate way. Young clients often benefit from learning that they do not have to get rid of every hard feeling before doing important things.
ACT for children and teens may help with anxiety, perfectionism, school stress, social worries, emotional regulation, identity development, family conflict, and low mood.
Therapy may include metaphors, activities, mindfulness exercises, values exploration, parent involvement, and small action steps that connect to the child or teen’s goals.
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Adults may benefit from ACT when they feel stuck in overthinking, avoidance, burnout, relationship stress, perfectionism, or self-criticism. ACT can help adults make meaningful changes while accepting that discomfort, uncertainty, and vulnerability are part of being human.
ACT is often a good fit for adults who want therapy that is reflective, skills-based, and focused on building a more values-driven life.
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In your first sessions, your therapist will get to know you, understand what brings you to therapy, and identify what you want life to look like beyond symptom reduction.
ACT sessions may include:
Discussing current struggles and goals
Identifying avoidance patterns
Exploring values and priorities
Practicing mindfulness skills
Learning how to step back from difficult thoughts
Building tolerance for uncomfortable feelings
Creating small, realistic action steps
Reflecting on what gets in the way of change
Practicing new responses between sessions
ACT is collaborative. Your therapist will help you apply ACT skills in a way that fits your life, personality, culture, relationships, and goals.
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ACT and CBT are related, but they are not exactly the same. Traditional CBT often focuses on identifying, challenging, and changing unhelpful thought patterns. ACT focuses less on challenging and changing the thought, and more on changing how you react and relate to the thoughts and feelings.
In ACT, the goal is not always to replace a negative thought with a more balanced one. Sometimes the goal is to notice the thought, let it be there, and still choose an action that reflects your values.
Both approaches can be very helpful, and many therapists use ACT and CBT together depending on the client’s needs.
