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This Special Interest Group focuses on promoting the practice of Acceptance and Commitment Therapy in the United Kingdom, as well as supporting research and training in contextual behavioural science.
Contact the ACT Special Interest Group by emailing act-sig@babcp.com
Acceptance and Commitment Therapy (ACT, said as one word rather than A-C-T) is an empirically-based contextual CBT that combines acceptance and mindfulness-based strategies to reduce the influence of fear and avoidance of difficult psychological experiences (e.g., thoughts, feelings, images, memories). Alongside this, ACT helps clients identify deeply held personal values and to use these to guide meaningful behaviour change. From an ACT perspective, what is ‘true’ is what works for the client to help them move towards those valued directions. The so-called ‘truth criterion’ of functional contextualism - the name given to the philosophical underpinning of ACT - is pragmatism. What is true is what works!
Together, these therapeutic processes aim to increase psychological flexibility, which means contacting the present moment fully as a conscious human being, based on what the situation affords, and changing or persisting in behaviour in the service of chosen values.
Based on Relational Frame Theory (RFT), ACT illuminates the ways that language can entangle clients into futile struggles to control their own inner lives, even when this leads to further distress. Through the use of metaphor, paradox, and experiential exercises clients learn how to make healthy contact with thoughts, feelings, memories, and physical sensations that have previously been feared and avoided.
Clients gain the skills to re-contextualise and accept these private events, develop greater clarity about personal values, and commit to needed behaviour change. The ethos and principles of the ACT model can lead us to a more consciously guided and enormously fulfilled, values-based way of being that continues to contribute long term benefits to emotional wellbeing and positive mental health.
Are you interested in teaching about ACT or already engaged in this activity? The Committee would like to compile a set of resources for teaching ACT, encourage trainers to share ideas, and generally support the dissemination of ACT on training courses in the UK. Please feel free to email the Committee about these issues.
Our guidance from BABCP is that ACT can be recognised in the same way as any other form of CBT for accreditation purposes. Further dialogue is ongoing; we encourage you to extend that dialogue in your own accreditation journey and to tell us about it.
ACT has a rapidly growing evidence-base of over 300 published and in press randomised control trials across a range of difficulties including (but not limited to) depression, anxiety, obsessive-compulsive related difficulties, personality disorder, substance use, eating disorders, pain, weight loss, cancer, multiple sclerosis, diabetes, fibromyalgia, smoking, exercise, sleep, epilepsy, tinnitus, asthma, HIV, and stroke. There is also growing evidence for the utility of ACT in other areas such as parenting, work, stigma, procrastination, aggression, and confidence. The evidence-base spans a diverse population (e.g., college students, healthy adults, medical and psychiatric patients, and children and adolescents) from a broad geography (England, Ireland, Iran, China, Sweden, Australia, Korea, India, Cyprus, and other). RCTs have used a range of active and inactive comparison conditions (e.g., CBT, treatment as usual, wait list controls), with treatment delivered in a variety of formats (e.g., individual, group, face-to-face, online). There are over 35 meta-analyses, narrative and systematic reviews summarising the overall impact of ACT, as well as an expanse of literature on the core therapeutic processes that mediate change. In the USA, the American Psychological Association (Society of Clinical Psychology (Div. 12)) have determined that the evidence-base supporting ACT is strong for chronic pain and modest for depression, mixed anxiety, OCD, and psychosis.
The Association of Contextual Behavioural Science (ABCS) website provides a very useful overview of ACT RCTs, broken down by topic at the bottom of the State of the Evidence page: http://contextualscience.org/state_of_the_act_evidence
To date (November 2019), there are 17 published RCTs evaluating the effectiveness of ACT with UK samples, spanning a broad range of target populations (Multiple Sclerosis, Stroke, Chronic Pain, Psychosis, Cancer, Osteoarthritis, Anxiety and Depression, Stress, Burnout and Obesity). Nine of these included the recruitment of NHS patients, totalling N=520. Overall, many of the studies reported findings that were in favour of ACT. However, the research is in its infancy; many of these studies were conducted with small samples and inactive control groups, meaning that larger trials are required.
ACT is increasingly being integrated into public and private sectors in the UK and we now have 13 peer-reviewed ACT trainers (second largest to America). ACT is not currently a NICE recommended treatment; symptom reduction, although a frequent outcome, is not directly targeted. ACT targets re-engagement in a meaningful life with valued outcomes. Hence there are challenges for ACT researchers in meeting empirical outcome measures set according to the agenda of the previous paradigm.
The continuing development of ACT in the UK is going to involve supporting research activity about contextual, third-wave approaches to CBT. The Committee hopes that the ACT SIG can promote a forum for researchers to meet, share ideas and collaborate on projects relevant to this aim. If you are researching ACT then please get in touch with the Committee as we want to organise events and meetings that will support this research.
The ACT SIG committee has declared a climate emergency. (Nov 2019)
Some implications of this announcement may be as follows:
Third party links on this page are provided for information purposes only. BABCP neither endorses or guarantees the validity of content on third party websites. Any link you make to or from another website is done so at your own risk.
https://www.youtube.com/watch?v=o79_gmO5ppg - Steven Hayes Ted Talk on Acceptance and Commitment Therapy and Psychological Flexibility (2016)
https://contextualscience.org/ - The Association for Contextual Behavioral Science (ACBS), the premier source of information about ACT, RFT and contextual behavioural science
UKACT listserv - our local email discussion group, multiple email discussion groups also offered from the above ACBS website
https://openforwards.ck.page/e9f55dcb7c - Current list of UK & ROI ACT supervisors.
Acceptance and Commitment Therapy 100 Key Points and Techniques. Richard Bennett & Joseph E. Oliver (2019). - An excellent introduction into ACT, RFT and Contextual Behavioural Science
https://www.newharbinger.com/professional - Main publishing house of CBS professional titles
https://wisemind.com/series/act-therapy-training/ - A series of 15 videos illustrating the science and practice of ACT. The series contains some of the most up to date conceptual developments in RFT, in an easy to understand format.
ACT/RFT Podcast: Check out "Functionally Speaking - A Third Wave Behavior Therapy Podcast" by DJ Moran at: http://djmoran.podbean.com – There are 15 different podcasts from experienced ACT therapists, the first instalment has interviews with Kevin Polk and Steve Hayes.
https://www.youtube.com/watch?v=ITwUMwJ4KjI&t=54s Praxis TV series: many voices, generally a great eclectic resource, this one is Robyn Walser with Martin Wilks & Kip Williams;1st of 6 episodes on the theme of ‘Ecological Valuing’