Acceptance and Commitment Therapy, abbreviated as ACT, said aloud as the word act, is a cutting edge, modern approach to direct practice. ACT is used as a form of psychotherapy, counselling, and coaching. Applied to healthcare (especially mental health), performance issues in business, academics and athletics, for weight loss, grief and many more settings.
Although therapy is in the name, we sometimes refer to ACT as a training. This is because ACT's initial development and application was for health related issues typically treated with therapies. However, ACT's universality makes it useful in non-clinical settings. My favourite example is my co-author, Jessica Borushok's research (supported by a NIOSH grant) on ACT with sedentary workers, demonstrating that ACT was helpful in getting people moving and also had other benefits, for example them liking each other more at the end of the study.
Check out our award winning book (2018 Benjamin Franklin Gold Seal for Psychology) The ACT Approach, we're super proud of its success and know it's a great introduction to ACT. If you're looking for something more self-help focused, there's my free ebook, Life Map: Finding Meaning in Chaos to Make Change.
Let me tell you how ACT works because this is the coolest part. ACT is based on a completely unexpected scientific advancement that demonstrates acceptance, making peace with what you think, feel, sense, and remember is the key to overcoming our personal hurdles. That word acceptance is tricky for a lot of people so imagine that it simply means being present with aversive private stuff (physical pain, emotional hurt, difficult thoughts, intrusive memories) and not being governed by those difficulties. Therein lies the profound part of this approach, living a rich, meaningful life is possible—we don't have to be free from anxiety, chronic pain, worry, anger, trauma histories, or heartache to live well.
If you're noticing throughout this post that I'm describing ACT as an approach, this is purposeful. ACT is not a set of techniques or methods, although ACT metaphors and exercises have become popular and synonymous with ACT leading some to believe that ACT's techniques are what it is. They're not. They're just a manifestation of ACT. Which leads us to answer: what is ACT exactly? The simple answer is that it's a series of processes that once understood are incredibly empowering for clinicians and trainers. This leads creative people who learn ACT to innovate creating their own effective techniques and methods for doing ACT.
For example, thanks to the generous mentorship of Kevin Polk, the creator of the ACT Matrix, Jessica and I were able to innovate our own variation that we use with all of our clients in every setting we work in called the Life Map.
This is a part of why I'm all in on ACT. It can be adapted in an infinite number of ways to fit almost any situation. If you're eager to experiment more with ACT or you're curious to see questions this approach asks and practices it suggests, check out my playlist of brief ACT practices. These videos are based on the wildly popular ACT Deck, 55 practices based on Acceptance and Commitment Therapy for use in therapy, classrooms or at home. These cards ask tough questions, encourage meaningful action and provide new perspectives to help you let go of negative thoughts and live in the present moment.
Yoga for Mental Health
Being in the present, aware of your surroundings and of your experience, is an essential process of learning to be psychologically flexible—a new and exciting measure of mental health. I like to talk about psychological flexibility and how to get it because it's positive, our culture spends a lot of time looking at pathology, discussing poor mental health but offers few practical and legitimate ways for improving it.
Yoga is just that. A practical and legitimate way of improving your mental health. However, not all forms of yoga are created equal. Yoga has become a catch-all phrase that describes the ancient, pre-medieval practice of preparing the body for long periods of meditation; it describes a spiritual movement that was transmitted orally as a tradition of what we could debate is an early form of psychology; it also describes fitness routines. I'd debate regardless of your spiritual orientation that yoga that is free of spirituality is merely Indian calisthenics. Yoga is of course free of religion although some religions use yoga in their practice of worship—yoga dictates you worship no God nor practice any religion.
So, how does yoga help? This hotly debated topic has taken a number of different twists and turns and the scientific literature is downright exciting. Early on during this journey, I published a peer-reviewed paper, did research and my Master of Social Work thesis on this topic. I would go on to develop and publish an eight-week protocol for using yoga in therapy for both groups and individuals. I called the program Mindful Yoga-based Acceptance and Commitment Therapy or MYACT for short (pronounced "my act"). MYACT is a combination of a gentle yoga class that is structured specifically to focus on training the practitioners to be psychologically flexible. This yoga practice is sandwiched with practical ACT (Acceptance and Commitment Therapy) exercises. In some contexts, rather than referring to ACT as a therapy, we instead call it Acceptance and Commitment Training because the psychosocial work done in the MYACT group isn't a traditional group therapy but instead training.
All this work didn't satiate my desire to explain the essential processes and functions that make yoga work in helping people to heal. I wrote an entire chapter in a health studies textbook, Holistic Healing on contemplative practices and was carefully scrutinized by peer-reviewers and the books editor, a scientist I admire very much.
And what is my conclusion? What have I found after traveling to India and working in Ayurvedic clinics where yoga is used as a prescription for health problems, doing yoga teacher trainings, publishing credible articles/chapters, and spending thousands of hours doing the work personally and facilitating it, sharing it with others? Those few simple opening lines of this post.. being in the present, aware of your surrounding and of your experience. It's so simple yet a deeply profound journey for any who dare chase it.
Yoga offers an opportunity to practitioners and I don't speak of contorting one's body into a pretzel-like shape but instead a new way to be present. A journey back to a place you haven't left. Told you that spirituality stuff seeps in.
For more on understanding the role of present moment awareness I'm including a link on mindfulness made simple.
In the spirit of practicing yoga and sharing it, I've created a 30 day yoga challenge and just as the best time to plant a tree is yesterday—if you're willing, take the plunge and commit yourself to doing 30 days of yoga with me. This link is a playlist of all 30 days.
If you have questions, don't hesitate to ask. Using yoga for mental health is a passion of mine.
I travel all over the world teaching Cognitive Behavioral Therapy (CBT) to clinicians. CBT is a great catch all because clients have generally heard the term CBT before and might actually look up therapists locally that practice it, most professionals in healthcare are aware of therapy in general and usually will recommend CBT as a treatment for a variety of issues, which is great but what is CBT? Well, it's kind of complicated.
The confusion is worsened because CBT isn't one thing and a lot of people think it is. I try to preempt any confusion with my clients, on my book a session page, I specifically note that there is no single cognitive behavioral therapy, it's a family of recognized psychological treatments with empirical support. Psychological meaning related to mental and emotional states, empirical meaning the therapies have been verified through randomized controlled trials to be effective for treating specific issues. This is where the really exciting part about CBT starts: you could have twenty different CBT therapists and each would not just have a different style but could also use different techniques. Generally these techniques are broken into three different generations of CBT. Before I describe the generations of CBT, please note that new does not necessarily mean better—past generations of CBT get good outcomes, they are after all evidence-based. However, just like the latest innovations in technology (think iPhones or computers) advancements occur, new information is collected, old ideas are falsified, and a new generation gets released. Check out my video 'What is CBT and how to do it!' for practical examples or read on below to learn more about the generations of therapy.
To date (the summer of 2018) there are three generations of therapies. Remember that each generation is relevant, contributing advancements to the field. Yet, time marches on and with it, so does the science that informs the work therapists do.
The first generation is past-oriented: focusing on suffering as a disease, the psychology of the abnormal. If you're depressed or anxious, that needs to be corrected by changing something in you to remove the experience of anxiety or depression. This also supports a hierarchy, the therapist is the expert, a sort of technician of the therapy. Importantly, this past-oriented theory focuses on historical reasons why someone thinks and acts the way they do today. Therapists who are trained in a first generation approach tend be meticulous at taking a persons history and understanding the nuance of how one has come to be working with a therapist. First generation therapies tend to be longer in duration and the experience of working with someone who helps you unpack how you understand yourself based on what you've been through can be an incredibly validating experience.
The second generation is present-oriented: focusing on why people do what they do right now. Conceptually, the second generation wanted to know what maintains a persons thinking and behaving, looking for environmental causes. This second generation looks to the problems someone is experiencing here-now and solutions to correct their thinking (cognitions) and doing (behaviors). From this perspective, therapists are driven by a theory that encourages them to be experts on the objective world, seeking information from the clients experience to change what they think and do.
The third generation is present and future oriented: focusing on building resources and competency in a person to grow their life in the presence of pain. The relationship between therapist and client from this perspective is about the client being an expert on their experience and the therapist being a companion on their journey. The therapist points out ideas, draw parallels between experiences, and suggests new skills along the way. This generation is uniquely not theory-driven but instead uses behavior analysis tools to create an individualized profile on how each persons behavior works . This is all at once liberating and exhausting. It requires a level of presence and technical mastery on the therapists part that can seem intimidating at first—remember I told you I travel all over the world giving workshops on the subject? Feedback I get at every workshop I give is therapists telling me how much the third generation makes sense but also how difficult it seems at first to master the entire approach. This is why my co-author Jessica Borushok and myself wrote a book on a third generation approach of CBT called ACT (Acceptance and Commitment Therapy) and we called the book, The ACT Approach because we wanted to make it clear that no matter who the reader is or what orientation/training they come from they can use the third generation perspective and incorporate it into their practice.
The evolution of the third generation of therapies has also enabled new and exciting innovations in cognitive behavioral therapies/evidence-based practice: specifically compassion, mindfulness, the integration of yoga, and many other developments that may have previously been left out of empirically supported treatments.
Find Your Zen
Tim is a social worker in Hamilton, Ontario; an award winning author, speaker, yoga teacher, and ACT trainer.