As an increasing number of people look to work on their mental health, different approaches to therapy become more well-known outside clinical circles. Cognitive Behavioral Therapy, or CBT, is one of those, with many people now having a basic understanding of what this is and how it works.
But what about acceptance and commitment therapy? While CBT and ACT are often discussed interchangeably, there are several fundamental differences in their approach that you should know about when making the best decisions for your mental health journey.
What is Cognitive Behavioral Therapy?
Also known as CBT, traditional cognitive behavioral therapy focuses on changing existing negative thoughts, feelings, and behaviors. It’s typically used as a short-term therapy that takes place over three to six months to recondition your beliefs around these harmful or destructive thoughts, resulting in new, more positive behaviors by the end of your therapy.
Once your negative thoughts or behaviors have been identified, your CBT counselor will work with you to change these thoughts, which then changes the behaviors associated with them. As the goals developed as part of a CBT plan are very specific to certain thought patterns, this approach usually focuses on one or two particular issues you’re currently dealing with.
Some of the most common strategies that counselors use when working with clients on CBT are:
Setting tangible outcome-oriented goals.
Developing problem-solving skills.
Learning greater self-awareness.
What is Acceptance Commitment Therapy?
ACT, or acceptance and commitment therapy, is a mindfulness-based therapeutic approach that allows you to accept negative thoughts or behaviors rather than actively trying to change them. The idea behind this type of treatment is that much of our negativity stems from thinking about and trying to combat these feelings rather than simply accepting that the difficult parts of life are normal and to be expected.
Once this acceptance has been reached, a more positive outlook will typically develop naturally. This is why reducing the negative symptoms of mental health conditions such as depression or anxiety is considered to be a side effect of ACT rather than an active goal trying to be achieved as it would be with CBT.
ACT is based on six core values. These are:
Acceptance. Accept any thoughts and feelings, both positive and negative, and understand that you often don’t have control over these. This helps to break the cycle of negative thinking by simply accepting that you will have these feelings.
Cognitive defusion. Understand that thoughts are simply that, rather than facts that have no alternative options. You can look at thoughts with an outsider’s lens, removing those thoughts' emotional impact.
Self observance. Recognize that you are not your thoughts or feelings and that these can change. Distancing yourself from these thoughts or feelings can make them feel less overwhelming or threatening as they’re no longer tied to you but are static forces that come and go.
Values. Have a deeper understanding of what matters most to you, your priorities, and what holds meaning for you. By focusing on the type of person you want to be rather than what you think others might expect or want from you, you can remove some of the anxiety that may come with certain feelings or situations.
Present moment awareness. Focus more on the here and now rather than the past or future. Mindfulness techniques like meditation engage your senses in the present moment, allowing you to focus on these rather than any thoughts you have.
Committed action. Understand that you need to take action on your values to build the life you want to have. This step combines all the previous core values, coming together meaningfully, allowing you to adapt and adjust your behavior.
During ACT sessions, you will build on the core principles of this therapy through discussions about what has and hasn’t worked for you in the past when reframing your thoughts and behaviors, along with identifying the specific negative patterns you’re currently experiencing.
Once both your negative thoughts and core values have been established, you’ll work with your therapist to take action toward your values and accept the thoughts and feelings that may come up in your everyday life. As a result of this acceptance, you should notice your behavior shifting towards a more positive outlook.
CBT vs ACT: Are They The Same?
Both CBT and ACT use elements of mindfulness in their approaches, focusing on how you relate to your emotions and experiences. However, the ultimate methods and goals of these therapies are different and unique.
With CBT, the primary focus is reframing negative thoughts and behaviors into more positive ones. In contrast, ACT focuses more on accepting these as a normal part of your life instead of trying to escape them. Instead, it concentrates on what motivates you to live a meaningful life in a way that makes sense for you.
CBT is also a short-term and goal-oriented approach, aiming to eliminate symptoms of mental health conditions by eventually removing the underlying negative or destructive thoughts and behaviors. ACT, though, is ongoing, with any relief of symptoms seen as a positive side effect rather than a targeted goal from the outset.
Which Type of Therapy Is Best?
Both CBT and ACT work from an evidence-based perspective and can be used to treat a wide range of mental health conditions, such as:
Anxiety
Depression
Trauma
Psychosis
Eating disorders
Substance use disorders
Everyday stress
Insomnia
Chronic pain conditions
CBT may be a better approach to start with if you're dealing with a specific issue. However, ACT can be an effective alternative if you struggle to acknowledge your thoughts and feelings or have multiple problems trying to manage. Some people find that a combination approach can work well, using CBT to eliminate particular symptoms before moving on to ACT for long-term support in building a more meaningful life.
You should also consider the environment you prefer for your therapy sessions. If you’re starting therapy for the first time or switching to someone new, ask about options for both one-on-one and group sessions. Mindfulness-based approaches are effective in individual and group settings, giving you the flexibility to decide on the best approach for you.
At Integrative Counseling Services (ICS), our team of experienced practitioners offers ACT-based counseling to support your goals. With individual, group, and family counseling options, ICS’s ACT therapy services help you develop a framework for understanding and moving on from negative thoughts, feelings, and behaviors.
Our mindfulness focus offers a holistic approach to recovery, giving you the necessary skills to see long-term success. Get in touch to schedule your first session with one of our therapists.