Acceptance and Commitment Therapy (ACT) – Part I

Acceptance and Commitment Therapy (ACT) is a form of behavioural therapy which helps us deal with some of the harsh realities of life so that we can live it in a rich and fulfilling way.

It’s particularly useful for those who are struggling with situations which may not change such as long term health conditions or a family situation which is challenging and enduring.
There are six core therapeutic processes:

  • Contacting the present moment (paying attention to the present moment)
  • Defusion (watching yourself thinking)
  • Acceptance (making room for pain and letting it be)
  • Pure Awareness (recognising that our identity doesn’t change even though our thoughts and emotions do; there is still a side to us that observes ourself)
  • Values (understanding what matters to us)
  • Committed action ( do what it takes)

These can be merged into 3 functional units:

  • Separating thoughts from feelings
  • Be present
  • Do what matters

The three processes are:

A: accept thoughts and feelings and be present

C: choose a valued direction

T: take action

ACT can be explained in a nutshell using the Clipboard Metaphor:

A therapist might use this metaphor to help explain how we may struggle with our own emotions, physical sensations and thoughts and how this gets in the way of life. The metaphor also shows how using ACT processes instead may be beneficial. The thapist would sit with the client and presents them with a clipboard.

The clipboard represents the distressing thoughts, feelings and physical sensations you have.

1.  Hold it close to your face. While you’re absorbed in these thoughts and feelings:

  • Do you feel engaged with me? Connected? If I did some hilarious dance, could you see?
  • What can see you in the room around you?
  • If I asked you to hug someone, drive to work, write a letter could you?

So you’re disconnected with people, the world and what you want to do.

2.  Now I’ll hold the clipboard and you try to push it away.

  • How does a day of doing this feel?
  • While you’re doing this, if I asked you to hug someone, drive to work, write a letter could you?
  • How easy is it to converse with me?

So you’re disconnected with people, the world and what you want to do.

3.  Now, put it on your lap.

  • Can you talk with me?
  • Can you hold a baby, drive a car, write a letter?
  • What can you see around you?

So you are more connected with people, what you want to do and what’s important to you and it’s less exhausting. Even though it’s still there.  Of course you don’t want it there but pushing it away didn’t work so how about we try something different and let it be?

Letting it be allows you to connect with everything important to you and the energy you would use fighting thoughts and feelings you can use for those meaningful activities.


When we are starting to use ACT, it is important to firstly understand:

  1. What stands in your way?
  • Thoughts
  • Avoidance
  • Behaviours

2. What valued direction do you want to move in?

  • What to stand for
  • What domains of life are most important?
  • What relationships do you want?
  • How do you want to grow and develop?
  • What strengths to cultivate is a website providing information about mental health and wellbeing. is provided by Anna Batho, a therapist working in High Wycombe and providing therapy in Amersham and the wider Buckinghamshire (Bucks) region.You can contact her here.

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