Acceptance and commitment therapy (ACT)
Finding more choice when difficult thoughts and feelings are part of life.
By Richard Mann · 15 October 2026
← Integrative therapy and the different approaches
It is understandable to want anxiety, sadness or shame to go away before you get on with your life. But waiting to feel completely ready can become a long wait. You may find yourself turning down opportunities, avoiding people or spending hours trying to settle an argument in your mind.
ACT explores how to make room for difficult inner experiences while choosing actions that reflect what matters to you. Its aim is psychological flexibility: having more freedom to respond, rather than being pulled automatically by a thought, feeling or urge.
How is acceptance different from giving up?
Acceptance means acknowledging an inner experience that is already present, rather than spending all your energy trying to remove it. It does not mean accepting abuse, approving of harm or remaining in circumstances you can change. You can feel fear and still take protective action.
Sometimes the struggle with a feeling adds a second layer of distress: being anxious about anxiety, or ashamed that you feel sad. ACT invites you to notice that struggle and consider whether a different relationship with the feeling would leave more energy for your life.
What can you practise in therapy?
You might learn to notice a thought as a mental event rather than a fact or instruction. Changing ‘I will fail’ to ‘I am noticing the thought that I will fail’ can create a little distance. The point is not to repeat a phrase until the thought disappears, but to see whether you have more choice about what you do.
Sessions can also explore attention, perspective and values. Values are ongoing directions—such as being caring, honest or curious—rather than achievements to tick off. Together you identify a small action that expresses a value and look at what gets in the way. Exercises should be adapted if they feel unhelpful or uncomfortable.
What might change in everyday life?
You may still experience an anxious prediction before a meeting, but spend less time trying to prove it wrong. You may notice an urge to withdraw and choose a short conversation because connection matters to you. These are changes in how you live, even if a feeling has not vanished.
ACT can be relevant when avoidance and the attempt to control inner experiences are narrowing life. It should not be used to suggest that distress caused by practical hardship is only a problem of attitude. Support may also involve changing circumstances, setting limits and asking other people for help.
Going out before confidence arrives
Imagine wanting to see a friend but deciding you must feel confident first. You might identify friendship as important, notice the mind’s warnings and agree to meet for a manageable length of time. You would not have to enjoy every moment or force yourself through overwhelming distress. Afterwards, the useful question is whether the step brought you closer to a valued relationship, and what would make the next step more workable.
What might change?
Less obedience to an anxious thought
A warning in your mind does not always have to determine your next move.
A clearer direction
Decisions can be guided by what matters, as well as how you feel today.
More involvement in life
Small actions can continue alongside uncertainty or difficult emotion.
These are possible signs of progress, not promises. What matters is whether the work is making a useful difference to your life. You and your therapist can review that together.
How this fits with integrative therapy
ACT ideas can help us connect practical changes with what matters to you. In integrative counselling, we can also explore why particular thoughts hurt so much, how relationships affect you and what support you need to take a step at your own pace.
Read about integrative therapy and explore the other approaches →Sources and further reading
- Association for Contextual Behavioral Science: About ACT
- ACBS: ACT, processes and psychological flexibility
- BACP: Types of therapy
This article explains an approach in general terms. The right support depends on your needs, preferences and the practitioner’s training.
We can begin with a conversation.
You do not need to work out which approach you need before getting in touch. I offer a free 15-minute consultation to talk about what is troubling you and whether working together feels right.
Sessions are available in North London and online across the UK.
Arrange a Consultation