Acceptance and Commitment Therapy (ACT)

Our rating
 1 smiley: This treatment is promising and may be useful. It has some evidence to support it, but more evidence is needed to be sure it works.

What is it?

Acceptance and Commitment Therapy (ACT) has two main processes. These processes aim to help a person cope better with experiences that may cause depression. They are: (1) acceptance of the situation based on what can and can’t be changed; and (2) commitment to personal values.

How does it work?

ACT teaches psychological flexibility. Psychological flexibility is the ability to choose how you think and respond to certain situations. The opposite is psychological rigidity. This means that a person reacts automatically without much thought about the consequences. By teaching psychological flexibility, ACT empowers a person to break psychological rigidity and respond in a way that will help their depression.

ACT teaches a person to be aware of their own thoughts (mindfulness). Mindfulness can help people to see how they react in certain situations and how this effects their depression. ACT also teaches people how to commit to personal values. This helps people to choose better ways of responding in certain situations. This can be personally meaningful which is helpful for depression.

Is it effective?

There is little scientific evidence on ACT for the treatment of depression. More studies are needed.

A review of two studies found people with depression who had ACT reported lower depression symptoms, compared to people who did not have ACT. Some studies have found that ACT is as effective in the short term as cognitive therapy for adults with mild-to-moderate depression. It is not clear whether ACT is as effective in the long term.

Are there any disadvantages?

ACT may involve seeing a therapist weekly for several months. It can be expensive, although in Australia Medicare provides rebates for visits to clinical psychologists, psychologists and other therapists (see below).

Where do you get it?

ACT is available from a range of people with different levels of training. These can be clinical psychologists or personal health and wellness consultants. 

In Australia, Medicare provides rebates for visits to some therapists under the Better Access to Mental Health Care scheme. ACT may be covered by some private health insurance funds and is sometimes available from therapists employed in hospitals or government-funded clinics.

Recommendation

ACT shows promise for adults with mild-to-moderate depression in the short term. It is not clear if ACT is effective for depression in the long term.

Key references

  • Powers MB, Zum Vörde Sive Vörding MB, M.G. Emmelkamp P. Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics. 2009; 78: 73–80.
  • Ost LG. The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis. Behaviour research and therapy. 2014; 61 :105-21.

Last reviewed and updated: 1 December 2016