CBT and ACT Therapy

The Freedom Room offers both CBT and ACT as part of the ongoing work we do with our clients.

Cognitive-behavioural therapy (CBT) is a form of talking therapy that can be used to treat people with a wide range of mental health challenges. CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behaviour) all interact together.

Acceptance and commitment therapy (ACT) focuses on helping clients to behave more consistently with their own values and apply mindfulness and acceptance skills to their responses to uncontrollable experiences.

What is Cognitive-Behavioral Therapy?

Cognitive-behavioural therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

It is important to emphasize that advances in CBT have been made on the basis of both research and clinical practice. Indeed, CBT is an approach for which there is ample scientific evidence that the methods that have been developed actually produce change. In this manner, CBT differs from many other forms of psychological treatment.

CBT is based on several core principles, including:

  1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
  2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.
  3. People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

CBT treatment usually involves efforts to change thinking patterns. These strategies might include:

  • Learning to recognize one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
  • Gaining a better understanding of the behavior and motivation of others.
  • Using problem-solving skills to cope with difficult situations.
  • Learning to develop a greater sense of confidence in one’s own abilities.

CBT treatment also usually involves efforts to change behavioural patterns. These strategies might include:

  • Facing one’s fears instead of avoiding them.
  • Using role playing to prepare for potentially problematic interactions with others.
  • Learning to calm one’s mind and relax one’s body.

Not all CBT will use all of these strategies. Rather, the psychologist and patient/client work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy.

CBT places an emphasis on helping individuals learn to be their own therapists. Through exercises in the session as well as “homework” exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions, and behaviour.

CBT therapists emphasize what is going on in the person’s current life, rather than what has led up to their difficulties. A certain amount of information about one’s history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.

What is Acceptance-Commitment Therapy (ACT)?

Acceptance and commitment therapy (ACT) teaches mindfulness skills to help individuals live and behave in ways consistent with personal values while developing psychological flexibility.

Acceptance and commitment therapy (ACT) is an action-oriented approach to psychotherapy that stems from traditional behaviour therapy and cognitive behavioural therapy. Clients learn to stop avoiding, denying, and struggling with their inner emotions and, instead, accept that these deeper feelings are appropriate responses to certain situations that should not prevent them from moving forward in their lives. With this understanding, clients begin to accept their issues and hardships and commit to making necessary changes in their behaviour, regardless of what is going on in their lives, and how they feel about it.

What to Expect

Working with us, you will learn to listen to your own self-talk or the way you talk to yourself specifically about traumatic events, problematic relationships, physical limitations, or other issues. You can then decide if an issue requires immediate action and change or if it can—or must—be accepted for what it is while you learn to make behavioural changes that can affect the situation. You may look at what hasn’t worked for you in the past so that the Recovery Coach can help you stop repeating thought patterns and behaviours that are causing you more problems in the long run. Once you have faced and accepted your current issues, you make a commitment to stop fighting your past and your emotions and, instead, start practising more confident and optimistic behaviour, based on your personal values and goals.

How It Works

The theory behind ACT is that it is not only ineffective but often counterproductive, to try to control painful emotions or psychological experiences, because suppression of these feelings ultimately leads to more distress. ACT adopts the view that there are valid alternatives to trying to change the way you think, and these include mindful behaviour, attention to personal values, and commitment to action. By taking steps to change their behaviour while, at the same time, learning to accept their psychological experiences, clients can eventually change their attitude and emotional state.

Psychological flexibility, the main goal of ACT, typically comes about through several core processes.

  • Developing creative hopelessness involves exploring past attempts at solving or getting away from those difficulties bringing an individual to therapy. Through recognition of the workability or lack of workability of these attempts, ACT creates opportunity for individuals to act in a manner more consistent with what is most important to them.
  • Accepting one’s emotional experience can be described as the process of learning to experience the range of human emotions with a kind, open, and accepting perspective.
  • Choosing valued life directions is the process of defining what is most important in life and clarifying how one wishes to live life.
  • Taking action may refer to one’s commitment to make changes and engage in behaviors moving one in the direction of what is most valued.

These processes are overlapping and interconnected, not separate. All of these processes are introduced and developed through direct experiences that are identified and taken part in by the person in sessions over the course of treatment. Psychological flexibility can be defined simply as “the ability to be present, open up, and do what matters.”

Mindfulness and ACT

Mindfulness can be described as maintaining contact with the present moment rather than drifting off into automatic pilot. Mindfulness allows an individual to connect with the observing self, the part that is aware of but separate from the thinking self. Mindfulness techniques often help people increase awareness of each of the five senses as well as of their thoughts and emotions. ACT does not attempt to directly change or stop unwanted thoughts or feelings but instead encourages people to develop a new and compassionate relationship with those experiences.

Mindfulness also increases an individual’s ability to detach from thoughts. Challenges related to painful feelings, urges, or situations are often first reduced and then eventually accepted. Acceptance is the ability to allow internal and external experience to occur instead of fighting or avoiding the experience. If someone thinks, “I’m a terrible person,” that person might be asked to instead say, “I am having the thought that I’m a terrible person.” This effectively separates the person from the cognition, thereby stripping it of its negative charge. 

When people experience painful emotions, such as anxiety, they might be instructed to open up, breath into, or make space for the physical feeling of anxiety and allow it to remain there, just as it is, without exacerbating or minimizing it.