Aviva Psychology Services
Acceptance + commitment therapy (ACT)
An evidence-based approach to improve your relationship to painful thoughts and feelings so you can replace avoidance with values-based living.
When the effort to avoid is making things worse.
If you're like many of the clients we work with, you've spent years trying to manage or avoid your unpleasant thoughts and feelings. You have told yourself to stop worrying, to let it go, or to just focus on what is good and positive. But the anxiety returns. The self-criticism creeps back in. The sadness takes over again.
This isn't a personal failing or lack of willpower. Decades of research on thought suppression show that the harder we try to push away unwanted thoughts and feelings, the more insistent and intrusive they tend to become.
Acceptance and Commitment Therapy (ACT) takes a different path. Rather than fighting these experiences or working harder to control them, you learn to change your relationship with them and to redirect that energy toward the things you value. If you're looking for ACT therapy in Massachusetts with experienced doctoral-level psychologists, we invite you to explore whether Aviva might be the right fit.
Understanding acceptance and commitment therapy
Acceptance and Commitment Therapy (ACT, pronounced 'act') is an evidence-based psychotherapy and part of the 'third wave' of cognitive behavioral therapies. Like CBT, it uses an intentional focus on goals, treatment plans, and skill practice between sessions.
Where ACT differs is in its emphasis on mindfulness and psychological flexibility. The goal is to work toward acceptance of what is outside your control and to make a commitment to changing what is within your control in order to improve and enrich your life. ACT helps you use mindfulness skills to lessen the impact of painful thoughts and feelings, clarify your values, and take conscious steps toward living a values based life.
ACT is recognized by the American Psychological Association as a research-supported treatment and has demonstrated effectiveness for many presenting concerns, including anxiety and depression.
Who is ACT designed for?
ACT is effective for a wide range of concerns, including:
- Anxiety disorders, such as generalized anxiety, panic, and social anxiety
- Depression and persistent low mood
- Obsessive-compulsive disorder
- Chronic pain and health-related anxiety
- Trauma and PTSD
- Grief and loss
- Stress related to life transitions, work, and relationships
- Difficulties with self-criticism and shame
ACT is often a good fit for individuals who feel stuck in patterns of avoidance, who value structure and learning tools they can apply in daily life, and who are open to exploring a new relationship with their inner experience.
How ACT works: The 6 core processes
01 Present moment awareness
Commonly known as mindfulness, this involves being aware of what is happening in the here and now, even when the present moment includes pain. The goal is to show up fully to whatever is going on in order to have a richer, fuller experience of life.
02 Defusion
Defusion focuses on learning to untangle yourself from negative thinking patterns. Rather than challenging negative thoughts, you learn to notice and relate to them differently. Over time, this changes your attachment to, perceived threat from, and believability of unhelpful thoughts.
03 Acceptance
Acceptance involves making room for whatever reactions come up in response to a particular experience. In ACT, acceptance is about changing your relationship with your thoughts, feelings, and emotions to reduce avoidant efforts and increase freedom to live in line with your values.
04 Self-as-context
ACT teaches clients to see themselves more flexibly in relationship to the greater context of their lives and to challenge some of the "rules" about themselves that may be getting in the way of meaningful change.
05 Values
Values help us decide what matters and what we stand for. They serve as a powerful compass that guides us toward what is important. Values-based living creates greater vitality, freedom, and clarity in life.
06 Committed action
Develop an inner toolkit that continues working beyond therapy and reduces the likelihood of getting stuck when life gets hard through values-aligned action.
Why we use this approach
At Aviva Psychology Services, several of our doctoral-level licensed psychologists have specialty training in ACT. We also aim to integrate a values-based orientation across all of the services we provide, making ACT a natural fit for our overall approach to care.
ACT aligns with our core belief that effective treatment addresses the whole person. Rather than focusing narrowly on symptom reduction, ACT helps clients clarify what they value, understand what is keeping them stuck, and take meaningful action toward a fuller life.
We value ACT's transparency. Clients understand what they are working toward, why specific processes are being introduced, and how progress is being measured. This supports collaboration and empowers clients to become active participants in their own treatment.
Our psychologists integrate ACT with other evidence-based approaches, including CBT and relational frameworks to provide individualized and comprehensive care. You can learn more about our clinicians and their training
here.
What does a session look like?
ACT sessions are structured but responsive. Your psychologist will typically begin by reviewing observations or practice from the previous week, then focus on current goals and concerns. Sessions involve active dialogue rather than one-sided reflection.
You will work together through the six core ACT processes at a pace that fits your needs. Your psychologist will introduce exercises and mindfulness-based skills tailored to your specific concerns, and together you will determine how to practice these between sessions.
The tone is warm, direct, and grounded. You maintain control over what you are ready to work on and how quickly the process moves. Many clients appreciate ACT's emphasis on practical skill building and its focus on daily life rather than extended analysis of the past.
Committed action exercises are a regular part of the work. These are not rigid assignments but collaborative experiments designed to help you move toward the life you want.
ACT applications
ACT is used to treat anxiety, depression, OCD, PTSD, chronic pain, grief, health anxiety, and stress-related concerns. It is also effective for relationship difficulties, life transitions, perfectionism, and chronic self-criticism. The
Association for Contextual Behavioral Science maintains an extensive research database supporting ACT's effectiveness across a wide range of presentations and populations.
Contact us
For more information and to assess fit, please contact us.
Benefits of ACT
Psychological Flexibility
Learn to hold difficult thoughts and feelings more lightly so they have less control over your choices.
Values-Driven Living
Clarify what matters most and build the skills to act in alignment with your values, even when discomfort is present.
Lasting Resilience
Develop an inner toolkit that continues working beyond therapy, reducing the likelihood of getting stuck when life gets hard.
ACT has been extensively researched and is recognized by the American Psychological Association as an empirically supported treatment. Studies show it is effective in reducing symptoms across anxiety, depression, OCD, and chronic pain with outcomes comparable to CBT in many presentations.
What makes ACT distinct is its focus on psychological flexibility rather than symptom elimination. Clients often report a fundamentally different relationship with their inner experience as a result of treatment.
While outcomes vary by individual, many clients begin noticing shifts in how they respond to difficult thoughts and emotions within the first month of treatment.
Could ACT be a good fit?
ACT may feel supportive if you are open to exploring your inner experience rather than simply trying to eliminate it. It tends to work well for people caught in cycles of avoidance who are willing to engage with values and meaning as part of the therapeutic process.
That said, therapy approaches are not one-size-fits-all. Your psychologist will discuss fit openly during the assessment process and collaborate with you to determine the best approach for your specific needs.
What to expect when you begin
Starting therapy can feel overwhelming, but we keep the process simple and supportive. Here’s what to expect:
Request an Appointment
Once you complete this form, we will reach out to schedule a complimentary 15-minute phone consultation to assess fit together.
Assessment and Planning
The first 2 to 4 sessions involve assessing your history, concerns, and goals. You and your psychologist will establish a treatment plan and discuss next steps.
Ongoing Weekly Sessions
Sessions are typically weekly for 55 minutes at a consistent time. You and your psychologist will work together at a pace that feels right for you.
FAQs about ACT
How is ACT Different from CBT?
Like CBT, it uses an intentional focus on goals, treatment plans, and skill practice between sessions. ACT differs in its emphasis on mindfulness and psychological flexibility.
A central goal in ACT is to change your relationship with difficult thoughts and feelings rather than trying to change the thoughts themselves. Another goal is to work toward acceptance of what is outside your control while making a commitment to changing what is within your control through values based action. ACT helps you use mindfulness skills to lessen the impact of painful thoughts and feelings, clarify your values, and take conscious steps toward living a values based life.
How long does ACT take?
The length of treatment depends on your specific concerns and goals. Some people find meaningful relief in a focused course of 12 to 20 sessions. Others benefit from longer-term support. Your psychologist will discuss a realistic timeline during the assessment process.
What kind of training do ACT therapists have?
All clinicians at Aviva are doctoral-level licensed psychologists or postdoctoral fellows with advanced training in evidence-based treatments, including ACT. They have completed graduate-level coursework, supervised clinical training, and ongoing professional development. You can learn more about our clinicians and their training here.
What if I have tried ACT before and it didn't work?
If a previous experience with ACT did not produce the results you were hoping for, it is worth exploring why. The fit between client and therapist, the depth of training of the provider, and how well the approach was tailored to your specific concerns all play a role. At Aviva, our psychologists are highly trained in evidence based treatments and integrate them thoughtfully with other approaches to provide individualized care.
Can ACT be used alongside medication?
Yes. ACT is compatible with psychiatric medication and is often used alongside it. Your psychologist will discuss your full clinical picture during the assessment process and collaborate with your other providers as appropriate.
Ready to get started with ACT?
If you are considering Acceptance and Commitment Therapy in Massachusetts, a consultation can help determine whether this approach is fitting with your goals. We will review your concerns, answer questions, and outline next steps if fitting.
