Acceptance and commitment therapy (ACT): Can it be a kinder way to cope with anxiety, depression and chronic pain?

What is acceptance and commitment therapy?

Acceptance and commitment therapy (ACT) is a form of psychotherapy that teaches a skill called psychological flexibility. This simply means learning to respond to your inner world in a kinder and more spacious way. Rather than battling every uncomfortable thought or emotion, ACT helps you notice what is happening inside you, allow it to be there, and then ask yourself: what truly matters to me right now, and how can I move toward that?

For someone living with anxiety, pain, depression, or trauma, this can be a powerful shift. The goal isn’t to stop the discomfort entirely. The goal is to stop the struggle and reclaim your ability to act in ways that support the life you want.

The core skills of ACT

ACT is built around six key processes. You don’t need to master them all at once, and many people naturally start with whichever feels most approachable. Over time, these skills work together to create more breathing room in your mind and your day.

Acceptance

This is about making gentle space for the thoughts, feelings, or sensations you usually push away. Acceptance does not mean liking the pain or giving up. It means stopping the internal fight so you can use your energy on what helps you.

Cognitive defusion

In ACT, you learn to see thoughts as thoughts, not as facts. Instead of “I’m failing as a caregiver,” it becomes “I’m noticing the thought that I’m failing.” Even that small shift can soften the grip of self-criticism and give you more choice in how you respond.

Present moment awareness

Mindfulness is an important part of ACT. It helps you reconnect with what is happening right here and now, instead of getting swallowed by worries about the future or memories of the past. People often describe this practice as feeling like they are “coming back to themselves.”

Self as context

This skill helps you develop a steadier sense of self. You begin to see that you are not your thoughts, moods, or symptoms. You are the person who notices them, and that perspective can feel surprisingly freeing.

Values

Values are the qualities that make life meaningful for you. Compassion, family, creativity, curiosity, stability, connection… ACT helps you explore what matters most so you can use it as a compass.

Committed action

Once your values are clear, you work toward taking small, realistic steps that move you in that direction. This could be joining a support group, taking a slow walk despite pain, asking for help, or setting boundaries around rest.

How does ACT compare to CBT?

Many people are more familiar with cognitive behavioural therapy (CBT), which usually focuses on identifying unhelpful thoughts and challenging them. ACT takes another route. It doesn’t try to change the content of your thoughts. Instead, it changes your relationship with them.

Where CBT might help you reframe a worry, ACT might help you notice the worry, breathe, and continue with what aligns with your values. Both therapies are well studied and effective, and many patients appreciate ACT because it feels less like a fight against their own mind and more like learning to navigate life with more kindness and clarity.

When can ACT help?

ACT has been studied across many conditions. It isn’t a magic solution, but it can be a supportive, evidence-based approach for people dealing with:

Anxiety

The acceptance and mindfulness skills in ACT help reduce the power of worry and avoidance. Many people find that anxiety becomes less overwhelming when they stop trying to control every feeling and focus on what they can meaningfully do.

Depression

ACT encourages gentle activity, values-based choices, and awareness of internal patterns. These small shifts can help reduce hopelessness and support momentum when energy feels low.

Chronic pain

ACT is widely used in chronic pain management. Instead of fighting the pain or waiting for it to disappear, ACT helps you build a life around what matters to you, even on difficult days. Research shows it can improve quality of life and functioning, even when the pain itself remains.

PTSD and trauma

For people recovering from trauma, ACT can help reduce avoidance and soften the fear around internal memories or sensations. It supports grounding, emotional regulation, and reconnecting with valued parts of life. It is often combined with other trauma-focused therapies.

Who is ACT for?

ACT can be helpful for many adults and teens who want a more compassionate, workable way to relate to their thoughts and feelings. It is used in private therapy, hospital settings, pain programmes, and more. Some people use it alongside medication or other therapies. Others find that ACT alone gives them the tools they need.

There are a few situations where ACT may not be the best starting point, such as during a severe crisis or when someone cannot engage with mindfulness or abstract thinking. In those cases, stabilising care usually comes first, and ACT may be introduced later on.

What can ACT offer patients and caregivers?

Living with a chronic condition or supporting someone who is struggling can leave very little room for your own wellbeing. ACT offers something gentle but powerful: a way to shift from fighting your inner world to navigating it with steadiness, acceptance, and intention.

For caregivers, ACT can bring relief from constant self-judgement and the pressure to “be strong”. For patients, it can create space to breathe, choose, and move toward what matters even when symptoms persist.

It doesn’t erase pain or fear, but it helps you find your footing again. Many people describe ACT as learning how to live a meaningful life alongside their challenges, not in spite of them.

Key takeaways

• Acceptance and commitment therapy (ACT) teaches psychological flexibility, helping people notice difficult thoughts and emotions without getting pulled under by them.
• Instead of trying to eliminate anxiety, pain, or sadness, ACT helps you stop fighting your inner experience and focus your energy on what truly matters to you.
• ACT is built around acceptance, mindfulness, values, and small committed actions that support a meaningful daily life.
• Compared to CBT, ACT does not challenge or replace thoughts. It helps you step back from them so they have less control over your choices.
• ACT can support people living with anxiety, depression, chronic pain, PTSD, and many other long-term challenges.
• It is suitable for many patients and caregivers, and can complement medication, trauma therapies, and other psychological approaches.
• ACT does not aim to remove symptoms. It helps you build a steadier, more values-guided life even when symptoms remain.
• The approach is gentle, practical, and focused on helping you reconnect with what gives your life meaning, connection, and purpose.

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Take care!