How acceptance and commitment therapy can help you manage anxiety
Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA
Acceptance and commitment therapy (ACT) uses 6 core principles to boost mental health and reduce anxiety. Learn how ACT works and how to find out if it’s right for you.
Anxiety has a way of showing up at the worst possible times. Your chest tightens before a meeting, your thoughts spiral at night, and your mind jumps to the worst-case scenario the second your phone buzzes.
Maybe you’ve tried breathing exercises, meditations, or journaling, but nothing seems to help long-term. If your anxiety always seems to creep back in and sabotage you in moments where you’re extra-vulnerable, acceptance and commitment therapy (ACT) might be supportive.
ACT is a type of therapy that helps you change your relationship with difficult thoughts and emotions rather than fighting them. Instead of aiming to “get rid of anxiety,” ACT teaches you to make space for it while still moving toward what matters most in your life.
What is acceptance and commitment therapy (ACT)?
Acceptance and commitment therapy is a form of psychotherapy that blends mindfulness skills with practical behavior changes. It’s based on the idea that pain and stress are a normal part of life, but they don’t have to control how you live.
ACT focuses on psychological flexibility, which is the ability to stay present with your thoughts and feelings without being pulled off track by them. This can allow you to respond in ways that support your wellbeing.
The role of mindfulness in ACT
Mindfulness—noticing what’s happening in the present moment without judgment—plays a central role in ACT. When your anxiety flares up, mindful techniques in ACT help you step back from unhelpful thought patterns.
Instead of getting caught in “what if” spirals, you learn to acknowledge your thoughts, label them, and then shift your attention back to what really matters.
What are the core principles of ACT?
ACT is built around six core principles, each of which helps you handle stress in healthier ways. They are:
Acceptance: Making space for uncomfortable feelings allows you to move through them with greater ease.
Cognitive defusion: This helps you learn to step back from your thoughts and see them for what they are: mental events. When you create distance from your thoughts, they lose their grip and feel less overwhelming.
Being present: Using mindfulness to ground yourself in the moment helps support a clearer and calmer awareness of what’s actually happening right now.
Self-as-context: Recognizing that you’re just the observer of your emotions helps foster a sense of stability, even when your inner experiences are intense.
Values: Identifying what truly matters to you, such as relationships, creativity, or health, can give direction and meaning to your choices and actions.
Committed action: Taking practical steps guided by your values, even when discomfort is present, turns intention into movement. It also helps you build a life that reflects what’s most important to you.
6 potential risks and benefits of ACT
ACT therapy can help you live more fully and intentionally, but it’s not a perfect fit for everyone. Here are some important considerations to make when it comes to ACT.
Benefits
It can help with many conditions: ACT provides structured and research-backed strategies designed to support people struggling with anxiety, depression, chronic pain, and stress.
You can use it to build resilience: Through techniques like acceptance, mindfulness, and values-based action, ACT gives you practical ways to handle life’s ups and downs. Over time, this can strengthen your emotional flexibility.
It’s easily adaptable: Acceptance and commitment therapy emphasizes real-world application, which means that skills learned in therapy can be integrated into your daily routine. This can make the practice feel more sustainable over time.
Risks or limitations
Sitting with uncomfortable thoughts can be overwhelming: ACT encourages individuals to sit with difficult emotions rather than avoid them. As a result, early sessions can feel intense or challenging.
Progress tends to take time: ACT focuses on changing your relationship to distress, but it doesn’t remove it entirely. This can be frustrating for those hoping for a quick fix.
It usually works best with guidance from a trained therapist: While you can practice ACT techniques on your own, ACT often works best with a skilled therapist. This can be limiting for some.
How to know if ACT is right for you
ACT invites you to build a different kind of relationship with your inner world, and while that’s great for some, it’s not right for others. Here are 8 tips to help you figure out if ACT is right for you.
1. Check your willingness to feel a little discomfort
Acceptance and commitment therapy asks you to make space for unpleasant thoughts and sensations. This doesn’t mean you have to love it. It just means you need to have some willingness.
2. Pick a format that fits real life
Consider what type of therapy will actually work for you. Individual ACT is great for personalized pacing and complex histories, but group ACT is more cost-effective and builds community. You may also want to consider starting with telehealth ACT if that works best with your routines.
💙 Get more familiar with Acceptance by listening to this meditation from Jay Shetty.
3. Set expectations for progress
Changes in your behavior and flexibility are signs that ACT is working. For example, if you start to notice that you’re doing more of what matters and you recover faster from anxiety spikes, ACT is probably a good fit.
Related read: How can mindfulness and therapy work together? 9 ways to explore
4. Decide how you’ll measure change
Pick a few simple indicators you can track weekly to monitor your progress. You could track how many value-linked actions you took or ask yourself how often you used an ACT skill. You could also do a brief anxiety or mood check in with yourself once a week.
5. Check your learning style
Acceptance and commitment therapy uses metaphors, mindfulness, and real-world practice. If you prefer someone to challenge your thinking, you may want to blend ACT with cognitive behavioral therapy (CBT).
Related read: 24 questions to ask your therapist to deepen your sessions
6. Plan for the “it gets harder before it helps” window
Early on, noticing thoughts and feelings can make your anxiety feel louder. Prepare for it by scheduling sessions when you can do a short recovery activity afterward, like walking, listening to music, or calling a friend.
💙 Learn to manage your bigger emotions by listening to Dr. Julie Smith’s Tools for Stress and Anxiety.
7. Consider identity and culture fit
Because ACT is values-driven, self-reflection is essential. Notice if your therapist invites your lived experience, family roles, faith, or community into the work.
8. Do a time-limited trial and review
Try it out for 4–6 sessions, and then ask yourself how it’s going. Are you using skills more automatically? Are your anxious thoughts less consuming? If not, adjust the plan or consider a different approach that might feel more natural to you.
Acceptance and commitment therapy FAQs
What does psychological flexibility mean?
Psychological flexibility is the cornerstone of ACT. It’s the ability to notice your thoughts and feelings without getting trapped in them.
For example, instead of canceling dinner because your anxiety tells you that “you’ll embarrass yourself,” psychological flexibility allows you to simply acknowledge the thought, feel the nervousness, and show up for the dinner anyway.
Can ACT help with anxiety and depression?
Yes, if you have anxiety, ACT can help teach you to stop struggling against fear and focus on living meaningfully with it. And if you experience depression, ACT can help you break the cycle of withdrawal by encouraging small and values-based actions even when your motivation is low.
Reaching out to a friend, going for a short walk, or working on a project that feels purposeful are all ways ACT can help reduce your depression symptoms and build a stronger sense of wellbeing.
Is ACT and mindfulness acceptance therapy the same?
ACT and mindfulness acceptance therapy both involve mindfulness and acceptance, but they’re not the same. Mindfulness acceptance therapy is about noticing and accepting experiences. ACT takes it one step further, helping you to identify your values and take committed action toward them.
In other words, mindfulness is just one piece of the puzzle in ACT. It can also help you use that awareness to build the life you want.
How is ACT different from CBT?
Cognitive behavioral therapy (CBT) focuses on challenging unhelpful thoughts and replacing them with more balanced ones. ACT, on the other hand, doesn’t ask you to debate or reframe your thoughts — it helps you accept them as they are and shift attention toward actions that reflect your values.
For example, if you experience social anxiety, CBT might involve testing whether the thought, “people will judge me,” is accurate. With ACT, you’d just focus on noticing the thought, acknowledging the anxiety, and letting it pass.
Can I practice ACT techniques on my own?
Yes, many ACT skills are simple enough that you can try them on your own. Mindfulness practices, defusion exercises (labeling thoughts as “just thoughts”), and values reflection are all things you can experiment with outside of therapy.
That said, it can still be challenging to apply these tools consistently when your anxiety is high. If this is the case for you, consider working with a therapist trained in ACT who can give you structure, feedback, and accountability while you practice.
What is values-based action, and how does it connect to ACT?
Making choices that are guided by what truly matters to you is values-based action. In ACT, values act like a compass. They point you toward the life you want to create.
So, if you’re someone who values being a supportive parent, then a values-based action might look like attending your child’s game even if anxiety tells you to stay home. Over time, this approach helps you build a life that feels meaningful and consistent with your core priorities, instead of one dictated by worry or discomfort.
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