The Powerful Impact of Acceptance and Commitment Therapy in Addiction Treatment
We all have a running dialogue in our head called self-talk. If you’re a person struggling with addiction, that self-talk can be destructive. However, a psychotherapy called acceptance and commitment therapy (ACT) can help you get unstuck from unhealthy habits.
What is Acceptance and Commitment Therapy?
Acceptance and commitment therapy is a form of cognitive behavioral therapy (CBT) with a focus on using mindfulness to fortify your psychological “muscles”, so that you can better engage in positive behaviors during times of difficult thoughts or emotions1. There are core processes that ACT uses that aid in reducing dysfunctional thoughts, feelings and behaviors. ACT can also be used to help to reduce psychological distress by using what’s called “psychological intervention” for people suffering from substance abuse problems.
One study found that ACT is as effective in treating anxiety disorders, depression and addiction as other established psychological approaches2. Other studies have shown that ACT effectively treats stress, psychosis, people with mixed substance abuse problems, chronic smoking and social anxiety3.
Young Adult Substance Abuse Rates
Young adults experience the highest substance abuse rates of7:
- Prescription Opioid Pain Medications
- ADHD Stimulant Drugs
- Anti-anxiety Drugs
The nonmedical use of prescription drugs is highest among young adults. Heroin addiction among young adults has doubled in the past 10 years8.
In 2014, more than 1,700 young adults died from prescription drug overdoses, and most of these deaths were due to opioids. That’s a quadruple increase from 1999, and add up to nearly 5 people dying each day.
The number of overdose deaths among young adults continues to rise. In 2016, there were more than 3,400 overdose deaths by any prescription opioid in the US among young adults aged 25-34. That adds up to about 9 people each day dying by drug overdose. More than 5,000 in the same age group died from heroin.
History of Acceptance and Commitment Therapy
Acceptance and commitment therapy (ACT) is a proactive type of therapy that comes from traditional behavior therapy (BT) and cognitive behavioral therapy (CBT). Since it blends two behavioral therapy approaches, it’s called the “third wave” by its creator.
ACT was created by Steven C. Hayes, PhD, a professor of psychology at the University of Nevada, in 19864. Dr. Hayes defines ACT as a psychological intervention that works well when it’s integrated into a treatment plan with dialectical behavior therapy (DBT), cognitive therapy (CT), and stress reduction techniques that focus on mindfulness.
The ACT Roadmap
Dr. Hayes laid out a roadmap to follow when using ACT. Using the internal dialogue in our heads we mentioned earlier, picture the mind as a tank of water. As negative thoughts fill the tank, the water level gets higher and higher until it overflows. A full, overflowing tank is a “mind-full” that can lead to self-destructive behaviors (like substance abuse). ACT aims to take the “mind-fullness” that so many of us walk around with every day and empty the negative thoughts by using positive mindfulness.
Positive mindfulness is focusing on what you do well, your strengths, your resources, and ways you can build up your “psychological muscles” so you’re more resilient to negativity. When you’re psychologically more flexible, you’re more able to handle stress, anxiety, depression, and other mental health issues. ACT also gives you tools to recover from addiction and to prevent relapse.
How Does Acceptance and Commitment Therapy Work?
Many therapists summarize ACT in 3 areas:
- Accept your reactions and be present
- Choose a valued direction
- Take action
Put simply, ACT is a type of therapy that helps you accept what is out of your control and commit to actions that can improve and enrich your life.
Accept your reactions and be present
Your ACT therapist will guide you on focusing on your breathing and your present thoughts and feelings, rather than avoiding them. It’s accepting any pain, trauma or negative thoughts, and being willing to experience them without attempting to control them.
Let’s say you’re thinking about a conversation you had with someone, and you didn’t get a positive reaction. Your thought is, “I’m such a jerk!” Rather than try to push away the thought and the feelings that come along with it, such as a sinking feeling in your stomach or a tightness in your chest, you stay in the present moment and experience your reactions.
You may then recognize that your feelings and physical sensations aren’t going to destroy you – they’ll eventually fade. You feeling like a “jerk” is not the end of the world. As you’re watching your feelings rise and fall in your body, you’ll sense them as transient experiences, rather than as who you are at your core.
Choose a valued direction
To consider yourself successful doesn’t mean you always feel happy or life is without pain, but rather success is living a full life in spite of tension, worry or pain. Choose a valued direction and make a go of it, even when you feel fearful about taking action.
When you face fear, the fear gradually decreases. Even if fear doesn’t lessen, you’ll know you’ve done your best. The knowledge of doing your best with what you have – without worrying about the outcome – neutralizes the cycle of self-doubt, regret and rethinking what you “could have done”.
We’re all going to act like a “jerk” or feel “stupid” at times in our lives. The key is not to let that define who you are. For you to live a meaningful and authentic life you must take risks, and that means tolerating uncertainty and anxiety.
ACT therapy helps you focus on taking action without the expectations of a certain outcome. You can choose a valued direction, but results are typically somewhat out of your control.
Misconceptions About Acceptance and Commitment Therapy
Acceptance vs Resignation:
One common misconception about acceptance is that it means giving up or resigning yourself to a life of suffering, but that’s not the case5.
Acceptance simply means you are accepting the way things are right now. It doesn’t mean you have to agree with, like, or hope it will always be this way. It’s only acknowledging what is at the present moment without judging it as good or bad. Once you acknowledge it without judgement, you can then choose your course of action (a valued direction).
Acceptance vs Defeat:
Another common misconception of acceptance is that it’s an admission of failure or defeat. Acceptance is not admitting you’ve failed. When you accept that a strategy isn’t going to work, you’ll tend to give it up. Now you have room to take a more effective approach towards success by building a more flexible and effective response to the situation.
Acceptance vs Tolerance:
Another common misunderstanding is confusing acceptance with tolerance, but these are two distinctly different things. Toleration is a form of acceptance where you’re willing to deal with discomfort or difficulty – but only up to an acceptable limit.
What Training Is Required for Staff for Acceptance and Commitment Therapy?
Experienced, licensed clinicians work closely with their clients in identifying negative attitudes, feelings and behaviors that are used to cope, and they help their clients replace the negativity. This leads to a more productive and successful life. There is no ACT certification for this process.
Clinicians that work in treatment centers typically have the education, training and experience in working with multiple evidence-based therapy approaches, which include:
- ACT – Acceptance and Commitment Therapy
- CBT – Cognitive Behavioral Therapy
- DBT – Dialectical Behavioral Therapy
- Mindfulness-based relapse prevention
- MI – Motivational Interviewing
Research shows that ACT works especially well in treating stress, anxiety disorders, depression, substance abuse and a wide-range of chronic medical conditions6. High-quality Addiction treatment centers integrate ACT as an evidence-based approach into treatment programs.
How Can You Integrate ACT in Your Life After Treatment?
Acceptance and commitment therapy can help you control your natural fight-or-flight response that’s a large part of anxiety. At its core, ACT can help you:
- Accept life’s challenges and problems
- Understand and overcome negative thoughts and feelings
- Choose life paths built on your own wishes and values
- Take action to carve out the life you desire
When you gain increased psychological flexibility from ACT, you’ll learn to be fully present in each moment, so you can experience and live whatever life brings. By doing so, you can stop avoiding anxiety.
Acceptance in Your Life
By using the acceptance part of ACT in your life, you’ll better understand your anxiety, what triggers your anxiety, and your anxious thoughts, feelings and behaviors. Once you can fully recognize what’s going on around you as well as within you, you can face it and accept it for what it is.
ACT comes with control and power. By reducing the control and power anxiety has on your life, your own self-control and power is greatly increased. When you live in the present, accept yourself and your life, you can then decide what it is that you want for yourself. Using ACT to loosen the grip that anxiety has on your life gives you the flexibility to define your values and take action with purpose, resulting in a rewarding and anxiety-free life.
While this discussion of using ACT in your life focused on anxiety to keep the points simple, you can plug in any of the issues you face – stress, depression or trauma – in place of the word anxiety and still use ACT.
Silvermist Recovery is committed to addressing clinical issues effectively and collaboratively to bring about real change. Transforming the lives of young people struggling with addiction starts with giving them purpose and developing a plan to achieve that purpose. One method is ACT, but we incorporate many other evidence-based treatments to aid young adults in developing their abilities, recognizing their individualism, and minimizing their addictive traits and behaviors. Call us today at (866) 787-4166 to get started on a revitalized life.