Clinicians use many forms of psychotherapy to treat substance use disorder (SUD) and mental health issues. Acceptance and commitment therapy (ACT) is one of the most effective treatments for addressing substance abuse. According to Neurotherapeutics, “ACT rests on the fundamental premise that pain, grief, disappointment, illness, and anxiety are inevitable features of human life, with the therapeutic goal of helping individuals productively adapt to these types of challenges by developing greater psychological flexibility rather than engaging in counterproductive attempts to eliminate or suppress undesirable experiences.” Exclusive Hawaii Rehab uses ACT to help clients focus on acceptance instead of avoidance during treatment.

What Is Acceptance and Commitment Therapy?

ACT is a form of cognitive-behavioral therapy (CBT) used to address substance abuse and mental health disorders. This therapy encourages mindfulness and commitment to positive lifestyle changes. According to the previously mentioned article by Neurotherapeutics, successful recovery using ACT “is achieved through committed pursuit of valued life areas and directions, even in the face of the natural desire to escape or avoid painful and troubling experiences, emotions, and thoughts.”

ACT is ideal for individuals experiencing the following:

  • Issues related to self-confidence, self-esteem, and self-acceptance
  • Intrusive thoughts, cravings, and compulsions
  • Fear of judgment, rejection, or abandonment
  • Difficulty managing high stress or emotional discomfort
  • Self-destructive and self-defeating behaviors
  • Resistance to change
  • Avoidance of emotions or lack of healthy emotion regulation

Clients recovering from substance abuse or mental health disorders often have difficulty accepting the consequences of their behaviors and making positive lifestyle changes. ACT helps clients accept the realities of addiction and make better decisions about their health.

Using Mindfulness-Based Techniques to Address Maladaptive Behaviors

ACT encourages people to use mindfulness-based techniques to address maladaptive behaviors, including substance abuse. According to the Journal of Clinical Medicine Research, “Mindfulness in ACT helps people to be aware of their negative feeling[s] without [being] judgmental towards themselves or trying to change the situation.” Being mindful of maladaptive thoughts and behaviors helps clients feel more comfortable accepting the need for change. “The commitment aspect of ACT helps the individual to achieve their long-term goals by focusing on the values that will help them get better.”

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Processes Used in Acceptance and Commitment Therapy

ACT uses a wide range of processes to help people identify and replace problematic behaviors and thoughts. Below are some of the most commonly used methods in ACT therapy.

Cognitive Defusion

Thoughts directly affect how people feel and behave. Cognitive defusion involves objectively observing thoughts, enabling people to make deeper connections between thoughts, beliefs, behaviors, and emotions. Clients must separate thoughts from experiences to practice cognitive defusion.

Self-talk is one way to successfully separate thoughts from an experience. For example, individuals thinking “I am a failure” can change their perspective and instead choose to tell themselves, “I am having the thought that I am a failure.” Removing emotional attachment from the idea makes gaining self-awareness and powerful insights easier during treatment.


Clients in therapy learn to accept their circumstances and past choices by directly and objectively acknowledging them without judgment or defensiveness. Acceptance allows people to better understand their own motivations and how to make healthier choices.

Contact With the Present Moment

Mindfulness exercises and grounding techniques help clients learn to remain in contact with the present moment.

Some examples of mindfulness-based techniques clients learn in ACT sessions include:

  • Focusing on the sensations of breathing
  • Paying close attention while completing everyday tasks, focusing on any sensations or thoughts the activity causes
  • Mindfully observing feelings like anxiety by mentally taking a step back and observing the feelings and the reactions they cause

Openness and a sense of connectedness help people feel less stress during mindfulness exercises. Clinicians guide clients through becoming more aware of the mind-body connection influencing their thoughts and behaviors.

Observing the Self

Self-awareness and self-compassion are essential skills during early recovery. Observing the self by practicing self-compassion and improving self-awareness reduces the risk of relapse and enhances the effectiveness of addiction treatment. According to the Journal of Contextual Behavioral Science, research studies reported an “ACT intervention led to large increases in self-compassion” compared to control groups. ACT directs people’s focus inward and encourages clients to gain a deeper understanding of their internal experience.


Identifying and implementing personal values can motivate significant positive change during early recovery. People are often more engaged in their recovery if they tie their goals to strong personal values.

Some of the values people choose to focus on and strengthen during ACT therapy include:

  • Honesty
  • Integrity
  • Accountability
  • Acceptance
  • Trust
  • Self-control
  • Respect
  • Responsibility
  • Patience
  • Open-mindedness

Clinicians help clients identify values they want to focus on during treatment.

Committed Actions

Clients use committed actions to put their values to the test by choosing to act on them in positive ways. According to the previously mentioned article by the Journal of Clinical Medicine Research, “ACT’s greatest focus is on psychological flexibility which is described . . . as the capability of a human being to confront the present moment and alter his actions to achieve the desired effect.” Committed actions are one way people use mindfulness to control and direct current actions and personal choices during addiction recovery.

Experience True Healing

Our deeply-caring staff and the surrounding natural beauty offer an unparalleled healing experience.

How Does Acceptance and Commitment Therapy Address Substance Abuse?

ACT helps clients address issues related to substance abuse by encouraging objectivity, mindfulness, and positive change. Exclusive Hawaii Rehab uses ACT and other forms of treatment to guide clients through the process of healing and preparing for long-term sobriety.