Prof. Dr. Kemal Arıkan
Psychiatrist

Acceptance – Commitment Therapy (ACT) in the Treatment of Depression and Anxiety

Depresyon ve Anksiyete Tedavisinde Kabul - Kararlılık Terapisi (ACT)

Emotional disorders, such as anxiety (anxiety disorder) and depression, are the most common psychiatric problems. Anxiety and depression are among the causes of disability around the world. The most recent estimations of the World Health Organization (WHO) show that 4.4% of the world population suffer from depression, while women have an anxiety rate of 3.6%. Furthermore, the comorbidity rate of both problems is over 50%. Even though these disorders are one of the causes of disability across the globe and lead to considerable economic, social and personal costs, only a small number of patients can receive a sufficient level of treatment.

Acceptance and Commitment Therapy (ACT, Hayes et al., 2006) is an intervention proven to be useful in the treatment of emotional disorders. Acceptance and Commitment Therapy is a psychotherapy model that includes interventions that are based on self-awareness and acceptance. ACT aims to let the individual know and be aware of their inner reactions, while ensuring they understand and regulate their reactions toward the outside world without suppressing them. The purpose here is the comprehension of the problems that appear as a consequence of the deficiency or dysfunction of several psychological mechanisms and to ensure that the person acquires a psychological flexibility through various methods.

Despite causing discomfort and challenges, psychological problems are the way the people respond to living conditions. Harsh reactions to inner experiences, or attempts to avoid or control them may bring relief along in the short run; however, they limit the person’s life by increasing the frequency and intensity of these unwanted experiences in the long run. Consequently, ACT aims to account for the functionality of the problem within the context of the daily lives of people and to act accordingly. ACT aims to increase the psychological flexibility without any need to avoid and/or run away from the current special experiences (bodily senses, thoughts, emotions, behavioral predispositions…).

There are 6 aspects of the ACT psychological flexibility model being implemented:

  1. Acceptance:To clearly accept the undesired inner experience instead of running away from it.
  2. To get in contact with the moment: This stands for the person focusing their thoughts and attention on the moment and noticing positive/negative bodily senses. Being able to focus on the present, moving away from the pressure of the past and future.
  3. Diffusion/Cognitive Differentiation: This stands for the person noticing the difference between the cognition (moment, thoughts…) and reality.
  4. Contextual self:To recognize the integrity and continuity of the self. To know the unchangeability of the self in spite of the experiences and emotions.
  5. Values:To determine the values that make the person’s life meaningful.
  6. Commitment/Determination:To focus on the values and take action.

ACT creates new patterns of behavior through various methods and tasks. Recent studies show that the Acceptance and Commitment Therapy is being effective in the treatment of emotional disorders. ACT can be as effective as psychological interventions in the treatment of anxiety, depression and somatic health problems. In conclusion, it has been seen that this treatment can be an effective complementary or alternative treatment for emotional disorders and that it can provide even more effectiveness when implemented on a group basis. Group-based ACT practices implemented for the treatment of emotional disorders (anxiety and/or depression) can be a fast and effective method for the recovery.

SOURCE:

  1. ACT’i Kolay Öğrenmek; Russ Harris; Litera Yayınları-2015
  2. Coto-Lesmes, R., Fernández-Rodríguez, C., & González-Fernández, S. (2020). Acceptance and Commitment Therapy in group format for anxiety and depression. A systematic review. Journal of Affective Disorders, 263, 107–120.

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