ACCEPTANCE &

COMMITMENT THERAPY
(ACT)

FOR DEPRESSION
NAME: MOHAMMED MEHARYAR HAIDER
ROLL# 253065251
 What is a Human
Experience?
When we pause to reflect on what it means to be human, we
connect to our own experiences, both personal and shared,
including those filled with simplicity and joy, amazement,
and belonging. We also realize in those moments that life
can be fraught with struggle and pain that fundamental
human experience also contains suffering. For many, this
experience comes and goes, but for others suffering and
pain may linger, even paralyze, in life-limiting ways.
DEPRESSION AS A HUMAN
EXPERIENCE
 Depression is one of these types of life-impairing
experiences that can have long-lasting effects.

 The experience of depression can profoundly affect a

person’s life. The personal cost and emotional suffering
related to depression can significantly impact
interpersonal and daily life functioning, leading to
further difficulties and a potential long-term decrease in
functioning.
 Click icon to add picture

 Acceptance and Commitment

Therapy (ACT), is one such
WHAT IS intervention that not only

ACCEPTANCE AND focuses on decreasing

suffering.
COMMITMENT  But also focuses on personal

THERAPY (ACT)? values in the service of

bringing vitality and
meaningful functioning to the
 Dr. Steven Hayes and colleagues developed ACT.
person’s life.
 It is considered a “third-wave” behavioral intervention
 It is one of a number of “acceptance-based psychotherapies” that
focuses on promoting acceptance of internal experiences and taking
committed actions consistent with personally chosen values.
 Clinical goals of ACT
 Therapist works to help the patient
accept internal events that includes
 thoughts
 emotions
 sensations
 images
 memories
 And also helps them make and keep
behavioral commitments that reflect
personal values.
 How ACT works?
 ACT works by assisting patients to shift from viewing

negatively evaluated internal experience as a problem

to be solved to an “event” to be experienced (i.e.,

emotions and thoughts are not like math problems;

they are more like sunsets.

 It is designed to target and reduce harmful

experiential avoidance and non-acceptance while also

encouraging patients to clarify values and engage life

by making powerful life-enhancing choices.

 It employs multiple core processes that decrease

maladaptive behaviors and unhealthy attempts to avoid

internal experience by focusing on increasing

behavioral and psychological flexibility.

 Psychological flexibility
Psychological flexibility is defined as “contacting the
present moment fully as a conscious human being,
experiencing what is there to be experienced, and
working to change behavior such that it is in the service
of chosen values.”

Being psychol ogically flexible allows people to adapt to

changes in the environment and react in new, creative and
healthy ways that align with an individual's goals and values.
This ability also plays a vital role in health and well-being.
CORE
PROCESSES
IN ACT
The general goal of ACT is to increase psychological
flexibility. And Psychological flexibility is
established through six core ACT processes. Each of
these areas are conceptualized as a positive
psychological skill, not merely a method of avoiding
psychopathology.
  Acceptance is taught as an
alternative to experiential
avoidance.
 Acceptance involves the active
and aware embrace of those
private events occasioned by
1. ACCEPTANCE one’s history without
unnecessary attempts to change
their frequency or form,
especially when doing so would

Rather than trying to push away or avoid uncomfortable cause psychological harm. For
emotions (such as anxiety, sadness, or fear), acceptance example, anxiety patients are
involves acknowledging and experiencing these feelings
without judgment. This contrasts with traditional cognitive- taught to feel anxiety, as a
behavioral approaches that often focus on eliminating or feeling, fully and without
changing unwanted thoughts and feelings.
defense.
Acceptance does not mean liking or approving of painful
experiences; it means allowing them to be present without  It is not an end in itself. Rather
 Undermining the language-based
processes that promote fusion with
“mind,” needless reason giving, and
unhelpful evaluation that cause
private experiences to function as
psychological barriers to life
enhancing activities is the process
2. COGNITIVE referred to as Cognitive Diffusion.
Unhooking from Thoughts:
DIFFUSION Cognitive diffusion
encourages individuals to view
Techniques in Cognitive Diffusion: their thoughts as just
Several exercises are used in ACT to promote cognitive thoughts, not truths or
diffusion. Some examples include: commands. The goal is to
“unhook” from these thoughts
Naming the story: Labeling the thought as part of a
“story” (e.g., “I’m having the thought that I’m a failure”). and reduce their impact. For
instance, instead of thinking,
Silly voices or songs: Saying the thought out loud in a
“I am worthless,” an individual
silly voice or singing it can help diminish its seriousness
and emotional charge.
practicing diffusion might
recognize, “I am having the
Physicalizing thoughts: Imagining that a thought is thought that I am worthless.”
physically present (e.g., as a cloud or object) and seeing it
 The third process,
getting in Contact
with the Present
3. BEING PRESENT Moment, is
actively working to
live in the present
moment,
contacting more
fully the ongoing
flow of experience
as it occurs.
 Self as Context is
the process where
the individual makes
4.SELF AS contact with a
CONTEXT deeper sense of self
that can serve as the
context for
experiencing
Self as Content refers to the stories we tell about
ourselves—our thoughts, memories, feelings, and ongoing thoughts
identities. For example, “I am anxious,” “I am a and feelings. It is
perfectionist,” or “I am not good enough.” distinct from the self
Self as Context, on the other hand, refers to the that may be defined
perspective of the observing self—the part of you that is
aware of your thoughts and feelings but is not defined by
by the content.
them. It’s the “witness” to your experiences, not the
experiences themselves. This shift allows you to view your
  Values are chosen qualities of
purposive action that can
never be obtained as an object
but can be instantiated
moment by moment.
• Values are freely chosen
life directions that provide
meaning and purpose.

5. VALUES • They answer the question,

“What do I want my life to
stand for?”

Distinction Between Values and Goals:

 ACT uses a variety of
Values are enduring and cannot be “completed” (e.g., “being
kind” or “living with integrity”). exercises to help a client
choose life directions in
Goals are specific, measurable, and finite actions aligned with
values (e.g., “helping a friend this weekend”).
various domains (e.g. family,
career, spirituality) while
Examples of Values: undermining verbal processes
Family: Being present and supportive in relationships. that might lead to choices
Community: Engaging and contributing to society. based on avoidance, social
compliance, or fusion.
  In ACT, it is important
not to forget the part
where you must take
action on your values.
 Committed action is
6. COMMITTED about taking effective
action and behaving in
ACTION ways that are guided by
your values.
 Taking committed
action which involves
building larger and
Committed action involves identifying what truly matters larger patterns of
to you—your values—and then taking steps toward those behavior that reflect the
values, even when it feels difficult. Values are broad life individual’s stated
goals (e.g., being a loving partner, contributing to the values.
community, living a healthy life), not specific outcomes or
achievements.
For example, someone who values health might commit to
regular exercise or preparing nutritious meals, despite the
 Each of the six core processes is designed to create and support
psychological and behavioral flexibility.
 In the following table we can see the pathological processes that
lead to problems more broadly and are the responses to internal
events and situations that can create long-term suffering. On the
right side of the table are the ACT processes that are used in
therapy to target and address these ineffective and problematic
strategies.
Why ACT for Depression?

 Acceptance and commitment therapy (ACT) is an effective intervention for

depression.

 Rather than focusing solely on reducing symptoms of depression, ACT

helps individuals accept their depressive thoughts and emotions while
engaging in behaviors that align with their personal goals.

 This holistic approach fosters resilience and empowers individuals to

navigate the challenges of depression with renewed strength and vitality.
HOW ACT WORKS FOR
DEPRESSION?
 MAIN GOALS OF ACT FOR DEPRESSION

 One of the main goals of ACT for depression is to help patients see that they
“have” a mind, not that they “are” their mind.

 When patients are struggling (and even when they aren’t), they make no
distinction between themselves and what they are thinking. It is as if they are
their thoughts.

 There are some specific ways, from the ACT perspective, in which patients
get entangled with their minds and these can be represented in a single
acronym: FEAR.
ACRONYM: FEAR

F: Fusion with thoughts

E: Evaluation of experience

A: Avoidance of experience

R: Reason-giving for behavior

ACT Techniques For Depression

 ACT therapy techniques include metaphors and experiential techniques, and skills like acceptance,
mindfulness, and diffusion. When applied to depression, these techniques offer transformative insights
and strategies for managing and overcoming depressive symptoms.

 Acceptance, mindfulness, and diffusion Skills (AMD) are core components of ACT. These skills are
essential for developing psychological flexibility, which is the ability to accept difficult thoughts and
emotions and engage in valued behaviors even in the presence of discomfort.

 Here is how ACT techniques are applied to depression:

ACCEPTANCE Instead of fighting
thoughts and emotions,
SKILLS let them come and go
without getting caught
up in them. It’s like
observing the weather
one can’t control the
rain or the sunshine,
but they can accept that
they’ll pass.
  With mindfulness
skills, people
MINDFULNESS focus on the
present moment
SKILLS without getting
caught up in their
thoughts and
emotions.
 This can be done
through practices
like meditation
for depression
etc.
  Defusion skills help people
distance themselves from
their unhelpful thoughts.
DEFUSION SKILLS This means not taking
thoughts too seriously or
believing in them as
absolute truths. Instead,
view them as just thoughts,
like passing clouds in the
sky.
 This can help them take
some of the power out of
the thoughts themselves,
making it easier to let them
go.
 Metaphors are a key tool in Acceptance
and Commitment Therapy (ACT) that help
clients understand complex concepts and
make behavioral changes:
 Metaphors compare unrelated
experiences to help clients gain new
insights and perspectives on their

USE OF challenges.
 Metaphors can help clients connect

METAPHORS with their values and motivate them to

make a commitment to change.
 Metaphors can help clients visualize
their unhealthy thought patterns, which
can help them become more
empowered.
 Metaphors can help clients practice
cognitive defusion, which is the process
of objectifying thoughts and defusing
irrational thought processes.
THE PROTOCOL
 Getting Started with ACT-D

 Getting Started with ACT-D ACT is a principle-based intervention and is broadly applicable to human
suffering in its various forms.
 It has been researched across a number of diagnoses and has demonstrated positive outcomes.
 Clearly, not every individual who experiences depression is the same and individuals diagnosed with
depression should not be treated as a homogeneous group.
 This treatment may not be appropriate for every individual who has or is experiencing depression.
 Individual assessment should guide treatment intervention decisions. Some key events to look for when
considering this intervention include, but are not limited to: experiential avoidance and inaction, being
“stuck” in the past, being overly bound to ineffective rules (loss of flexibility), long-standing and/or
difficult to treat depression, and multiple treatment failures.
The Structure of ACT-D

 This 12-session protocol contains the basic structure for implementing ACT-D with individuals
who are experiencing depression alone or depression with cooccurring anxiety.
 The protocol was developed for the veterans Training Program and is designed to speak to the
application of the therapy and the nature of the therapist using ACT, while also considering the
Veteran with depression.
 Although 12 sessions are required, it is recognized that the therapy could take more or less time
for an individual patient.
 For some Veterans, it may require up to 16 sessions to be fully implemented, for others, it may
take only 10 sessions.
 Session topics are generally organized around the six core processes with each session
containing several key content areas.
Overview of ACT-D Sessions

Session 1: Informed Consent; Formal and Informal Assessment; Rapport Building

S e s s i o n 2 : Va l u e s A s s e s s m e n t / G o a l s o f T h e r a p y S e s s i o n 3 : C r e a t i v e H o p e l e s s n e s s

Session 4: Control as the Problem

S e s s i o n 5 : Wi l l i n g n e s s : B u i l d i n g A c c e p t a n c e , D e f u s i n g L a n g u a g e – P a r t I

S e s s i o n 6 : Wi l l i n g n e s s : B u i l d i n g A c c e p t a n c e , D e f u s i n g L a n g u a g e – P a r t I I

Session 7: Self-as-Context – Part I

Session 8: Self-as-Context – Part II

S e s s i o n 9 : Va l u e s – P a r t I

S e s s i o n 1 0 : Va l u e s – P a r t I I

Se s s i o n 11 : C om m i t t e d Ac t i on

S e s s i o n 1 2 : Te r m i n a t i o n
Session 1: Rapport
Session
2
Value
Assessm
emt
Session 3
Creative
Hopeless-
ness
Session 4
Control
as
Problem
Session 5
Willingness –
Building
Acceptance and
Defusion (Part I)
Session 6
Willingness –
Building
Acceptance and
Defusion (Part II)
Session 7: Self-as-
Context – Part I
Session 8: Self-
as-Context –
Part II
Session 9:
Values –
Part I
Session
10:
Values –
Part II
Summary
of Session
11:
Committed
Action
Session 12:
Termination
 STRENGTHS VS WEAKNESSES

Strengths Weaknesses

 ACT encourages people to live a life  ACT may not be the best fit for people who don't resonate
driven by values, rather than just with its principles, or who find it difficult to practice
managing symptoms. mindfulness and acceptance.

 IT focuses on teaching life skills to help  It is a broad-based approach that focuses on overall well-
people meet future challenges. being, and may not directly address specific issues or
symptoms.
 IT encourages people to accept negative
experiences as part of life, and to change  It may require more effort than therapies that focus on
how they respond to them short-term symptom relief.

 It is not suitable for people with impaired cognitive

functioning, psychosis, intoxication, organic brain injury,
or who require emergency medical treatment.
THANK YOU!

Any Qs?