Acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) are two common types of talk therapy. Both aim to improve mental health but ACT and CBT are very different in their approach, using different pathways and techniques to help you heal. ACT focuses on acceptance and values while encouraging you to embrace your thoughts and feelings. CBT relies on structure and attempts to alter negative thought patterns and behaviors to improve mental health and reduce symptoms.
Figuring out which style of therapy will benefit your specific needs can feel overwhelming at first, but understanding how each works can help.
If you’re trying to decide on ACT vs. CBT therapy, keep reading to explore more about each type of therapy, including their benefits and their differences. Learning as much as you can about ACT therapy and CBT therapy will help you make an educated decision.
What is ACT?
ACT, or acceptance and commitment therapy, is a form of psychotherapy that helps you embrace your thoughts and feelings rather than fight them or feel guilty about them. It’s different from the more traditional cognitive behavioral therapy approach, which focuses on identifying and changing problematic thoughts and behaviors.
Rather, ACT principles teach you to change the relationship you have with your thoughts. It’s based on the principle that it is possible to enhance your well-being by overcoming negative thought patterns and feelings using emotional regulation techniques like mindfulness and focusing on behavioral changes.
Techniques used
According to the Association for Contextual Behavioral Science, ACT uses several core techniques, including:
Cognitive defusion: Learning how to stop dwelling on unhelpful thought patterns, images, emotions, and memories.
Acceptance: Deciding to accept events and experiences when they occur.
Mindfulness: Learning to be present and in the moment without judgment.
Self as context: Believing that you are more than your experiences, thoughts, or emotions.
Values: Discovering what’s most meaningful to you and working toward it.
Committed action: Setting goals and then carrying out actions to achieve them.
Benefits
ACT takes a dynamic approach to mental health by building resilience and promoting sustainable changes in your behavior. Benefits of ACT include:
Increased psychological flexibility: ACT’s primary goal is to help you adapt to situations while remaining open, aware, and focused.
Enhanced ability to cope with negative thoughts and emotions: Rather than avoiding distressing thoughts, ACT teaches you that being open to them reduces their power over you.
Improved quality of life: By aligning your actions with your values, you can lead a more purposeful and meaningful life.
Stress reduction: Mindfulness and acceptance are techniques used in ACT that can significantly reduce stress levels.
Mental health decline resilience: ACT can prevent the worsening of depressive or anxious symptoms.
What is CBT?
The major difference between CBT vs. ACT is that cognitive behavioral therapy is a structured, short-term, goal-oriented style of psychotherapy that takes a hands-on approach to problem-solving. Cognitive therapy helps you identify and change problematic thought and behavior patterns. Traditional CBT is used to treat a wide range of issues — from sleep difficulties to relationship problems to drug and alcohol abuse to anxiety and depression.
One advantage of CBT is that it’s a short-term commitment — it often takes just 5 to 10 months before you’ll see drastic improvement. You typically attend 1 session per week and it lasts around 50 minutes. During individual sessions, you work with a therapist to start understanding your problems and developing strategies to tackle them.
CBT is a highly goal-driven, focused style of therapy. It’s best for people who are comfortable with introspection and thrive in a structured environment. CBT can be effective in treating a wide range of mental health conditions, including mood disorders, anxiety disorders, personality disorders, eating disorders, substance use and abuse disorders, and psychotic disorders.
Techniques used
CBT uses several techniques. Some of the most common and prominent CBT techniques include:
Cognitive restructuring or reframing: Identifying and changing distorted thought patterns, beliefs, or attitudes.
Behavioral experiments: Testing beliefs against reality so you can modify them based on the outcomes.
Exposure therapy: Gradually facing a feared situation in a controlled and safe environment.
Relaxation and stress reduction exercises: Using tools like deep breathing, muscle relaxation, and mindfulness to reduce stress and anxiety.
Problem-solving skills training: Learning coping techniques that can help you tackle difficult situations.
Role-playing: Preparing for a problem or a stress-inducing interaction through role-play.
Homework: Practicing what you learn in sessions in a real-world setting.
Benefits
CBT has many benefits. Research suggests it can be superior to other therapy forms, which is why it’s the gold standard for psychotherapy treatment. Some of the benefits of CBT can include:
Highly effective for various conditions: CBT is one of the most highly researched, evidence-supported treatments today. It’s effective in treating depression, anxiety disorders, and post-traumatic stress disorder (PTSD), among other conditions.
Short-term treatment: Most people see results in a relatively short period compared to other treatment modalities.
Prevents relapse: The skills you learn in CBT are both valuable and practical. You’ll gain helpful strategies and coping skills you can use in your everyday life, so relapse is much less likely.
Key Differences Between ACT and CBT
Despite both being grounded in behavioral science, ACT therapy vs CBT have varying methodologies, goals, and techniques. The differences help highlight the ways ACT and CBT can improve your mental health.
Goals
ACT is designed to increase psychological flexibility. By learning to accept your thoughts and feelings without judgment and committing to action based on your values, you can live a meaningful life despite your mental health struggles.
CBT is primarily about identifying and modifying distorted or maladaptive thought and behavior patterns to alleviate symptoms you’re experiencing.
“ACT might be better suited for conditions where the goal is to foster psychological flexibility, mindfulness, and acceptance of difficult thoughts and emotions, such as in cases of chronic pain or anxiety disorders. On the other hand, CBT might be preferred when the goal is to modify specific thought patterns and behaviors associated with conditions like depression, phobias, or obsessive-compulsive disorder, aiming for symptom reduction and skill-building in coping strategies.”
– Talkspace therapist Cynthia Catchings, PhD, LCSW-S
Focus
ACT focuses on behavior changes in the context of personal values. It encourages you to accept your experiences and fully commit to living your life, true to your values, regardless of any negative thoughts or feelings you might have.
Conversely, CBT concentrates on thoughts and behavior patterns and aims to change them if they result in negative emotions or unhealthy behaviors.
Techniques
Mindfulness, cognitive defusion, and exploration of values are some of the successful techniques used in ACT. These strategies help you relate differently to your thoughts and feelings so you can change your behavior.
CBT employs techniques like cognitive restructuring, exposure therapy, and skills training to alter destructive patterns and behaviors that impact mental health.
Approach to emotions
In ACT sessions, you’ll learn to observe, accept, and embrace your emotions without trying to change or avoid them. This style of therapy requires you to be open to emotional experiences and willing to sit in discomfort if it serves a valuable purpose.
CBT, by contrast, helps you reduce emotional distress by teaching skills and coping techniques to help you achieve emotional regulation.
Which is Right for You?
Deciding which therapy is best depends on your goals for therapy, personal challenges, and, sometimes, philosophical outlook on mental health. ACT and CBT both offer unique benefits that can address different psychological needs.
When to choose ACT
ACT might be a good fit if you:
Value personal growth and mindfulness
Have tried other forms of therapy without success
Are dealing with chronic pain or illness
Are looking for a holistic approach to treatment
Are comfortable with accepting — not eliminating — negative thoughts and behaviors
When to choose CBT
CBT can be a better option if you:
Want a structured, short-term therapy
Have specific symptoms or concerns you want to address
Appreciate homework and thrive on detailed tasks
Believe in the power of changing thought patterns
Are dealing with anxiety, phobias, or panic attacks
Connect with a Therapist for Personalized Treatment
ACT and CBT can be highly effective forms of therapy — there isn’t a right or better choice. How suitable one is depends on your circumstances, preferences, specific goals, and needs. The efficacy of each type of therapy relies on how committed you are to the process and how well the underlying principles and techniques resonate with you.
If you’re unsure which type of therapy might be best, discuss your concerns with a mental professional or your doctor. They can help you determine the best approach to address your needs.
Talkspace can be your resource to connect with licensed therapists who are trained in various therapeutic approaches, including ACT and CBT. Knowing how to get the most out of online therapy will enhance these effective techniques.
Talkspace therapists ensure your treatment plan is tailored to your unique needs so you can achieve the best possible outcome. Contact Talkspace today to learn more about online therapy.
Sources:
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The six Core Processes of ACT | Association for Contextual Behavioral Science. https://contextualscience.org/the_six_core_processes_of_act. Accessed July 21, 2024.
Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral therapy: A review of Meta-analyses. Cognitive Therapy and Research. 2012;36(5):427-440. doi:10.1007/s10608-012-9476-1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/. Accessed July 21, 2024.
David D, Cristea I, Hofmann SG. Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry. 2018;9. doi:10.3389/fpsyt.2018.00004. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/. Accessed July 21, 2024.
Kar N. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Neuropsychiatric Disease and Treatment. Published online April 1, 2011:167. doi:10.2147/ndt.s10389. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083990/. Accessed July 21, 2024.
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