Acceptance and Commitment Therapy vs. Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) remains the most widely used therapeutic intervention for treating mental health disorders.

CBT is designed to help you identify and address any unhelpful or negative thinking patterns. These thought loops can make you feel trapped or lost. The idea behind CBT is that changing your thoughts can change your emotions, which can change your behavior.

Therapists usually consider CBT a short-term commitment — once a week for 3 to 5 months — that focuses on a specific issue the client wants to address.

Moreover, CBT could be applied to many difficult scenarios that you may experience.

For example, consider a person unhappy in their job but believes they’ll never get a high-salary job that they enjoy. In CBT, they work with the therapist to better understand why they think that and find ways to channel those thoughts into positive action.

This new belief leads to more positive emotions, which may motivate them to start applying for new jobs, go back to school, or take another useful step toward their goals.

Simply, CBT can be a versatile and short-term form of therapy that can help you break free from habitual, unhelpful thought patterns. This may prove helpful with relationship issues, life crises, and managing anxiety disorders.

Acceptance and commitment therapy (ACT) is an intervention that increases psychological flexibility by using mindfulness and various behavior-changing strategies.

The idea behind ACT is that our issues don’t only come from the painful experiences in our lives. Rather, much of our discomfort comes from struggling against the uncomfortable feelings and thoughts about these experiences.

ACT shows you how to confront and accept your experiences, feelings, and thoughts and stop overthinking and struggling against them.

ACT reminds you that stress and difficult emotions are parts of the human condition, yet you can find ways to still acknowledge and work through the issues that cause them.

Overall, ACT is based on six core values:

• Acceptance: Accepting your thoughts and feelings.
• Cognitive diffusion: Recognizing your thoughts as just thoughts, not facts.
• Present moment awareness: Focusing on what is happening within you and your environment.
• Self-as context: Recognizing that you are not your thoughts and feelings. Simply observe them.
• Values: Pinpointing your priorities in life and recognizing what motivates you and gives you meaning.
• Committed action: Taking action on your values to create a fulfilling life.

ACT can be either short term or extended over a longer period.

Finally, you learn how to behave in ways that may make your life more meaningful.

ACT and CBT are similar in that they can help clients break through difficult thoughts and feelings.

However, both approach this goal differently:

• In CBT, you learn to reframe any harmful thought patterns. In ACT, you would learn to accept your situations and negative feelings as a typical part of life. By accepting difficulties, ACT focuses on your values and what motivates you.
• CBT aims to reduce symptoms. ACT sees symptom-relief as a side effect.
• In CBT, your therapist plays a major role. In ACT, the work is divided equally between you and the therapist.
• CBT is goal-oriented and typically focused on a specific, short-term problem. ACT is ongoing and is meant to be integrated into your daily life.

Both types of therapy can be used in individual, couple, or group therapy settings.

CBT has long been held as evidence-based, and ACT has more recently been accepted as well. Evidence-based means that it has a robust research presence and is generally accepted by clinicians as the treatment of choice.

Both CBT and ACT have been used to treat various mental health conditions, including:

• depression
• anxiety disorders
• attention deficit hyperactivity disorder (ADHD)
• eating disorders
• personality disorders like dependent personality disorder (DPD)
• trauma
• chronic pain
• schizophrenia
• insomnia
• psychosis
• substance use disorders

Your mental health care professional may use a combination of therapies and medications to treat your symptoms, depending on your specific symptoms and personal factors.

If you have a specific issue to work through, CBT might be better than ACT.

ACT is helpful if you avoid your problems because you’re encouraged to accept and work with uncomfortable feelings. In ACT, you’ll learn acceptance and self-compassion, which may be helpful for the rest of your life.

Whether you choose CBT or ACT, both therapies are likely to show positive results.

Overall, CBT is older and better researched, and most therapists are trained to use it. So, CBT may often be the go-to therapy, at least at the beginning of treatment, especially with patients facing conditions like psychosis, according to a 2018 study.

Sometimes, if a client isn’t getting significant results with CBT, a therapist might change to ACT.

Mindfulness-based cognitive therapy (MBCT) is group psychotherapy that combines CBT with mindfulness techniques, such as meditation and yoga.

In MBCT, people are taught to use these techniques to interrupt any automatic thoughts and feelings that might trigger depression. Clients also learn how to recognize themselves as separate from their moods and thoughts, which may help symptoms of depression.

MBCT was originally developed to prevent formerly depressed individuals from experiencing recurrence. Still, it can help people with many mental health disorders.

Overall, MBCT is a structured 8-week group program with weekly sessions lasting 2 to 2.5 hours. Clients complete daily homework assignments that involve listening to audio recordings and practicing mindfulness meditation.

Though MBCT is typically conducted in a group format, a pilot study observed how group MBCT compared to individual MBCT. The findings suggest that people in both groups were equally satisfied.

While CBT, ACT, and MBCT therapies all seek to help you make sense of your thoughts and emotions, it’s worth comparing how these therapies stack up against each other:

CBT, ACT, and MBCT can be effective therapies to help you work through challenging thoughts and feelings.

In general, CBT can help you work through a specific problem in a brief period. ACT can help you accept uncomfortable feelings and learn mindfulness techniques. MBCT is a little of both in a group setting.

When considering different therapies or techniques, it’s worth considering all the options. Some mobile apps can point you toward more treatment options to start feeling happier and healthier.