This is the final article in a series about Acceptance and Commitment Therapy (ACT), a therapeutic approach that I often use in my practice. ACT involves six core concepts that make up the ACT Hexaflex: Acceptance, Cognitive Defusion, Being Present, Self as Context, Values and Commitment.

The final core concept of Acceptance Commitment Therapy is Commitment. This is where behavioral change happens. Once a client has articulated their values and understands what is truly meaningful for them in living their best life, my role as the clinician is to help them translate these into action. The work we do together in ACT – acceptance, defusion, being present and self as context – supports the individual’s ability to cope with the painful thoughts, emotions and feelings as they take positive action.   

While Values are always evolving and aren’t ever completed, this part of the ACT Hexaflex challenges the client to act. Making the commitment helps the individual to keep moving forward in a positive direction even when they encounter obstacles.

In his series of presentations on “Demystifying ACT,” DJ Moran Ph.D., likens this step in ACT to creating a values-based “To Do” list.

As an example, he describes a situation where a person is struggling with a social phobia. What steps can they take to move forward? If they are a church-going person, one item on their To Do list may be to “sit in a pew in church instead of standing in back” another may be to “talk to two people at the post-service breakfast.”

Developing the To Do list is a collaborative process between therapist and client. With my support, my client chooses certain actions and I use the interventions in my therapeutic toolbox to support their goals and encourage them to persist so that they can successfully act. Using the example above, I might ask my client to do homework in preparation for their church experience such as spending time doing mindfulness or relaxation exercises. The client’s list of committed actions can grow and become more ambitious as we progress together.

Setting Values-Based Goals

A commonly used framework used in multiple fields for setting realistic goals is using the SMART goal acronym.

Psychotherapist and author Dr. Russ Harris has adapted SMART for ACT. In his guide for ACT clinicians, Harris outlines what achievable goals look like:

  • Specific: Specify the actions you will take, when and where you will do so, and who or what is involved.
  • Meaningful: The goal should be personally meaningful to you. If it is genuinely guided by your values, as opposed to following a rigid rule, or trying to please others, or trying to avoid some pain. If it lacks a sense of meaning or purpose, check in and see if it is really guided by your values.
  • Adaptive: Does the goal help you to take your life forwards in a direction that, as far as you can predict, is likely to improve the quality of that life?
  • Realistic: The goal should be realistically achievable. Consider your health, competing demands on your time, financial status, and whether you have the skills to achieve it.
  • Time-bound: To increase the specificity of your goal, set a day, date and time for it. If this is not possible, set as accurate a time limit as you can.

If you have tried everything to overcome or change negative emotions or stop repeating destructive patterns, but nothing has worked, you may want to consider ACT. ACT is a research-based therapeutic intervention that helps individuals change the way they cope with difficult feelings and experiences rather than trying to eliminate them, and then taking meaningful action to move forward. It is effective for treating a variety of clinical issues including anxiety, depression, stress and substance abuse. To learn more contact me at

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