Acceptance and commitment therapy, shortened to ACT, is a talking therapy that helps you to respond more flexibly to difficult thoughts and feelings, so they stop deciding what you do, while you take steps towards what matters to you. It is pronounced as the word "act", not as three letters.
You might be looking into ACT because of anxiety, low mood, stress or something that has been weighing on you for a long time. Below we explain how it works, what the research says, what happens in sessions and how to find ACT therapy in Ireland, in Dublin, Galway or online.
Acceptance and commitment therapy explained
ACT is an evidence-based psychological therapy that grew out of the cognitive behavioural tradition. The Association for Contextual Behavioral Science (ACBS), the professional body for the approach, describes it as a therapy that uses acceptance and mindfulness strategies together with commitment and behaviour change strategies to increase psychological flexibility. That is the goal: not getting rid of every unwanted thought or emotion, but being able to stay in contact with the present moment and keep doing what you care about, even when your mind is noisy.
The idea behind it is one many people recognise straight away. The energy we put into suppressing, avoiding or controlling what is going on inside us, makes the distress louder, and our lives smaller. You stop going to the gym because you might panic there. You turn down the promotion because the self-doubt is too loud. ACT calls this pattern experiential avoidance. A second pattern, cognitive fusion, is when a thought such as "I'm useless" feels like a plain fact rather than something your mind is saying.
The two words in the name are often misread, so it helps to be clear. Acceptance does not mean approving of what is happening, giving up or putting up with harmful circumstances. It means making room for feelings you cannot switch off, rather than fighting them. Commitment means taking practical steps, small ones to begin with, towards the values you choose for yourself.
ACT rests on a theory of human language and thinking called relational frame theory. You don't need to know it to benefit from therapy. In short, it explains how language lets our minds pull us into battles with our own inner lives, and why arguing with a thought often keeps it going.
How ACT therapy works
ACT aims to help you notice difficult thoughts and feelings without automatically obeying them, running from them or being swept away by them. The ACBS sets out six core processes that work together to build psychological flexibility. Here is what each can look like in everyday life:
- Acceptance: letting the knot in your stomach be there before a difficult conversation, instead of cancelling the conversation to make the knot go away.
- Cognitive defusion: noticing "I'm having the thought that I'll fail" rather than taking "I'll fail" as a prediction, so the thought loosens its grip.
- Present-moment awareness: bringing your attention back to the dinner you are eating with your children, rather than replaying an email from work.
- Self-as-context: recognising that you are the one who notices your thoughts and moods, so you are more than any one of them. Some people describe it as being the sky rather than the weather.
- Values: working out what kind of friend, parent, partner or colleague you want to be, in your own words rather than anyone else's.
- Committed action: turning a value into something concrete, such as phoning a friend you have been avoiding this week.
In practice, ACT therapists use a mix of exercises. These include short mindfulness practices, naming thoughts ("there's the 'not good enough' story again"), metaphors that make an abstract idea easier to hold, values clarification, willingness exercises where you practise staying with discomfort for a short time, specific behavioural goals and practice between sessions. Which of these a therapist uses, and how, depends on their training and on you. The six processes are the established model. The particular exercises are tools, and good therapists choose them to fit the person.
ACT is active and collaborative. Your therapist will not tell you what your values should be. That part is yours. What they will do is help you notice where struggle and avoidance are getting in the way, and support you in taking steps that make sense to you. We think this pairing is what makes ACT distinctive: acceptance on its own could become passive, so it always comes with action.
What ACT can help with, and what the evidence says
ACT is used for a wide range of difficulties. These include anxiety and panic, depression and low mood, stress and burnout at work, obsessive or repetitive thinking, trauma-related distress, chronic pain, adjusting to long-term illness, and coping with big life changes such as a separation, a move to a new country or a bereavement. It is not right for every diagnosis or situation, and part of a good assessment is working out whether it suits you.
ACT can be the main approach in therapy, or it can be woven into broader counselling, psychotherapy or a pain management programme. The aim is often better day-to-day functioning and quality of life, as well as fewer symptoms. For some people, being able to go back to work, sleep better or enjoy time with family again matters more than whether anxiety ever fully disappears.
The research is encouraging, though it is worth reading carefully. A 2020 review of 20 meta-analyses, covering more than 12,000 participants (Gloster et al., Journal of Contextual Behavioral Science, 2020), found ACT effective for anxiety, depression, substance use, pain and mixed groups of conditions. ACT generally did better than waitlist and treatment as usual, and better than most other active treatments, but not better than CBT. In other words, ACT and CBT are both well supported, and neither is the clear winner for everyone.
For chronic primary pain, the UK's National Institute for Health and Care Excellence (NICE) recommends that ACT or CBT for pain be considered for people aged 16 and over (guideline NG193, published April 2021). That is a meaningful endorsement from a body that weighs evidence strictly.
What this means for you is that ACT is a sound choice, not a guaranteed one. Results vary from person to person. If your symptoms are severe, complicated, getting worse quickly or tied to a physical health problem, we would always suggest talking to your GP as well. A psychologist, psychiatrist or another appropriate professional may also need to assess what is going on, so that therapy sits alongside the right medical care.
What happens in ACT sessions and how long it takes
Most ACT therapy follows a similar shape, though it is never a rigid script. Your first session is an assessment: you talk about what is troubling you now, what you would like to be different and what you have already tried. From there, you and your therapist start to spot the patterns of avoidance or struggle that keep you stuck. Later sessions usually involve clarifying your values, practising ACT skills and agreeing realistic actions to try before you meet again.
Sessions are a mix of conversation and practice. You might do a short mindfulness exercise, work through a written values exercise, explore a metaphor, or plan a small behavioural experiment, such as speaking up once in a meeting. The next session often starts with what happened when you tried it, including what got in the way. If you would like a feel for how a first meeting with us runs, our guide to what to expect in your first therapy session walks through it.
ACT can be offered one to one or in a group, in person or online, depending on the therapist and the service. Some hospitals and clinics run fixed group programmes, but that structure belongs to those services. It is not a rule of ACT itself.
There is no set number of sessions. How long therapy takes depends on what you bring, your goals, how complex things are, how you get on and whether ACT is used briefly or as part of longer-term work. Some therapists use a brief form called Focused ACT, or FACT, designed for shorter contact. Brief does not mean a promise of quick results, though. We would rather review progress with you regularly than guess at a number at the start.
The difference between ACT and CBT
ACT and cognitive behavioural therapy are related, evidence-based approaches that overlap a good deal in practice. They are not rivals. The main difference is in how they treat difficult thoughts: traditional CBT looks at whether a thought is accurate and helps you build a more balanced alternative, while ACT is less interested in whether a thought is true than in whether holding onto it helps you live the way you want.
| Area | ACT | Traditional CBT |
|---|---|---|
| Main emphasis | Changing your relationship with thoughts and feelings | Examining and changing unhelpful thoughts and behaviours |
| Response to difficult thoughts | Notice them, defuse from them and make room for them | Test their accuracy and develop more balanced alternatives |
| Goals | Psychological flexibility and values-led action | Less distress and changes in thinking and behaviour |
| Common techniques | Mindfulness, acceptance, values work and committed action | Cognitive restructuring, behavioural experiments and exposure |
| Shared features | Collaborative, structured and focused on behaviour | Collaborative, structured and focused on behaviour |
Modern CBT is itself varied, and many CBT therapists now use mindfulness, acceptance and values too, so the line between them is not always sharp. Compassion-focused therapy is another related approach some people find helpful, particularly when a harsh inner critic is part of the picture. We think the right choice comes down to your needs and preferences, the evidence for your particular difficulty and, very much, your relationship with the therapist. If a more structured approach to challenging thoughts appeals to you, you can read about our cognitive behavioural therapy (CBT) service.
Who ACT suits, and its limitations
ACT can be adapted for different ages, cultures, communication styles and for neurodivergent people, but how well it fits depends on you and on your therapist's skill. Helpful adaptations include plainer language, visual materials, attention to sensory needs and less reliance on abstract metaphors, which some autistic people and people with ADHD find more confusing than useful. If this matters to you, our neurodivergent affirming therapy starts from how your mind actually works.
ACT has drawbacks worth knowing about before you begin. Mindfulness and emotion-focused exercises can feel uncomfortable at first, especially if you have spent years avoiding certain feelings. Some ideas, self-as-context in particular, can seem abstract. Progress depends on practice between sessions, which is hard when life is already full. And as with any therapy, a poor fit with your therapist can limit what you get from it. It is fine to say so, and to change.
One point we feel strongly about: the acceptance in ACT should never be used to encourage anyone to accept abuse, discrimination, unsafe conditions or harm that could be avoided. Accepting a feeling is very different from accepting a situation that needs to change. Often, making room for fear is exactly what lets someone take action to protect themselves.
ACT is generally considered low risk when delivered by a properly trained practitioner. It does not replace emergency help, medical treatment or specialist mental health care where those are needed. If you are in immediate danger or thinking of harming yourself, call 112 or 999, go to your nearest emergency department, or call Samaritans free on 116 123. The HSE lists urgent and emergency care options across Ireland.
FAQs
How much does ACT therapy cost in Ireland?
Fees vary with the practitioner's qualifications, location, session length and whether therapy is one to one, in a group or online. Our current rates are on our prices page, and if cost is what's holding you back, we also keep a low-cost counselling option for people who would otherwise go without. Your health insurance or workplace assistance programme may cover some sessions, so it is worth asking.
How can I find a qualified ACT therapist in Dublin or elsewhere in Ireland?
Start with the therapist's core professional qualification and their membership of a recognised body, such as the Irish Association for Counselling and Psychotherapy (IACP), the Irish Association of Humanistic and Integrative Psychotherapy (IAHIP) or the Psychological Society of Ireland (PSI), each of which keeps a directory. Then ask about specific ACT training, experience with your concern and how they use supervision. A good therapist will be glad to answer.
Is ACT therapy available online in Ireland?
Yes. ACT works with the same core processes online as in a room, and we offer online therapy to people anywhere in Ireland as well as sessions at our Dublin and Galway locations. Before you start online, it helps to talk through whether it suits you, where you will have privacy, what technology you need and what the arrangements are if you are in crisis between sessions.
Getting started with ACT therapy in Dublin, Galway or online
If ACT sounds like it might suit you, we would be glad to talk it through. Before you begin, it is reasonable to ask any therapist about their ACT training, their experience with your concern, session format, fees, availability and how you will review progress together. A first conversation is not a commitment and it cannot promise a particular outcome, but it can help you decide what feels right. Whenever you feel ready, get in touch for a confidential enquiry.