What is done in acceptance and commitment therapy?
Written by the clinical team at The Lyceum Clinic. Clinically reviewed by Sanah Younis, Clinical Director, BABCP-accredited (no. 1000792). Published 28 October 2026. Last reviewed 28 October 2026.
ACT works on six processes: defusion, acceptance, present-moment contact, self-as-context, values and committed action. Sessions mix discussion with experiential exercises, some of which are deliberately strange, and the homework is about noticing rather than fixing.
Defusion: the exercise that shocks people
We have clients sing their darkest, most terrifying intrusive thought to the tune of Happy Birthday, or say it in a cartoon voice. The first reaction is nervous laughter, then relief. The thought has been stripped of its teeth. It is still there; it just stops being an instruction.
Acceptance: saying hello to it
In session one we ask people to locate the feeling of inadequacy or anxiety in their body and, instead of trying to make it go away, to make space for it. To say hello to it. It shocks them, because they have spent their whole life running from it.
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The first homework
Noticing when "the Critic" takes the microphone. Just catching the tone of voice you use with yourself and writing it down. No trying to be positive; just witnessing the cruelty of the internal dialogue. That is data for everything that follows.
Values and committed action
Working out what you want each area of your life to stand for, then planning concrete steps in line with those values while the difficult feelings are still present. The turn comes when someone can sit with profound emotional pain or physical discomfort and still choose to take a step towards their values.
What we tell people at the end
The goal was never to empty your mind of pain. The goal was to build a life so big and meaningful that the pain becomes a small passenger in the back seat.
Present-moment contact and self-as-context
The mindfulness in ACT is kept practical: short exercises in noticing what is here now, rather than long meditation. Self-as-context is the recognition that there is a part of you that observes your experience and is not defined by it, which gives the difficult thought somewhere to sit that is not the driving seat.