Rather than focusing on symptom reduction, ACT helps individuals embrace discomfort as part of life and move forward with purpose. Grounded in relational frame theory (RFT) (Hayes et al., 1996), ACT has been widely applied to anxiety, depression, trauma, and chronic pain.

Origins and history

Acceptance and commitment therapy was developed in the 1980s by psychologist Steven C. Hayes, who sought a new approach to psychological suffering beyond symptom reduction (Hayes et al., 1996).

Influenced by behaviorism, cognitive psychology, and mindfulness traditions, ACT integrates these elements to enhance psychological flexibility (Hayes et al., 2012).

Hayes (2005) developed ACT theory as part of the third wave of behavioral therapies, distinguishing it from earlier cognitive-behavioral models by emphasizing acceptance over avoidance and values-driven action.

It is now widely used for treating anxiety, depression, chronic pain, and trauma, among other concerns (McLean & Follette, 2016).

Relational frame theory

A key foundation of ACT is relational frame theory, which explains how language and cognition shape human behavior (Hayes et al., 2001). Unlike traditional behavioral models that focus on direct conditioning, RFT suggests that humans derive meaning by relating words and concepts in complex ways.

For example, if a child is taught that spiders are dangerous, they may later fear all small, crawling insects, even without direct experience. This ability to form associative relationships allows humans to develop sophisticated reasoning skills but also contributes to psychological distress when unhelpful thoughts become rigid and limiting (Blackledge, 2007).

The ACT approach applies RFT principles by helping individuals detach from unhelpful thought patterns (cognitive defusion) and shift their focus toward valued actions rather than struggling against internal experiences (Hayes et al., 2012).