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Specializing in the Treatment of OCD and Related Anxiety Based Conditions

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Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a form of behavioral therapy that focuses on helping individuals accept their internal experiences rather than fighting or avoiding them. ACT was developed in the 1980s by Steven C. Hayes and is grounded in principles of Relational Frame Theory (RFT) and combines aspects of mindfulness, acceptance, and behavioral change strategies.

Unlike traditional cognitive-behavioral therapy (CBT), which often focuses on challenging and changing the content of thoughts, ACT emphasizes changing one’s relationship with thoughts and feelings. The goal is to help individuals live a meaningful and values-driven life while making space for painful experiences that are inevitable.

At its core, ACT promotes psychological flexibility — the ability to stay present and open to experiences while acting in ways that are consistent with one’s values.

The Six Core Processes of ACT

ACT is structured around six interconnected core processes that help foster psychological flexibility:

  1. Cognitive Defusion:
Learning to step back from thoughts and see them as just that — thoughts, not truths or commands. For example, instead of “I must wash my hands or something bad will happen,” the individual learns to see this as a mental event, not a literal fact.
  2. Acceptance:
Making room for unpleasant feelings, urges, and sensations rather than avoiding or suppressing them. Acceptance does not mean liking these experiences but allowing them to be present without struggle.
  3. Contact with the Present Moment:
Practicing mindfulness to stay in the “here and now,” rather than ruminating on the past or worrying about the future.
  4. Self-as-Context:
Developing a sense of self that is separate from one’s experiences — recognizing that one is not defined by their thoughts or feelings.
  5. Values:
Identifying what truly matters to the individual, such as relationships, honesty, creativity, or helping others.
  6. Committed Action:
Taking steps toward values-based goals, even in the presence of discomfort, anxiety, or doubt.
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How ACT Is Used in the Treatment of OCD and Anxiety Disorders

ACT provides an alternative and complementary approach to traditional CBT for OCD and anxiety. Here’s how its principles are applied:

  1. Acceptance of Intrusive Thoughts and Emotions
    In OCD, people often feel the need to eliminate or neutralize intrusive thoughts. ACT encourages acceptance of these thoughts rather than resistance. For example, someone with contamination OCD may be encouraged to allow thoughts about germs to be present without immediately washing their hands. This reduces the struggle and paradoxically decreases the power of the thoughts over time.
    For individuals with generalized anxiety, panic, or phobias, ACT helps them accept the physical sensations of anxiety (e.g., racing heart, dizziness) without avoidance. The more one is willing to feel anxiety, the less control it tends to exert over one’s behavior.
  2. Cognitive Defusion for Obsessive Thoughts
    Rather than analyzing or challenging obsessive thoughts (as in traditional CBT), ACT teaches cognitive defusion techniques to help individuals “unhook” from their thoughts. One common method is stating a distressing thought out loud in a silly voice to decrease its emotional charge (e.g., “I might have food poisoning and throw up.” said like Daffy Duck).
    This diminishes the believability of the thought without trying to prove it right or wrong — reducing the compulsion to act on it.
  3. Exposure with Values-Based Action
    Like Exposure and Response Prevention (ERP), ACT encourages facing fears, but it does so in the service of living in alignment with values. For example, a person with social anxiety may fear public speaking but deeply values leadership. ACT would guide them to approach public speaking not to “beat anxiety,” but to live more fully in line with the value of leadership.
    This reframes exposure as a meaningful choice rather than a clinical exercise, enhancing motivation and long-term engagement.
  4. Focus on Values Rather Than Symptom Reduction
    In contrast to treatments that aim to eliminate symptoms, ACT helps clients shift their focus from feeling better to living better. When people commit to actions aligned with their values, they often find that symptoms become more manageable or less disruptive — even if they don’t disappear entirely.
    For example, a person with OCD who values parenting may learn to tolerate intrusive thoughts about harming their child without engaging in mental checking or seeking reassurance — because being present and loving is more important to them than feeling certain.
  5. Self-as-Context and Detachment from Diagnosis
    Many people struggling with OCD or anxiety identify with their disorder (e.g., “I am an anxious person” or “I’m broken”). ACT promotes the idea of self-as-context, a perspective from which the individual is not defined by their thoughts, emotions, or labels. This fosters resilience and reduces shame.
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Evidence Base for ACT in Treating OCD and Anxiety

ACT has been increasingly supported by empirical research for a wide range of disorders. Meta-analyses suggest that ACT is effective for anxiety, depression, and OCD, with outcomes comparable to CBT in many cases.
Some studies have shown that ACT may be particularly helpful for individuals who do not respond well to traditional CBT — especially those who struggle with thought suppression or have difficulty engaging in cognitive restructuring.

Conclusion

Acceptance and Commitment Therapy offers a powerful and flexible approach to treating OCD and anxiety disorders. Rather than trying to control or eliminate distressing thoughts and feelings, ACT helps individuals change their relationship to these experiences. Through acceptance, mindfulness, and values-based action, clients learn to move toward what matters most — even in the presence of anxiety, doubt, and discomfort.

For those struggling with OCD and related disorders, ACT provides not just symptom relief but a pathway to a richer, more meaningful life.

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NEW In-Person OCD Group at our Brentwood Location

Day and Time To Be Determined (Share Your Preferences Here)

Please contact our client coordinator, Lisa, at (310) 824-5200 ext. 4 or lisa@ocdla.com for more information.

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