Acceptance And Commitment Therapy for Substance Abuse

Embrace Change, Overcome Addiction with Acceptance and Commitment Therapy

What are the Six Core Processes of ACT?

Psychological flexibility is the main goal of ACT. It is established through six core processes, which include:

Core Process #1: Acceptance:

Being actively aware of your thoughts, feelings, and experiences without judging them. Acceptance aims to decrease avoidance and help you pay attention to the present moment. You will focus on what you can change vs. what you can’t.

Core Process #2: Cognitive Defusion

Cognitive defusion is a mindfulness practice. Once you accept that you are having a specific thought, cognitive defusion helps you see your thoughts as “just thoughts” (rather than facts).

Examples of cognitive defusion techniques include:

• Labeling the process of thinking. For example, an ACT therapist will guide you to think to yourself, “I am having the thought that I am lazy” as opposed to “I am” This helps you avoid seeing your thought as something that is “fixed” or “true.”
• Visualization techniques that help you let go of thoughts. For example, visualizing your thoughts floating down a river.
• Reflecting on the values and emotions associated with a thought are, potentially including where those values come from and whether you truly align with them.

You will likely practice cognitive defusion with your ACT therapist. Then, you can start using the techniques you learn in your daily life.

Core Process #3: Being Present

ACT helps you directly experience the present moment rather than turning to avoidance. When you are present, you can act more intentionally. As you learn to stay in the current moment, grounding techniques may be helpful.

Therapists can help you find grounding exercises that work for you. For example, a body scan, mindful breathing, or meditation. Even though it can be hard to stay present at first, therapy will help you increase distress tolerance.

Core Process #4: Self As Context

Self as context is a key part of ACT interventions. Rather than viewing the self as content ( defining yourself by thoughts, beliefs, feelings, roles, or labels), the self as context contextualizes your experience and helps you free yourself from negative beliefs.

Analogies may be used to help you do this. For example, emotions can be like weather – they can vary significantly. Some might be calm, some might be harsh. But, they come and go, and they do not define the sky.

Core Process #5: Values

Drug and alcohol abuse often conflict with a person’s values. It might even cause you to lose sight of them. For example, you might value family. Or, you might value honesty. However, substance abuse tends to affect family life negatively. It can also lead to lying or secrecy.

ACT approaches involve identifying your values. Once you identify your values, you will practice living in accordance with them. This can help you get and stay committed to the recovery process.

Core Process #6: Committed Action

Behavior change is an important part of substance abuse treatment. First, ACT helps you take the power away from negative beliefs like “I can’t do this” or “I need alcohol to function.” These beliefs can lead to psychological inflexibility, which prevents behavior change.

After breaking through those thoughts, ACT guides you to take positive actions that align with your personal values. This includes taking positive actions after you make a mistake or act in a way you are not proud of.

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Identifying the Role Substances Play in Your Life

In substance abuse treatment, many people find it helpful to explore why they use drugs and alcohol. Despite negative consequences, you may use substances to avoid painful emotions, cope with uncomfortable feelings, or as an escape from reality.

ACT focuses on steps that help you meet your needs in a different way. Rather than see drug abuse as a fixed part of who you are, or as nothing more than a bad behavior, you can employ self-compassion.

Do you use alcohol, for example, to cope with stress? How would it feel to acknowledge that you are stressed out instead? After acknowledging that you are stressed out, what are some healthy coping skills you can use? Can you take a walk, use breathing exercises, meditate, urge surf, or talk to someone?

These are some of the things you might explore in ACT.

How ACT Helps People Overcome Barriers to Sobriety

ACT can target addictive behaviors directly. It can also help you overcome possible barriers to sobriety that extend beyond negative beliefs or self-perception. For example:

Chronic Pain and Physical Health Conditions

Chronic pain and other physical health problems are a barrier that some people in therapy for substance use disorders face. Being in pain can take a toll on your state of mind and well-being. It’s important that people who experience these concerns have proper tools and support.

In addition to the treatment of substance abuse and mental disorders, ACT can improve outcomes related to chronic pain. For example, ACT for chronic pain can help to reduce psychological inflexibility and catastrophizing while improving quality of life.

Trauma and Life Stressors

When a person in substance abuse treatment has past trauma or significant life stressors, it’s crucial that they’re acknowledged by professionals. For example, you might have a high-stress job (e.g., healthcare or law enforcement), or you may have survived one or more traumatic events.

ACT can help you validate these challenges. Let’s say that you work long hours as a nurse. Or, perhaps you grew up in a family heavily affected by addiction. ACT approaches encourage you to say, “I acknowledge the struggle I face or have been through.”

From there, a therapist will guide you in finding ways to improve your quality of life. This could include solutions (like setting boundaries or making schedule changes), coping skills, or self-care strategies, to name a few.

Mental Health Conditions

Many people with substance abuse issues have one or more co-occurring mental health conditions. For example, depression, anxiety, or post-traumatic stress disorder (PTSD). If this is true for you, our providers will help by providing treatment that addresses your mental health concerns as well as substance use.

Like with ACT for addiction, a therapist will help you set and meet practical goals. Goals of ACT for mental health may include increasing confidence, getting through negative emotions, and using healthy coping skills.

It’d be unrealistic to hold yourself to the standard that you should never experience painful emotions or thoughts again. Instead, the focus is on incorporating meaningful behaviors that support you in reaching your goals.