Acceptance and Commitment Therapy
Evidence-based therapy that helps you carry hard thoughts and still move toward what matters.
Navigating Acceptance and Commitment Therapy
What Is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy, written ACT and said as the word “act,” is an evidence-based therapy that teaches you to stop wrestling with painful thoughts and feelings so that energy can go into the life you actually want. It grew out of the same research tradition as cognitive behavioral therapy, but it asks a different question. Instead of asking how to get rid of a thought, ACT asks what that thought is costing you.
Most people arrive having already tried to think their way out of anxiety, grief, or pain, and found that arguing with a thought keeps it in the room longer. ACT teaches skills for holding thoughts more lightly and taking small concrete steps toward what matters, while the difficult feeling is still there.
Acceptance here is not approval, and it is not giving up. It means calling off a fight you were never going to win. Our therapists use ACT the way it was built to be used, as a structured skills-based treatment with a direction, not as open-ended talk.
How Effective Is ACT?
ACT is an evidence-based treatment, and pooled reviews of randomized trials show it helps people living with chronic pain and adults treated for cancer. People do not always report less pain or fewer anxious thoughts. They do report those things interfering less with their lives, and doing more of what they care about. That distinction is the whole point of the approach, and it is what the research measures.
The two findings below are pooled reviews rather than single studies, and both come from populations we work with every week. Each one links to its source so you can read it yourself.
Chronic Pain Trials
A 2024 review pooled 21 randomized trials of ACT for chronic pain and found medium gains in pain interference, daily functioning and depression. Source: Ye et al., 2024, PLoS One.
Patients in Cancer Trials
Across 16 randomized trials in six countries, ACT improved anxiety, depression and psychological flexibility in adults treated for cancer. Source: Jiang et al., 2024, Frontiers in Psychology.
What Conditions Can ACT Treat?
ACT treats anxiety, depression, chronic pain, long-term illness, fear during cancer care, stress, and grief. It is not built around a single diagnosis. It works on something that runs underneath a lot of them: the effort of fighting your own thoughts and feelings, and the way that fight quietly shrinks a life. That is why the same treatment turns up in pain clinics, anxiety clinics and cancer centers.
These are the areas we use it for most. We also use it for adjustment to disability and for neurological conditions.
Anxiety and Panic
ACT helps with generalized anxiety, panic and social anxiety, where the struggle with the feeling feeds the next wave.
Depression and Low Mood
Depression can narrow your life to a few routines and bring harsh self-talk with it.
Chronic Pain
For chronic pain of almost any origin, ACT aims at what the pain costs you, not at a lower pain score.
Long-Term Illness
ACT supports people managing a long-term illness, along with the fatigue and sleep trouble that come with it.
Cancer and Serious Diagnosis
During cancer care, some frightening thoughts are true and cannot be reframed away. ACT helps you carry them.
Trauma and PTSD
Avoidance keeps trauma symptoms running, so ACT is often used as a bridge into trauma therapy.
Stress and Burnout
When stress will not let up, doing more of what used to work often stops working.
Grief and Life Transitions
Grief rarely has a tidy resolution, and neither does the uncertainty of fertility treatment or a change in identity.
If what you are carrying is not on this list, it is still worth asking. ACT is a fit for most situations where something cannot simply be fixed and still has to be lived with.
How Does ACT Work?
ACT works by building six skills, and they really are skills rather than insights. You practice them in session and between sessions until they are actually available to you in the moment you need them.
Your therapist leads with whichever of these is most in your way right now, and the sixth, learning to observe yourself from a steadier vantage point, develops across all of them.
Defusion: Seeing a Thought as a Thought
A thought like I’m going to fail at this feels like a report on reality. Defusion is the skill of hearing it as a sentence your mind produced, which changes how much authority it carries. Nothing about the thought has to change for this to work.
Acceptance: Making Room Instead of Fighting
Pushing a feeling away takes constant effort and tends to enlarge it. Acceptance is the deliberate practice of letting an emotion or a physical sensation be present without arguing with it, which frees up the energy the fight was consuming.
People tell us the change is rarely dramatic. It’s catching yourself a beat earlier each time, and realizing you get to choose what happens next.
Present-Moment Contact: Coming Back to Now
Anxiety pulls attention toward the future, and low mood pulls it toward the past. Present-moment contact is trained attention, close to what you would learn in mindfulness-based therapy, used to bring you back to what is happening now.
Values: Naming What You Actually Want
Values are not goals, which get ticked off. They are directions you want your life to run in. Most people have never said these out loud. Naming them gives the rest of the work something to aim at, and it is what separates acceptance from resignation.
Committed Action: Small Steps, Repeated
This is the part where ACT becomes a way of living rather than a theory. You and your therapist pick concrete steps in the direction of what you named, sized so you will actually take them, and you keep taking them even while the difficult feeling is still there.
Is ACT Right for You?
ACT is often a good fit if you are living with something that cannot be changed, such as a diagnosis, a loss, or ongoing pain. You don’t need to understand the model to start. A free 15-minute consultation is a conversation, not a commitment, and it is usually enough to tell whether this way of working fits what you’re carrying. We offer both in-person and telehealth sessions.
What Is ACT Like at Rowan Center?
ACT sessions are more active than most people expect. You will talk, and you will also do things: a short exercise in the room, a metaphor you take away and test, a small experiment to run before the next session. Sessions are close to an hour, usually weekly to start.
The first sessions are mostly assessment. Your therapist wants to know what you have already tried, and what you would be doing differently if this were not in the way. That answer becomes what the rest of the treatment aims at.
Sessions alternate between practicing a skill and looking at what happened when you used it.
We combine ACT with CBT or mindfulness-based therapy where that serves you better. Sessions are available in person and online.
How Do You Get Started With Therapy at Rowan?
These four steps are the same whichever approach you end up working in, ACT included. Here’s exactly what happens, from the first call to your first session.
Start by Reaching Out
Call us directly, fill out the interest form, or schedule a free consultation, whichever is easiest for you.
One-on-One Intake Conversation
Our intake team reviews your information and reaches out for a one-on-one call to talk through what's been going on, what you've already tried, and what you want help carrying. If you would rather skip the phone, this step can happen over email.
Expert Therapist Match
Based on your needs and preferences, we match you with a therapist trained in ACT, factoring in what you're working on and whether in-person or online care fits your week.
Start Your First Session
Once matched, you begin sessions at our office or through our secure online platform, whichever fits the week you actually have.
Why Choose Rowan Center for ACT?
At Rowan, ACT is delivered by therapists trained in the model, and most of them are doctoral-level psychologists. Treatment has a direction set in the first sessions and a way of checking whether it’s working. Plenty of practices list ACT among the things they offer. Here, behavioral medicine is the whole practice, not one service on a menu.
The first sessions map what you've tried, what it has cost you, and where your life has narrowed. It's a conversation rather than a test, and it ends with something concrete: a picture of what you'd be doing if this weren't in the way.
What we work on comes from what you said matters, not from a fixed curriculum. Two people with the same diagnosis often get very different plans here, because they're aiming at different lives.
You leave early sessions with something you can use, not months of background first. That might be defusion for the 2am spiral, acceptance for a sensation you keep bracing against, or one small step toward your values for the week. These skills are small and practiced early, before any insight arrives.
With your permission we work directly with your physician, specialist, or pain team. The goal is one shared plan, so your psychological care and your medical care aren't running on separate tracks.
We track progress against what you set at the start, not a general sense that sessions are going fine. If something hasn't moved after a reasonable stretch, we change the approach rather than continue out of politeness.
Sessions run in person and by telehealth. ACT asks you to practice between sessions, so the schedule has to be one you can actually keep, and we'd rather build that around your week than against it.
Frequently Asked Questions About ACT
How is ACT different from CBT?
CBT works on the content of a thought and ACT works on your relationship to it. Classic CBT asks whether an anxious prediction is accurate and helps you test it. ACT asks what happens in your life when you treat that prediction as an instruction, and teaches you to carry it differently instead. Both are evidence-based and they share a research lineage, so this isn’t a rivalry. In practice our therapists often use them together, leaning on CBT where a belief is genuinely distorted and on ACT where the thought is accurate, unfixable, or simply not worth the fight.
How long does ACT usually take?
Most people work in a course of roughly twelve to sixteen weekly sessions, though that varies with what you’re carrying. ACT is structured and time-limited by design rather than open-ended. You’ll set a direction in the first sessions and review progress against it, so you should have a sense of whether it’s working within the first month or so. Some people continue with occasional sessions afterward to keep the skills sharp, and some stop and come back when something new arrives.
Does ACT mean I have to accept things I don't want to accept?
No. Acceptance in ACT applies to your internal experience, not to your circumstances. Nobody is asking you to be at peace with an unfair diagnosis, a loss, or a situation worth changing. The skill is about stopping the losing fight with the feelings that come with it, precisely so you have the energy to change what can be changed. If anything, people usually take more action after this work, not less, because less of them is tied up in the struggle.
Does insurance cover therapy at Rowan Center?
Rowan is in-network with Medicare, Aetna, and Cigna, and is credentialed with Tricare East and West as a non-network provider. For most other PPO plans we can provide a superbill you submit for out-of-network reimbursement, and we can process claims directly with your insurer. If you’re not sure what your plan covers, call us and we’ll help you work it out before you book.