For those more savvy, self-help accepting, curious potential psychotherapy clients out there, I’ve created a brief description of the differences of two of the more common types of therapy being used by clinicians these days. I don’t expect most people to know the differences between therapeutic techniques, but surprisingly, I’m finding more and more people are knowledgeable about this stuff and are genuinely interested in how this works. This is a good thing as you should know what kind of evidenced-based treatment your therapist is providing to you anyway! Below I have included a general explanation of both CBT and ACT and how they are both similar and different in treating something like depression.
Cognitive behavioral therapy (CBT)
CBT is a psychosocial intervention that is the most widely used evidenced based practice for treating mental disorders. CBT focuses on the development of personal coping strategies that target solving current problems and changing unhelpful patterns in cognitions (e.g. thoughts, beliefs and attitudes). The underlying concept behind CBT is that our thoughts and feelings play a fundamental role in our behavior.
CBT is generally short-term and focused on helping clients deal with a very specific problem. During the course of treatment, people learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior. Many people begin to identify “core beliefs” that have dictated their emotions and behaviors for years. CBT teaches individuals to notice thoughts that are contributing to their suffering. i.e. “I will always be lazy and I will always be depressed”.
Example of CBT works: An individual reports that he/she is “hopeless that things will get better”. CBT would help the individual identify the thought distortion and help them discover thoughts that are realistic and effective in helping them feel better. i.e “I do not always feel depressed. There are times when I enjoy my life”. Noticing and shifting one’s thinking affects one’s emotions which affects one’s behavior.
Further explanation from above example: When the individual applies a more optimistic (and realistic) thought, their emotion changes (more hopeful) and their behavior changes (get out of bed and takes a walk).
The goal of cognitive behavior therapy is to teach patients that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment.
Acceptance and Commitment Therapy (ACT, pronounced “act”)
ACT is a form of psychotherapy commonly described as a form of cognitive behavioral therapy. It is an empirically based psychological intervention that uses acceptance, mindfulness strategies, commitment and behavior-change strategies, to increase psychological flexibility.
ACT differs from CBT in that rather than trying to teach people how to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to just notice, accept and embrace their private events.
ACT is a powerful tool that can reduce suffering by helping one observe thoughts and feelings as they are, without trying to change them. ACT also emphasizes behaving in ways consistent with valued goals and life direction.
Example of how ACT works: One would develop acceptance around depression and learn how to develop a relationship with it rather than avoid it (what ACT refers to “experiential avoidance”). The basic premise of ACT with depression is that while emotional pain hurts, it is the struggle with pain that causes suffering.
ACT is proven to be effective in treating not only depression but also addiction and anxiety. ACT doesn’t attempt to improve or alleviate symptoms, but rather aims to help the person stop obsessing over his or her symptoms, create new lifestyle patterns, and make healthier choices. It encourages being fully conscious in the present moment and maintaining or changing behavior based on what the moment involves.
Lindsay Melka, LPC
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