Acceptance and Commitment Therapy (ACT) is a newer type of behavioral therapy being used to help people recover from addiction. ACT is part of the care options at Westwind Recovery®, where evidence-based therapies are a core part of treatment. Many people in the United States face substance use disorders, and researchers continue to study new ways to improve recovery and prevent relapse.
ACT stands out because it focuses on helping people manage difficult thoughts and feelings without trying to eliminate them. Instead of fighting cravings or emotions, ACT helps people focus on what matters to them and take purposeful action, even when things feel hard.
What is Acceptance and Commitment Therapy for Substance Abuse?
Acceptance and Commitment Therapy for substance abuse is a behavioral therapy designed to help people respond differently to cravings, urges, and distressing emotions connected to addiction. ACT is called a “third-wave” therapy, meaning it builds on older types of therapy by encouraging acceptance and mindfulness rather than only trying to change thoughts or behaviors.
One of the main ideas in ACT is psychological flexibility. Psychological flexibility is the ability to acknowledge cravings or difficult emotions, yet still make choices based on personal values rather than automatic habits or impulses. In addiction, this means learning to be present with cravings or stress without giving in to substance use.
Experiential avoidance is another important concept in ACT. This means trying to escape or avoid uncomfortable thoughts or feelings. People who struggle with addiction often turn to substances to avoid pain, sadness, or anxiety. ACT helps people notice these patterns and respond in healthier ways.
Research from 2021 to 2024 shows that ACT can support addiction recovery, with studies reporting sustained abstinence rates ranging from 40% to 60%. ACT involves learning acceptance skills, practicing mindfulness, and committing to actions that match your personal values. At Westwind Recovery®, ACT is included in comprehensive addiction treatment plans to help people build these skills and support lasting recovery.
How ACT Differs From Traditional Addiction Therapies
Acceptance and Commitment Therapy, or ACT, uses a different approach to treating addiction compared to traditional therapies. ACT does not focus on fighting or eliminating difficult thoughts and feelings. Instead, it helps people accept these experiences and take actions that match their personal values, even when uncomfortable emotions or cravings are present.
Traditional CBT vs ACT Approach
Cognitive Behavioral Therapy is a well-known therapy for addiction. In CBT, people practice challenging and changing negative thoughts. The goal is to reduce distress and replace harmful habits with healthier behaviors.
With ACT, the process is different. Instead of trying to change or challenge their thoughts, ACT teaches people to observe their thoughts and release their grip. The focus is on accepting discomfort and moving toward actions based on what matters most to the individual.
Dialectical Behavior Therapy vs ACT Methods
Dialectical Behavior Therapy is another common therapy. DBT helps individuals accept and reframe their thoughts, regulate intense emotions, and develop coping and relationship skills.
ACT shares some similarities with DBT, such as acceptance, but emphasizes observing thoughts without believing them and taking actions that align with personal values, rather than only managing emotions.
| Approach | Thoughts | Emotions | Behaviors |
|---|---|---|---|
| CBT | Challenge and change negatives | Reduce distress | Replace with healthy habits |
| DBT | Accept and reframe | Regulate intense feelings | Build coping and interpersonal skills |
| ACT | Observe and defuse | Accept discomfort | Act in line with values |
Key differences:
CBT focuses on changing negative thought patterns. DBT focuses on managing intense emotions and improving coping skills. ACT focuses on accepting difficult experiences and acting in accordance with personal values, even in the face of cravings or stress.
Recent studies show that ACT is as effective as CBT and DBT for treating substance use disorders. Some research suggests ACT may lead to higher rates of long-term abstinence and lower relapse rates compared to traditional therapies.
The Six Core Processes of ACT in Addiction Treatment
Acceptance and Commitment Therapy (ACT) uses six main processes to help people address addiction. Each process targets a specific way that thoughts, feelings, and behaviors interact during recovery from substance use.
Substance abuse and mental health issues can harm relationships. EMDR therapy helps individuals process negative emotions and memories, improving communication and empathy. This leads to healthier relationships, which are vital for recovery and mental well-being. A strong support network promotes sobriety and recovery.
Cognitive defusion involves creating distance from unhelpful thoughts, thereby reducing their influence on actions. In addiction treatment, a person learns to recognize thoughts such as “I need a fix” as just thoughts, not commands. For instance, saying “I’m having the thought that I need a drink” creates space between the thought and the action.
Present-moment awareness, also known as mindfulness, is the practice of staying grounded in the present moment, especially when facing triggers. In treatment, this means noticing triggers as they arise and observing them without reacting automatically. For example, someone might focus on their breath when the urge to use comes up.
Self-as-context refers to seeing oneself as more than the addiction or the thoughts that come with it. In addiction treatment, this process involves building an identity that is not limited to substance use. A person might remind themselves, “I am not my addiction; I am a person experiencing cravings.”
Values clarification means identifying what is most important in life. In treatment, individuals explore their personal values and use these as motivation to stay sober. For example, someone might choose not to use substances because they value being a present parent.
Committed action involves taking specific steps toward a meaningful, substance-free life. This includes setting and working toward goals that align with personal values. An example is regularly attending support groups or therapy sessions as part of a recovery plan.
Recent studies indicate that values clarification and committed action are closely linked to successful recovery from substance use.
Research and Effectiveness of ACT for Drug and Alcohol Addiction
Recent studies and reviews from 2021 to 2024 show that Acceptance and Commitment Therapy (ACT) is an effective, evidence-based approach for treating substance use disorders. Meta-analyses and clinical trials indicate that ACT achieves abstinence rates between 40% and 60%, which is similar to or higher than rates seen with Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT).
ACT has been shown to reduce relapse rates by up to 30% when compared to standard treatment methods. Clients who participate in ACT programs are approximately 20% more likely to complete treatment than those in other therapy approaches. Research also highlights that ACT works well for people who have both substance use and mental health disorders at the same time.
Results are positive for several types of substance use, including opioids, alcohol, and stimulants. Studies support the effectiveness of ACT in both individual and group therapy settings. The therapy’s focus on helping people become more psychologically flexible is linked to improved outcomes over time.
Managing Cravings and Urges Through Psychological Flexibility
Acceptance and Commitment Therapy (ACT) includes specific strategies for handling cravings and urges, which are common in addiction recovery. These strategies are grounded in developing psychological flexibility, or the ability to experience uncomfortable thoughts and feelings without acting on them.
Mindful observation is a technique where a person notices cravings as mental events rather than as instructions to act. For example, someone might say, “I notice I’m having a craving, and that’s okay.” This approach views cravings as transient experiences.
Urge surfing is a method that involves noticing an urge, understanding that it will rise and fall like a wave, and letting it pass without responding to it with substance use. Focusing on the breath and allowing the feeling to subside is an example of this technique in action.
Values-based redirection involves turning attention away from the craving and toward what is most important to the individual. For instance, someone might remind themselves, “Staying sober helps me be there for my family,” guiding their actions toward personal goals instead of succumbing to urges.
Recent neuroscience research suggests that ACT is linked to enhancing areas of the brain associated with self-control and decision-making. This has been linked to reducing the influence of cravings.
ACT Integration with Medication-Assisted Treatment and Other Therapies
At Westwind Recovery®, Acceptance and Commitment Therapy (ACT) is often used together with other scientifically supported treatments. One example is medication-assisted treatment (MAT), which uses medicines like methadone, buprenorphine, or naltrexone to help people with opioid or alcohol use disorders. ACT can be used in conjunction with these medications, creating a more comprehensive approach to care.
ACT is also used in group therapy and with peer support. In these settings, people practice ACT skills together, learn from one another, and receive feedback from peers. This group process helps reinforce what is learned in individual sessions.
Trauma-informed care is another approach that can work with ACT. Trauma-informed care pays attention to the effects of past trauma on substance use and recovery. Because ACT focuses on accepting difficult thoughts and feelings and living in accordance with personal values, it aligns well with trauma-informed practices.
Research from recent years shows that combining ACT with medication or other therapies can lead to higher rates of abstinence—sometimes up to 30% more—than using these treatments alone. Studies also show that people are 15-20% more likely to finish treatment when ACT is included. Integrated approaches like this address substance use, mental health, and trauma at the same time, supporting more complete recovery.
Insurance Coverage and Accessing ACT Programs for Addiction
Acceptance and Commitment Therapy (ACT) for addiction is available through different insurance and payment options. Medicare and Medicaid plans often include ACT as part of outpatient or intensive outpatient programs. Many private insurance plans list ACT under behavioral health services, particularly when licensed therapists are involved in its delivery. Individuals without insurance may pay out of pocket, and some programs offer sliding-scale fees or payment plans based on income.
Qualified ACT therapists are typically licensed mental health professionals who have additional training or certification in ACT. ACT is offered at Westwind Recovery® as part of its treatment programs.
ACT is provided in several formats. These include individual therapy sessions, group therapy, intensive outpatient programs (IOP), and telehealth (online) sessions. Research from recent years shows that telehealth ACT can be as effective as in-person options for many people.
Frequently Asked Questions About ACT and Addiction Treatment
Acceptance and Commitment Therapy (ACT) for addiction usually takes 12 to 24 sessions, spread out over three to six months. The number of sessions can vary depending on each person’s situation and the frequency of therapy sessions. Some people start to notice changes and improvements within the first few sessions.
ACT is used for people who have both addiction and other mental health disorders, which is sometimes called dual diagnosis. This approach focuses on psychological inflexibility, which can play a role in both addiction and mental health problems. Research finds ACT helpful for issues like anxiety, depression, and post-traumatic stress disorder (PTSD) when these occur together with substance use disorders.
Values-based redirection involves turning attention away from the craving and toward what is most important to the individual. For instance, someone might remind themselves, “Staying sober helps me be there for my family,” guiding their actions toward personal goals instead of succumbing to urges.
Taking the Next Step in Your Recovery Journey
Acceptance and Commitment Therapy is an approach used in addiction recovery that helps people notice and accept challenging thoughts and feelings, rather than avoid them. At Westwind Recovery®, ACT is used as one part of a full treatment plan that also includes other therapies, medication-assisted treatment when appropriate, and ongoing support from a team of professionals.
The focus is on helping individuals practice psychological flexibility. This means learning to respond to cravings, stress, or negative emotions by making choices that match personal values. Therapy sessions often include exercises to help identify what matters most to each person and to support actions that align with those values.
Recovery from addiction is a process that involves both learning new skills and practicing them over time. ACT is structured to support this process in a manner that is respectful, individualized, and grounded in current scientific evidence. More information about ACT and integrated recovery programs is available at Westwind Recovery®. Contact us to get started.
Dr. Deena is the Chief Clinical Officer of Westwind Recovery®, an award-winning outpatient treatment center in Los Angeles where she oversees the clinical and administrative program and treatment methods. Dr. Deena is a doctor of psychology and licensed clinical social worker since 1993. LCSW #20628. Originally from the East Coast, Dr. Deena has worked running treatment centers, worked as a therapist in psychiatric hospitals as well as school settings and currently has a thriving private practice in the LA area. Dr. Deena has appeared regularly on the Dr. Phil Show as an expert since 2003. She has also been featured on many other TV shows, podcasts and has contributed to written publications as well as podcasts.
