What Is ACT Therapy? An Evidence-Based Approach to Building Psychological Flexibility

When children, teens, or adults struggle with worry, sadness, or unhelpful habits, families often look for effective, research-based treatments. One approach that has gained increasing recognition in child psychology is Acceptance and Commitment Therapy (ACT). ACT is not about “fixing” problems or pushing difficult thoughts away—it’s about learning new ways to live a meaningful life, even when challenges are present.

The Foundations of ACT

ACT (pronounced as the word “act,” not spelled out letter by letter) was developed in the 1980s by psychologist Steven C. Hayes and colleagues. It is part of what psychologists call the “third wave” of cognitive-behavioral therapies.

At its core, ACT aims to build psychological flexibility—the ability to stay present, open up to experiences (even uncomfortable ones), and take actions guided by personal values. Instead of trying to eliminate difficult feelings, ACT helps people relate to them differently, so that emotions and thoughts don’t dictate behavior.

The Six Core Processes of ACT

ACT uses six interwoven skills to strengthen psychological flexibility:

1. Acceptance – Allowing space for uncomfortable feelings instead of struggling against them.

2. Cognitive Defusion – Learning to notice thoughts as just thoughts, not absolute truths.

3. Being Present – Developing mindful awareness of the here and now.

4. Self-as-Context – Recognizing a sense of self that is more than passing emotions or roles.

5. Values – Clarifying what truly matters to the person.

6. Committed Action – Taking practical steps toward those values, even when it feels hard.

Together, these processes help children and adults shift from “being stuck” in their inner experiences to actively engaging with life in ways that feel meaningful.

How ACT Works in Practice with Children and Adolescents

In therapy with children, ACT often uses play, stories, metaphors, and experiential exercises. For example:

• A therapist might compare anxious thoughts to “radio static”—noise that plays in the background but doesn’t have to control what station you choose.

• A child who fears making mistakes at school may practice noticing the thought “I’ll fail” without letting it stop them from raising their hand in class.

• Teens might explore what values—such as friendship, creativity, or fairness—are most important to them, and then set small steps aligned with those values.

Parents are often included in sessions so they can support these skills at home.

What Does the Research Say?

ACT has a growing evidence base in children, adolescents, and adults. Studies have shown ACT to be effective for:

• Anxiety disorders

• Depression

• Chronic pain and medical conditions

• Obsessive–compulsive disorder (OCD)

• Stress and burnout

For young people in particular, ACT has been linked to improvements in emotional regulation, self-acceptance, and resilience. Reviews and meta-analyses indicate that ACT can be as effective as traditional cognitive-behavioral therapy (CBT), with the added emphasis on values and mindfulness that many families find helpful.

Why Families Choose ACT

Parents often appreciate that ACT does not require children to “get rid of” fears or worries before they can live their lives. Instead, ACT focuses on building courage, flexibility, and direction—even when challenges remain.

By teaching children to approach their inner world with openness and compassion, ACT can help them develop lifelong skills for navigating change, setbacks, and stress.

Takeaway

Acceptance and Commitment Therapy is an evidence-based approach that empowers children, teens, and adults to live according to what matters most to them. Through acceptance, mindfulness, and committed action, ACT strengthens psychological flexibility—the foundation for well-being.

At Baumgarten Child Psychology and More, we integrate ACT principles into our work with children and families to help them face challenges while moving toward growth and fulfillment.