Mindfulness & ACT

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Acceptance and Commitment Therapy (ACT) is a behaviorally based therapy, developed by Steven Hayes, that emphasizes the acceptance and commitment to one’s life. ACT offers behavior-change strategies to promote psychological flexibility. Dr. Russ Harris embraced Hayes’ ACT and distilled the intricacies of this therapy into down-to-earth terms. His text, The Happiness Trap, is exceedingly applicable and usable to all. 

The six core principles of ACT, adapted from The Happiness Trap, provide a helpful framework for therapy.

This overarching philosophy is founded on six key components:

• Defusion: Lessening the power of your thoughts by changing your relationship with them.
• Expansion: Instead of suppressing unwanted thoughts/feeling, make space for them.
• Connection: Be present and engaged with what you are experiencing in the moment.
• The Observing Self: Observation and awareness of oneself without judgement or evaluation.

These first four components are collectively known as mindfulness skills. The other two parts of ACT include Values and Committed Action.

• Values: Defining and connecting what is important and meaningful to your life. Allowing these values to guide and motivate you to change. 
• Committed Action: Active engagement and the taking action in life (which again, are guided by values)

Development of ACT

ACT originated with Dr. Steven Hayes and colleagues over 30 years ago. ACT was established on the approach of behaviorism, just like ABA was – ACT is an empirically based psychotherapy and is often referred to as “the third wave of behaviorism.” ACT’s anchors of acceptance and commitment help the individual to become the driving force in making desired changes; based on their own values. 

ACT has been adopted to assist with treatment in areas of both mental and physical illnesses, such as: anxiety, pain management, addiction, grief, chronic illness, just to name a few. It is important to note that ACT is not stand-alone but may help address certain gaps that have been identified in the literature (which are often left unaddressed by established therapies such as Cognitive Behavioral Therapy [CBT]).  

ACT, ABA, & Autism

Recently ACT has been embraced in the ABA and autism communities. A person with autism often experiences sensory and emotional dysregulation, inattention, moving rapidly from activity to activity, thought to thought, etc. Such sensory and emotional concerns associated with ASD have been demonstrated to improve, with the help of ACT. 

Steven Hayes and Spencer Smith skillfully guide their audience through the process of Get Out of Your Mind & Into Your Life (as their book is entitled) including chapters such as: “Letting Go”, “The Trouble with Thoughts”, and “Willingness: Learning How to Jump”. Central to the core of ACT is understanding that your thoughts are just words; words that are in one’s mind. From the three-year-old filled with recurring fears of seeing a dog, to the young adult reliving the meanness of girls that taunted her in middle school; these thoughts are just words. 

From childhood to adulthood, many individuals with ASD are governed by rumination of past experiences. These experiences may include certain fears, anxieties, or assumptions that can contribute to maladaptive behaviors. Implementing ACT can teach the individual with ASD to reframe their bothersome thoughts by learning to be present and accept the idea that thoughts are just words. 

ABA is an essential foundation for therapy for individuals with ASD, but it is insufficient by itself. For over 25 years, I have implemented mindfulness into my practice. I have seen immense gains for individuals in using ACT in conjunction with ABA therapy. One of our clients evolved socially and emotionally, from an unsuccessful high school life, to now a successful university graduate. She arrived one day for a meeting and announced to me, “I am too busy at school and I just don’t need therapy anymore.” She had friends, a successful academic path, and chose to liberate herself. Thanks to ACT, one of our 5-year-olds became aware of what he saw and felt by learning to be present through bird watching. The idea of being present also helped teach him how to self-regulate his emotions. A three-year-old with limited language, learned to be calm and to not tantrum. Instead, he found alternative ways to communicate his frustrations. We started with being present during eating (a preferred activity of his) and expanded from there.

The additions of mindfulness (ACT) to a more structured and systematic therapy approach (ABA) can not only help reduce behavioral concerns, but also can enhance the quality of life for both the individual with ASD and their family.