Acceptance and Commitment Therapy in New Jersey

Addiction is tough to fight, but over the years, various behavior change strategies have been developed to break bonds of dependency and help people move on to an improved quality of life. Acceptance and commitment therapy (ACT) is one of the most effective. A2020 study published in Psychiatric Annals (PMC7524566) found that ACT led to a 27.8% increase in abstinence at the end of treatment, which rose to 43.8% abstinence at 6-month follow-up in incarcerated women with substance use disorders.

But what exactly is this therapy, and what does it involve?

What Is Acceptance and Commitment Therapy for Addiction?

Acceptance and commitment therapy is a form of cognitive behavior therapy based on contextual behavioral science that focuses less on eliminating negative thoughts and processes and more on your relationship to these thoughts. It changes how you respond to your thoughts and feelings, to promote healthier behavior. People who undergo therapy tend to become more focused on the present moment and choose actions based on their core values rather than knee-jerk emotions.

The Six Core Processes of ACT in Addiction Treatment

This transdiagnostic behavioral intervention therapy is based on six core processes as follows:

• Acceptance: The willingness to accept your feelings and cravings, rather than trying to push them away.
• Cognitive Defusion: The ability to step away from your emotions and see them as thoughts and feelings rather than truths you must obey.
• Being Present: Mindfulness of the present moment, which differs from being stuck on autopilot and following old thoughts and patterns.
• Self as Context: Seeing yourself as more than your addiction.
• Values: Understanding what truly matters to you.
• Committed Action: Acting on your values, even when it’s hard.

Psychological Flexibility and Experiential Avoidance in Substance Abuse

ACT is also based on a psychological flexibility model and minimizes experiential avoidance.

Psychological flexibility is the ability to stay present and act in line with your values, despite uncomfortable emotions. Experiential avoidance involves trying not to notice thoughts and feelings. For example, someone who relies on experiential avoidance will do drugs and drink alcohol to avoid their feelings.

ACT guides you to embrace emotions without acting on them. It helps you gain the flexibility to deal with your emotions in a healthy way.

ACT and the Relational Frame Theory

The relational frame theory (RFT) focuses on human language and cognition, explaining why ACT works and what it targets. For example, our language often reinforces thought processes. We relate using drugs to being weak and slipping to failure, so they become learned and context-driven.

ACT interventions cause people to recognize these languages as verbal events, so they don’t have so much weight. They also reframe how we see ourselves and help us stick to our values.

How ACT Differs from Cognitive Behavioral Therapy

Although commitment therapy acceptance is a subset of cognitive behavior therapy (CBT), they are not the same. CBT teaches you to feel better by thinking better, while ACT teaches you to live better even if you don’t think better.

Let’s look at how this plays out in a practical sense:

How They Treat Thoughts:

• CBT identifies distorted thoughts and aims to replace them with more realistic ones.

• ACT changes your relationship to your thoughts by using cognitive defusion to see them as mental events rather than commands.

How They Treat Feelings:

• CBT uses coping mechanisms for emotional regulation.

• ACT makes space for distressing thoughts and encourages you to adjust to them.

View of Avoidance:

• CBT recognizes avoidance as unhelpful.

• ACT puts stress on emotional avoidance as a core driver of addiction and trains the willingness to deal with emotions rather than escaping through substance use.

ACT Techniques and Strategies for Managing Cravings and Triggers

ACT teaches clients to manage cravings and triggers through the following processes:

• Mindful Observation: You notice cravings as temporary sensations rather than commands you must obey.

• Urge Surfing: You ride our cravings like a surfer riding a wave.

• Mindfulness and Breathing Techniques: Breathing exercises can help you become more mindful when urges arise, so you don’t overreact.

• Acceptance without Action: You accept your feelings without letting them dictate human behavior.

Evidence-Based Research Supporting ACT for Addiction and Mental Health

Several clinical psychology studies have shown that ACT is an effective behavioral and cognitive therapy. Here are some to consider:

• A 2022 review of 17 studies published in Psychiatric Annals reveals that ACT is effective in supporting long-term abstinence, a higher quality of life, and psychological flexibility.

• Meta-analyses of ACT for substance use show effect sizes with U3 scores ranging from 63.3% to 67.4%, indicating ACT participants performed better than the majority of control group participants.”

• According to research published in the Harvard Journal, a direct comparison showed ACT outperformed CBT, leading to better abstinence rates in incarcerated women (43.8% vs. 26.7% after six months).

What to Expect in ACT Sessions at BlueCrest Recovery

BlueCrest Recovery’s trained ACT therapists guide clients through a process that leads to higher success rates and improved quality of life. Here’s what our treatment entails.

• Initial Sessions: In the early stages, a mental health professional will assess your physical and mental health history, core principles, and recovery goals, and begin introducing mindfulness and acceptance strategies.

• Mid-Treatment Sessions: At this point, you will practice mindfulness defusion techniques, learn to accept distressing thoughts without emotional reactivity, and build commitment to valued behaviors. Techniques will be practiced in live sessions and through homework assignments.

• Later Sessions: In later stages, your progress will be evaluated, and the remaining psychological barriers will be addressed. Strategies will be developed to ensure long-term sobriety.

Sessions typically last 45-50 minutes and extend from 6-24 weeks depending on the client’s mental health needs. In some cases, therapy can be ongoing.

ACT for Co-Occurring Disorders and Dual Diagnosis Treatment

Many people who deal with addiction develop co-occurring disorders. They self-medicate to treat stress and pain symptoms that may be related to an emotional disorder, often finding themselves on a downward spiral. These individuals will also now have two issues to treat: their initial disorder, such as anxiety disorder, borderline personality disorder, or depression, as well as addiction.

Addiction specialists often treat co-occurring disorders with a dual diagnosis approach, addressing both the addiction and its underlying cause. ACT is effective in this treatment method because it teaches people to cope with their emotions without relying on drugs and alcohol. The therapy teaches mindfulness techniques to support emotional regulation and lead to health behavior change.

Integrating ACT with 12-Step Programs and Holistic Recovery

BlueCrest recognizes the effectiveness of a 12-step program and finds that ACT can easily fit into this model. For example:

• Steps 1-3 focus on changing feelings of unmanageability and powerlessness. ACT supports this by teaching people to accept their emotions without trying to control everything.

• The 12-Step program focuses on “Let go and let God.” ACT promotes this idea with cognitive defusion, treating thoughts as mental experiences rather than commands.

• Principles and values are a main focus of both the ACT and the 12-Step programs.

• The 12-Step program encourages people to take recoveryone day at a time, a principle supported by ACT’s mindful approach.

Reach Out to BlueCrest Recovery Today

BlueCrest is a recommended source for addiction treatment with a focus on commitment training. We offer the following benefits:

• A team of licensed and ACT-trained mental health professionals focused on developing individualized care to support meaningful life goals

• BlueCrest offers private pay options and can work with most major insurance plans on an out-of-network basis. Contact our admissions team at (888) 292-9652 to discuss payment options. BlueCrest does not accept Medicaid. All calls are confidential and there is no obligation.

• Accessibility to New Jersey cities and New York- our Woodland Park facility is close to various destinations throughout New York and New Jersey, including Newark, Patterson, Jersey City, and Manhattan, with various public transportation options available

• Integration with New Jersey’s dual diagnosis requirements- We uphold the high standards required by the New Jersey government, emphasizing integrated treatment

• Connections to ACT-recovery-based resources in Pasaic County and surrounding areas- We continue to support your journey, offering resources so you can receive ongoing ACT-based care. The Passaic County Division of Mental Health and Addiction Services can provide additional guidance and resources. Contact us to learn more about how we can help you achieve a higher quality of life.