You have been sitting with it for a while now. That low hum behind everyday tasks, the one that shows up before important conversations, or in quiet moments when there is nothing to distract you from your own mind.
Maybe it is anxiety that has been harder to shake than you expected. Maybe it is a flatness that has settled over things despite your life, by most measurements, being perfectly fine. Maybe it is the sense that you have been going through the motions for months, functioning and meeting commitments, but feeling somehow detached from your own experience.
Whatever it looks like for you, you have probably already tried to manage it. Told yourself to think differently. Stayed busy. Made the lists. Reminded yourself of what you have to be grateful for. And still, at some point in the day, it returns. Not dramatically. Not in a way that other people would necessarily notice. Just quietly, persistently, as though it has no intention of going anywhere.
If this sounds familiar, there is something important to understand about what is happening beneath the surface. The pattern of working harder and harder to control your inner experience is not simply exhausting. Research tells us it is one of the central mechanisms that keeps psychological distress in place over time. This is precisely what Acceptance and Commitment Therapy was developed to address.
Acceptance and Commitment Therapy, known as ACT (pronounced as the word act), was developed in the 1980s by American psychologist Dr Steven C. Hayes at the University of Nevada. It belongs to what researchers describe as the third wave of cognitive behavioural therapies, alongside approaches such as DBT and Schema Therapy, reflecting a significant evolution in how psychological difficulties are understood and treated.
Unlike older therapeutic models that focus primarily on identifying and correcting distorted thinking, ACT takes a fundamentally different position. It does not aim to eliminate uncomfortable thoughts or feelings. It aims to change your relationship with them.
The goal of ACT is not a pain-free life. It is a life that is no longer controlled by the effort to avoid pain. At the heart of this approach is a concept called psychological flexibility: the capacity to remain present with difficult internal experiences without allowing them to dictate your behaviour, while continuing to act in ways aligned with what genuinely matters to you (Kashdan & Rottenberg, 2010, Clinical Psychology Review).
Here is a brief thought experiment. For the next ten seconds, try not to think about a white bear.
For most people, the white bear appears almost immediately and returns throughout the exercise. This reflects something important: the conscious effort to suppress an unwanted thought frequently increases its frequency and intensity. Applied to everyday psychological life, this explains why anxiety-suppression strategies so often leave people feeling more anxious, and why deliberately pushing down a feeling so often makes it louder.
ACT calls this broader pattern experiential avoidance: the tendency to escape, suppress, or manage uncomfortable thoughts, feelings, sensations, or memories. Research consistently identifies experiential avoidance as a transdiagnostic factor - meaning it plays a maintaining role across anxiety, depression, trauma, chronic pain, and many other presentations (Hayes et al., 2012). The harder you work to not feel something, the more energy it occupies.
What ACT offers is a fundamentally different strategy: learning to make room for difficult inner experiences, without allowing them to steer your behaviour or shrink the life you are living.
The evidence base for ACT is substantial and continues to grow rapidly. A major review by Gloster and colleagues (2020, Journal of Contextual Behavioral Science) examined 20 meta-analyses covering 133 studies and more than 12,000 participants, and found ACT to be effective across anxiety, depression, chronic pain, and other presentations - with effects maintained at follow-up.
More recent research has strengthened this picture further. A meta-analysis of 27 randomised controlled trials involving 2,860 young people (Lopez-Pinar et al., 2025, Journal of Affective Disorders) found ACT significantly reduced anxiety and depression symptoms, with improvements in psychological flexibility predicting those gains. For depression specifically, Zhao and colleagues (2023, Annals of General Psychiatry) found that ACT significantly reduced depressive symptoms and improved psychological flexibility across multiple randomised controlled trials, with benefits sustained well beyond treatment.
The Australian Psychological Society (APS) recognises ACT as a Level I evidence-based treatment for depression, anxiety disorders, chronic pain, and stress-related presentations.
ACT works through six interconnected processes, collectively known as the ACT Hexaflex. Each one addresses a different aspect of the patterns that maintain psychological distress:
Acceptance - developing willingness to experience difficult internal states without avoidance or suppression, creating space for more deliberate responses.
Cognitive Defusion - learning to observe thoughts as mental events rather than treating them as literal truths. A thought such as I am not good enough can be noticed with curiosity rather than obeyed automatically.
Present Moment Awareness - bringing flexible, open attention to what is happening right now, rather than being pulled into rumination about the past or worry about the future.
Self-as-Context - developing a stable observing perspective that is larger than any single thought, feeling, or experience. You are not your anxiety. You are the one noticing it.
Values Clarification - identifying what genuinely matters across key domains of your life, separate from what fear, low mood, or avoidance has been directing.
Committed Action - taking real, meaningful steps toward those values, even when the path involves uncertainty or discomfort.
Together, these six processes build the psychological flexibility that research identifies as a central predictor of resilience and quality of life (Kashdan & Rottenberg, 2010).
Research supports the use of ACT across a wide range of clinical presentations. At Chrysalis Psychology & Wellbeing, ACT may be offered as a primary approach or integrated with other evidence-based therapies such as CBT, EMDR, DBT, or Schema Therapy, depending on individual circumstances and clinical presentation. ACT has well-established evidence for:
ACT sessions are collaborative, practical, and experiential. Rather than spending significant time analysing the past, the focus is on building real-world skills and moving toward a life shaped by your values. Your psychologist will draw on exercises, metaphors, and mindfulness-based practices tailored to your specific situation.
You do not need to have things figured out before you arrive. The process itself is where the work happens. Many people find that something shifts not because painful thoughts have disappeared, but because those thoughts have lost their power to steer.
At Chrysalis Psychology & Wellbeing, ACT is delivered through individual psychology sessions in Battery Point, Hobart and via telehealth psychology across Australia. No GP referral is required - you can self-refer at any time.
If something here has resonated, support is available. At Chrysalis Psychology & Wellbeing in Battery Point, Hobart, our psychologists provide ACT-informed therapy for adults, adolescents, and families.
Sessions can be accessed through a Mental Health Treatment Plan (Medicare, up to 10 rebated sessions per year), NDIS, DVA, Open Arms, EAP, private health insurance, or self-referral. To enquire or book, contact us on (03) 6263 6319 or visit chrysalispsychwell.com.au/contact-us.
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