Acceptance and Commitment Therapy (ACT) is a third-wave cognitive-behavioral therapy developed by Dr. Steven Hayes. Unlike traditional CBT, which focuses primarily on changing the content of thoughts, ACT works with a person's relationship to their thoughts and feelings — developing psychological flexibility rather than attempting to eliminate or suppress difficult internal experiences.
The core premise of ACT is that psychological suffering arises not from having difficult thoughts, feelings, or memories, but from the way a person relates to them — particularly through experiential avoidance: the attempt to control, suppress, or escape from unwanted internal experiences. ACT teaches patients to accept what cannot be changed, to defuse from unhelpful thought patterns, and to commit to actions aligned with their values — even in the presence of discomfort.
Acceptance — actively embracing difficult thoughts, feelings, and sensations rather than fighting them. Not resignation or approval — making room for experience without being controlled by it.
Defusion — changing the patient's relationship to their thoughts: learning to observe thoughts as thoughts, rather than treating them as literal truths or commands that must be obeyed or escaped.
Present moment awareness — grounded in mindfulness — contacting the here-and-now with openness and curiosity, rather than being lost in rumination about the past or worry about the future.
Self as context — the sense of a stable observing self, a perspective from which experiences can be witnessed without being defined by them. This counters the rigid self-narratives that maintain psychological suffering.
Values clarification — identifying what truly matters to the patient: what kind of person they want to be, and how they want to engage with the world. Values provide direction and meaning, independent of mood or circumstance.
Committed action — taking concrete steps in the direction of one's values, building a life of purpose and engagement even when difficult thoughts and feelings are present.
ACT has a strong and growing evidence base across a wide range of presentations. It is particularly effective for depression — including chronic and recurrent presentations; anxiety disorders where experiential avoidance is a maintaining factor; OCD where fusion with obsessional thoughts is prominent; eating disorders; substance use disorders; burnout and work-related stress; chronic pain and health anxiety; and adjustment to serious physical illness.
ACT is also used as a maintenance and relapse prevention approach in recurrent conditions — building the psychological flexibility that reduces vulnerability to future episodes.
ACT does not attempt to challenge or change the content of negative thoughts. Instead, it works to reduce the power those thoughts have over the patient's behaviour. If a person can learn to observe the thought "I am worthless" as a thought — rather than a fact — it loses its capacity to drive avoidance and withdrawal.
ACT sessions typically include experiential exercises, mindfulness practices, metaphors, values exploration, and behavioural commitments — as well as review of between-session action steps.
ACT is conducted directly in English, Russian and Hebrew — without an interpreter. Experiential exercises and values work in ACT are culturally embedded — exploring what genuinely matters and what gets in the way requires direct linguistic and cultural communication.
ACT is delivered within an integrated clinical framework. Where pharmacotherapy is also involved, the ACT therapist and treating psychiatrist work in close coordination.
ACT may be combined with mindfulness-based approaches such as MBCT, and with CBT where structured skills work is also indicated. It is frequently offered as a complement to psychiatric medication management for chronic conditions where building psychological flexibility is a long-term clinical goal.
All ACT at IsraClinic is delivered within the framework of the Psychoergonomic Method — ensuring the approach is built around this specific patient's values, history, and clinical presentation.
ACT is indicated when experiential avoidance is a central maintaining factor; when chronic conditions require a long-term framework for living well despite ongoing vulnerability; when values clarification and committed action are clinically relevant goals; and when the patient is open to an approach involving acceptance of difficult experience rather than its elimination.
ACT is appropriate across the full severity range — from mild adjustment difficulties to severe and complex psychiatric conditions.
IsraClinic accepts patients for in-person consultation in Tel Aviv and online, in English, Russian and Hebrew. No referral is required.
Clinical Programme Curator: Valery Kravitz | IsraClinic | Last reviewed: 2026
ACT does not ask you to feel better before you start living — it helps you live better even while difficult feelings are present. Our team is available in English, Russian and Hebrew.