DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

Acceptance and Commitment Therapy (ACT) considers the processing of emotional
experiences as significant in the development of eating disorders and other
psychopathology. The ideas proposed by ACT have been applied to the understanding of
eating disorders and weight control in those that may be overweight/obese. ACT will be
described and the process of inflexibility i.e. cognitive fusion and experiential avoidance
defined before providing evidence of its application to weight control and body image.
Evidence for the utility of the concept of inflexible psychological processing (and its
reverse flexibility) and its application to the eating disorders and obesity are then offered.
Acceptance and Commitment Therapy
ACT derives from the philosophy of functional contextualism (Biglan & Hayes, 1996;
Hayes, Wilson, Gifford, Follette, and Strosahl, 1996) and Relational Frame Theory
(RFT), a detailed theory and research program about the nature of human language and
cognition that has a substantial body of evidence with some techniques borrowed from
experiential approaches (Hayes, Barnes-Holmes, & Roche, 2001). A core insight of RFT
is that cognitions (and verbally labelled or evaluated emotions, memories, or bodily
sensations) have their effect not only by their content or frequency, but by problematic
management such as when private events need to be controlled, explained, believed, or
disbelieved, rather than being experienced.
From an ACT perspective, many forms of psychopathology can be conceptualised as a)
unhealthy efforts to control emotions, thoughts, memories, and other private experiences
(Hayes, Wilson, Gifford, Follette, & Strosahl, 1996), b) unhealthy examples of the
domination of cognitively based functions over those based in actual experience, and c) a
lack of clarity about core values and the ability to behave in accordance with them
(Hayes, Masuda, Bissett, Luoma, & Guerrero, (in press). The general goal of ACT is to
diminish the role of literal thought (‘cognitive defusion’), and to encourage a client to
contact their psychological experience directly, fully, and without needless defence
(‘psychological acceptance’) while at the same time behaving consistently with their
‘chosen values’. ACT refocuses change efforts toward overt behaviour or life situations,
rather than personal history or automatic thoughts and feelings.
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