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What is Acceptance and Commitment Theory?

William S. Evans, PhD, CCC-SLP

March 1, 2024



What is Acceptance and Commitment Theory (ACT)?


Acceptance and Commitment Therapy (ACT) is a framework that is used to understand and address the relationship between communication deficits and mental health factors that can mutually influence and exacerbate each other within our patients. ACT is a modern form of third-generation psychotherapy, and is a variant of cognitive behavioral therapy (CBT) due to its emphasis on understanding thoughts and cognition, as well as facilitating behavioral change.

In ACT, the experience of suffering is considered a common human phenomenon, affecting everyone, albeit to varying degrees and in diverse ways. A fundamental principle of ACT is that suffering itself is a normal aspect of psychology. One of ACT's frequently cited principles is that clients are not “broken;” suffering is not seen as pathological but rather as a state of being "stuck."

Individuals typically seek counseling because they're suffering, struggling, or dealing with mental health symptoms. However, rather than solely focusing on reducing symptoms, ACT aims to change the relationship with symptoms and struggles so they no longer impede living according to one's values. The objective in ACT isn't to feel happy constantly and avoid struggle altogether because that's an unrealistic aim. Instead, the aim is a fulfilling, meaningful life, even amidst painful thoughts, feelings, and sensations. By trying to alter our relationship with unwanted experiences, mental health symptoms often diminish as a secondary effect. However, even if symptoms persist, individuals still have the capacity to progress and lead a profound, purposeful life, even amidst ongoing struggles.

What is particularly helpful in this model, especially for SLPs, is that most of the individuals we work with are dealing with chronic conditions such as developmental disorders and acquired brain injuries. For many of them, these are core issues and struggles that are lifelong. Therefore, having a model that can assist them without relying on the premise of eliminating those struggles provides them with a multitude of pathways forward.

This Ask the Expert is an excerpt from the course, Acceptance and Commitment Therapy: An Introduction for SLPs, presented by William S. Evans, PhD, CCC-SLP. 


william s evans

William S. Evans, PhD, CCC-SLP

William S. Evans, PhD, CCC-SLP, is an associate professor at the University of Pittsburgh in the Department of Communication Science and Disorders with a joint appointment in the Clinical and Translational Science Institute. He completed his undergraduate and graduate training at UMass Amherst and Boston University in the areas of psychology, linguistics and speech-language pathology, and has practiced clinically at Mass General Hospital and the Pittsburgh VA. At the University of Pittsburgh, he directs the Language Rehab and Cognition Lab and is a member of the multi-PI Pittsburgh Translational Aphasia Research Initiative. He teaches graduate coursework in the areas of counseling, aphasia and cognitive-communication disorders, and his federally-funded aphasia clinical trial research is focused on counseling, therapeutic games and adaptive computer-based interventions.

Related Courses

Acceptance and Commitment Therapy: An Introduction for SLPs
Presented by William S. Evans, PhD, CCC-SLP


William S. Evans, PhD, CCC-SLP
Course: #10771Level: Intermediate1 Hour
  'I enjoy learning the importance of diffusion process and how it impact the patient and caregivers'   Read Reviews
An introduction to Acceptance and Commitment Therapy (ACT), a modern evidence-based counseling approach, is provided in this course. Research support for ACT is discussed, and case studies to illustrate how ACT techniques can help patients and their families with the psychosocial consequences of living with communication disorders are presented.

Cognitive Behavioral Therapy for SLPs: Practice Updates
Presented by William Evans, PhD, CCC-SLP


William Evans, PhD, CCC-SLP
Course: #8899Level: Advanced2 Hours
  'It addressed an area that SLPs rarely do which is the emotional aspects of a comm disorder'   Read Reviews
This course reviews the use of Cognitive Behavioral Therapy (CBT) for SLPs, with a focus on counseling and behavioral change for adults with aphasia or cognitive deficits following acquired brain injury. Literature updates and case examples from the presenter's clinical practice are included.

20Q: Mental Health, Aphasia, and the SLP’s Role
Presented by Rebecca Hunting Pompon, PhD


Rebecca Hunting Pompon, PhD
Course: #10306Level: Intermediate1 Hour
  'Very good information presented via self reading format related to post examination'   Read Reviews
Depression and other mental health challenges are prevalent in individuals with aphasia. Recent research on the mental health status of individuals with aphasia, along with mental health and well-being screening options and basic counseling approaches that can be used by SLPs, are discussed in this 20Q.

Supporting Mental Health in People Living with Aphasia
Presented by Katie Strong, PhD, CCC-SLP


Katie Strong, PhD, CCC-SLP
Course: #10173Level: Intermediate1 Hour
  'The instructor is extremely knowledgeable and was able to present the information in an easy to listen and follow manner'   Read Reviews
This course provides an overview of the psychosocial impact of aphasia, with particular attention to depression and anxiety as well as barriers to accessing mental health services. The importance of interdisciplinary collaboration between speech-language pathologists and mental health providers, and of supports such as stepped psychological care, peer befriending, support groups, and communication partner training, is also discussed.

Animal Assisted Therapy in Communication Sciences and Disorders: The State of the Evidence
Presented by Sharon Antonucci, PhD, CCC-SLP


Sharon Antonucci, PhD, CCC-SLP
Course: #9434Level: Introductory1 Hour
  'Interesting topic! Looking forward to incorporating some of these ideas with my stroke survivors'   Read Reviews
This is Part 1 of a two-part series. This course will review the evidence base for animal-assisted therapy (AAT), including discussion of areas where further research is needed, and will describe uses of AAT in speech-language treatment for cognitive and communication impairments including autism, dementia, traumatic brain injury, and aphasia.

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