Acceptance and Commitment vs. Mindfulness-Based Cognitive Behavior Therapy

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Introduction

Buddha’s teachings analyze that mindfulness is an awareness of a spiritual faculty that is of great significance to enlightening. Mindfulness is the reality of things, especially at the present moment. This psychological aspect becomes power when one understands his or her life. Buddha advocates that individuals should establish mindfulness in their daily lives while trying their best to maintain calm awareness in their bodily functions, feelings, objects of sensations, and consciousness (Herbert & Evan, 2011). The western psychologists borrowed this practice from Buddhists so as to use it in the alleviation of depression, drug addiction, and relapses among other conditions; which might be mental or physical in nature. Depression is the feeling of sadness or blueness, and while these feelings are short-lived, it takes many days for an individual to heal.

The condition comes with a lot of pain to the affected individual and those around him hence causing a lot of inconveniences for many people. According to my observation, this is a common serious illness, but many people living with it do not seek medical attention (Piet & Hougaard, 2011). The condition is curable when medical attention is sought, especially for intensely affected patients. This illness can be treated by; psychotherapies such as acceptance and commitment therapy (ACT) and mindfulness-based cognitive behaviour therapy (MCBT). This is a reflective essay comparing, contrasting, and critiquing, two of the cognitive approaches to therapy. The approaches to be explored are acceptance and commitment therapy and mindfulness cognitive-based therapy. I will consider these approaches in my own professional practice. I will critique each therapy through a discussion of the strengths and weaknesses, and I will give reasons for concluding that one is better than the other. I will further discuss each therapy outlining the strengths and weaknesses of each which will be supported by relevant literature.

Acceptance and Commitment Therapy (ACT)

This is a type of psychotherapy that can help in accepting life difficulties. The therapy needs the participant to accept his or her condition and be mindful. These two components will lead to behaviour change and enhance the chances of ensuring that psychological flexibility is successful. This approach, developed by Steven Hayes, was first called comprehensive distancing before it was renamed acceptance and commitment therapy (Hayes, Luoma, Bond, Masuda & Lillis, 2006). Under this therapy, the wellbeing of an individual can be attained by overcoming negative thoughts and feelings. I find this therapy useful because it focuses on character traits of a person and his or her behaviour, and it assists the person to reduce coping styles that are avoidant (Hayes, Luoma, Bond, Masuda & Lillis, 2006). Moreover, the therapy addresses an individual’s commitment to propose changes, and I have seen it useful in providing solutions, especially to challenges of sticking to set goals.

The Six Core Processes of ACT

There are six core processes of acceptance and commitment therapy, and they include;

Connection; this means being in the present moment while connecting fully with what is happening wherever one is at that particular moment. This is commonly referred to in the therapy as “contacting the present moment” (Harris, 2006, p. 6).
Defusion; I ensure that my clients do not remain in worries or memories that destruct them. He or she should learn how to let go thoughts and worries, which are not useful, instead of allowing these memories to overcome one. I encourage my participants to hold back and keenly observe their thinking so that they are ready to handle the condition when it comes instead of getting lost in unhelpful thoughts (Harris, 2006).
Expansion; this is where a client is encouraged to open up and create room for sensations and feeling, which are painful. I advise my clients to by dropping struggles within themselves, allowing some breathing space and not interfering with their lives. Under this phrase, the more patients open up and give room to their struggles, the easier struggles will come and go without affecting their lives (Harris, 2006).
The Observing Self; this is whereby, one accounts for his or her awareness and attention. The process involves the two parts of the mind. The first is the self, which is responsible for thinking, feel and do at a particular moment and accounts for all beliefs and judgments. The second one is the observing self, which is always aware of what one is thinking, feeling, or doing at a particular moment. I always warn my clients that without this part, one cannot develop mindfulness skills (Harris, 2006).
Values; this is the fifth process, and it involves what one wants his life to be as deep inside his heart. Values involve what one stands for; how he wants to spend his time, what he wants to do with his time while living and what it will be like to be remembered by those he loves when he or she dies (Harris, 2006).
Committed action; in this stage, the action is taken by the guide of one’s values by doing the right thing regardless of the challenges.

The combination of these six steps leads to the development of psychological therapy, which enables one to open up, present himself, and concentrate on matters that are of importance to him. If one is in a good position to do this, he is in a good position to live a quality life. The participant can effectively deal with the situation when it comes along (Harris, 2006).

Strengths of ACT

Some ideas have been borrowed from ACT to create acceptance and commitment training, which are non-therapy in version. For example, in my professional practice, I use ACT to train patients because it enables the development of mindfulness values and even acceptance away from medical centres like in businesses and schools. ACT training and application is similar to awareness management movement where techniques such as cognitive shifting and mindfulness are applied as in business (Blackledge, 2007). The therapy is a wonderful tool to deal with stress because of its ability to have the participant regains a rich and meaningful life.

While I am dealing with my clients, I also teach them psychological skills, which enable them to deal with their painful thoughts and feelings. That way, the painful thoughts will have less effect and influence on their lives (Blackledge, 2007). I ensure my clients get important skills of the therapy, which can assist them in differentiating good and bad. They are required to use that knowledge to guide and inspire them to brighten their future. Most of my clients, whom I have given this therapy, have recovered from various illnesses. This therapy does not cure every illness or make it perfect, but it reduces upsurges in patients hormones, elevate mood, and upsurge chemicals produced in large volumes when one is stressed.

This therapy introduces positive thinking, which is a recovery process from mental illnesses. This therapy prevents a person from thinking negatively because it changes the way one perceives situations by evaluating motivations, which can drive other people. I have also discovered that this therapy is not important to the sick only, but it can also assist other people like athletes. For instance, students can focus on achieving high test scores, and by reduction of test anxiety and focusing on studies. This therapy assists many people to adopt optimism even in difficult moments of life (Blackledge, 2007). My clients try to find solutions to their problems or use these hard times to help others reduce test anxiety by studying the therapy. ACT is effective in executive coaching of life (Blackledge, 2007). There are tactics that I apply in my practice such as cultivating acceptance, openness and mindfulness, which help in treating depression, substance abuse, chronic pain and anorexia, among other complications. I usually teach my clients that this therapy has its disadvantages. First, people who have adopted it can become too optimistic about a condition called optimist bias. At this point, they tend to think that they are immune to moments of life or believe that greater things in life have a high chance of occurring as compared to negative things. If this happens, cases like smokers believing that they cannot get cancer can occur (Blackledge, 2007). I teach my clients to know that optimism is usually tempered with realism, which is not negative.

Limitations of ACT

ACT utilises mindfulness strategy similar to mystical aspects of Buddhism and other religions. At times I received complains that after applying the ACT therapy, some of my clients have had experiences of confusion between psychological experiences and the proposed mechanisms of change in the ACT. I understand that some critics argue that both of them are intervention methods; which has pressurized the proponents of the therapy to seek more evidence to differentiate the therapy from psychological experiences. However, the therapy is based on the assumption that other mindfulness-based treatments are similar to that of Morita therapy (Forsyth & Georg, 2007). Therefore, I usually advocate for an alternative when confusion occurs because there is no object therapy for clients.

Mindfulness-Based Cognitive Therapy

Mindfulness-based cognitive therapy can be defined as a psychological therapy used to prevent the relapse of depression on those people with major depressive disorder (MDD). This therapy uses traditional cognitive behavioural therapy (CBT) methods and complements with new psychological strategies, such as mindfulness meditation and mindfulness (Hofmann, Sawyer & Fang, 2010). Cognitive methods comprise of educating the participant on depression while mindfulness and mindfulness meditation usually focuses on one being informed of all insight feelings, thoughts and accepting themselves as they are: rather than reacting to them in a strange or unacceptable way (Hofmann, Sawyer & Fang, 2010). The main objective of mindfulness-based cognitive therapy targets at interrupting the normal life in the participant and make him or her not to concentrate on stimuli from outside. These stimuli are better observed without any judgment for a better outcome.

This is because it is possible for participants to realise when automatic processes are in action, and therefore acquire skills of altering them. Most researches carried out to check on the effectiveness of MBCT have found it to be effective, especially on those people suffering from depression (Hofmann, Sawyer & Fang, 2010). This is believable because the mindfulness-based approach is meant to deliberately focus on an individual’s present experiences without judging him or her. This therapy has its roots in Buddhism. The approach was developed by Segal Zinde, Mark Williams, and John Teasdale (Hofmann, Sawyer & Fang, 2010). Under this therapy, the participant must direct and focus his or her mind away from thoughts that are external. In this case, it is advisable for any participant to observe and accept the current situation with all its offerings; whether good or bad.

Phases of Mindfulness-Based Cognitive Therapy

Recognition; the phase informs the participants on how to recognise his actions and the best responsibility to take at that particular moment. It also informs participants on how to carry their burdens without blaming them on other people. At this point, I advise my clients that what we do is very different from the source of suffering. For instance, pain exists, but suffering is a subjective process conditioned by thinking that is usually attached to the pain (Leahy, 2006).
MT; at this point, one should know how to handle relationship together with his problems. Transformation and healing take place during this phase. I teach my clients to learn to recognize their reactivity so as to transform it because if they do not feed this anxiety, it will weaken, and eventually die out (Leahy, 2006).
Relationship; my clients make informed and flexible decisions at this point, according to the teachings of Buddha, compassion which is allowing pain to prevail safely while at the same time ensuring that the ego is at control.
Resolution; at this point, the participant enters into another phase of inner thoughts and feelings. The road to resolution presents itself naturally, and it enables the exploration of details of what brings about the resolution of the emotion (Leahy, 2006).

Strengths of Mindfulness-Based Cognitive Therapy

Mindfulness-based cognitive therapy focuses on thoughts, beliefs, and feelings which are just on the surface. This is because participants close their eyes most of the time. This enables them to explore their inner structures with full concentration, explore their anxieties and depression, anger, and traumatic memories. The therapy focuses on the inner sensory structure of anxieties and other emotional imbalances instead of concentrating on the surface of thoughts or personal story (Leahy, 2006). MBCT concentrates on unhelpful thoughts which allow stress and depression due to un-compulsive force.

The therapy works from general to specific, which makes the therapy effective because it is easier working from general to specific than the other way round. For instance, worrying is a proliferate thinking that can change a little anxiety into a large nightmare. If this is dealt with early, large anxieties of worry can be avoided (Leahy, 2006). In this therapy, information about cognitive therapies such as depression and exercise are available. These therapies combine thinking and the way the results affect the feelings. The therapy has a formula of guiding participants to work with thoughts of depression, and the way skills negative moods and thought patterns are recognised.

This therapy can be molded to address a variety of symptoms as well as circumstances. My profession requires me to make follow up on the progress of my client and advise him or her to be fully dedicated to the participation. After sometime, the client gets some mindfulness skills, which can assist him or her deal with the situation wherever and whenever even in the absence of professional personnel. Those who regularly practice this therapy gain emotional healing fast than those who do not practice it. Mindfulness based therapy is mostly delivered through the practice of mindfulness approach. I encourage my clients to consider their thoughts, their past, their present, and their future anticipations when they seem to deviate from the present. This way, I win back their attention to the present moment (Shapiro, Carlson, Astin & Freedman, 2006). In my working with the client, I ensure that he or she gets to know the negative thoughts, which can be caused by these types of emotions and advice them to be alert so that when they come, he or she can recognise them.

This therapy aims at relieving the signs of psychological stress, physical pain as well as negative mental states (Shapiro, Carlson, Astin & Freedman, 2006). Meditation and yoga movements are very useful in reminding the participants their physical sensations, and reminding them to maintain deep breath and straight movements during the period of taking exercises. This should continue outside the therapeutic process session to allow him the opportunity of serving, exploring, and experiencing mindfulness in an environment that is not clinical (Shapiro, Carlson, Astin & Freedman, 2006). It is important to examine and evaluate the results and obstacles one gets in his life and use these results to alter his behaviors and thoughts.

Limitations of Mindfulness Based Cognitive Therapy

During times of stress, I encourage my clients to pause for sometime and be in their current status. I do this because the mindfulness based cognitive therapy is into people’s behavioral pattern in a way that they are always trying ways of combating stress and improving the quality of their lives (Leahy, 2006). According to my professional teachings, mindfulness meditation is effective in both health and performance. Finally researches carried out on mindfulness based cognitive therapy have argued that people suffering from chronic depression have not been benefiting from this type of therapy. Therefore, they are advocating for deeper research to be done on this therapy to assist people with chronic depression (Leahy, 2006).

Comparing and Contrasting ACT and MBCT

Acceptance and commitment therapy is a branch of the mindfulness based approaches just as mindfulness based therapy. Mindfulness is a powerful therapeutic intervention aimed at increasing emotional intelligence (Lau, & McMain, 2005). ACT has proved to be an effective therapy in most researches. Mindfulness requires one to be focused, open, and aware in one’s daily activities. In my professional practice, I find this useful not only to the sick, but also to athletes and business people (Lau, & McMain, 2005). ACT is a branch of MCBT and presents a new form of psychotherapy. ACT is method of treating conditions like depression, stress, post-trauma and anxiety among others. Both ACT and MBCT rely on the philosophy of contextualism school of thought. The school advises people to be in a context so as to understand ideas and words well. MBCT on the other hand concentrates on identification of hot thoughts (Lau & McMain, 2005). These thoughts are throes of depression or anxiety.

The therapy evaluates the thought and list evidence to show why it is not true. Many who think about this process come to know that what they are thinking is not the truth. They learn skills of easily dismissing those thoughts when they occur. ACT differs from MCBT in accepting the thought immediately. Participants of ACT do not actively dismiss previous unwanted thoughts (Lau & McMain, 2005). This is also the case with MCBT because MCBT aims at the reduction of unwanted thoughts. ACT has so many ways of learning its skills and some of them take a short period of time. Acceptance, defusion and contact with the present moment are the components of ACT. These three aspects require participants to be uninterrupted by external thoughts and feelings (Lau, & McMain, 2005). Sometimes the ACT therapists have claimed that the ACT therapy takes long as compared to MCBT. This is because ACT helps people accept situations the way they come, live life the way it is, and take appropriate action where necessary. As a result of this, I find ACT to be more effective than MCBT.

Conclusion

ACT is more explored and researched as compared to mindfulness based cognitive therapy, which has almost all the skills in ACT. However, ACT is a powerful therapy when integrated well with the mindfulness based approach. Mindfulness based approach is widely used in ACT in research, application, and analysis of results. The therapy applies all the skills involved and other new specialised skills in the therapy. These skills are not found in mindfulness based approach. This is what makes ACT more preferable or effective as compared to mindfulness based therapy. ACT uses traditional and modern skills in assisting people get out of stress, depression, and other disturbing aspects of life. If these skills are practiced daily, unhelpful thoughts and painful feelings will find no room to influence or affect the participants. ACT is an effective therapy in doing away with depression, worrisome thoughts, and stress among others. Although both approaches can be applied separately, they can be combined to make a strong therapy for participants.

References

Blackledge, J.T. (2007). Disrupting verbal processes: Cognitive defusion in acceptance and commitment therapy and other mindfulness-based psychotherapies. The Psychological Record, 57, 555-576.

Forsyth, J. P., & Georg, H. E. (2007). The mindfulness and acceptance workbook for anxiety: A guide to breaking free from anxiety, phobias, and worry using acceptance and commitment therapy. Oakland, CA: New Harbinger.

Harris, R. (2006). Embracing your demons: an overview of Acceptance and Commitment Therapy. Psychotherapy in Australia, 12(4), 2–8.

Hayes, S.C., Luoma, J.B., Bond, F.W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. New York: Nova Science Publishers.

Herbert, J. D., & Evan M. F. (2011). Acceptance and mindfulness in cognitive behavior therapy: Understanding and applying new theories. Hoboken: John Wiley & Sons.

Hofmann, S. G., Sawyer, A. T., & Fang, A. (2010). The empirical status of the “New Wave” of cognitive behavioral therapy. Psychiatric Clinics of North America, 33 (3), 701–710.

Lau, M.A., & McMain, S.F. (2005). Integrating mindfulness mediation with cognitive and behavioral therapies: The challenge of combining acceptance-and-change-based strategies. The Canadian Journal of Psychiatry, 50(13), 863-869.

Leahy, R.L. (Ed). (2006). Contemporary cognitive therapy: Theory, research, and practice. New York: The Guilford Press.

Piet, J., & Hougaard, E. (2011). The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis. Clinical Psychology Review, 31 (6), 1032–1040.

Shapiro, S.L., Carlson, L.E., Astin, J.A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62 (3), 373-386.

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