Acceptance and Commitment Therapy - What the heck is it?

Acceptance and Commitment Therapy (ACT) is a third wave cognitive behavioral therapy, developed by Stephen C. Hayes. It’s been around for 20 years, and it is an evidence backed treatment for all people struggling with psychological flexibility, and is especially good for folks like us with ADHD.  

Of the two parts of the name of the treatment, Acceptance means that we embrace all of the feelings, good, great and bad.  There are no bad feelings by the way, they are all valid and all of them tell us a story.  The second part is commitment, and that means we need to find the courage to live authentically. Sit in those emotions, and still be true to our values, and make each choice with consideration to those values, not reactive to our emotions. 

ADHD in adulthood isn’t just about “focus” or “getting things done.” It’s about how we engage with our own thoughts, emotions, and struggles. ACT is powerful for ADHD because it shifts the focus from controlling thoughts to changing our relationship with them.

Research backs this up. Studies have shown that ACT helps adults with ADHD reduce emotional distress, increase psychological flexibility, and improve executive functioning. One of the biggest challenges in ADHD is that inner tug-of-war—the shame of not meeting expectations, the overwhelm of starting tasks, and the emotional weight of feeling "behind." ACT doesn’t try to eliminate those thoughts. Instead, it teaches us to hold space for them without letting them run the show.

There are six core principles of ACT:

1. Acceptance – It’s about giving ourselves permission to feel what we feel. Instead of pushing away difficult emotions, we learn to make room for them. 
2. Cognitive Defusion – At the same time, ACT helps us recognize that our thoughts aren’t always facts. Sometimes, our minds serve up stories that just aren’t true. By creating distance between ourselves and our thoughts, we can prevent them from running the show.
3. Present Moment Awareness – Mindfulness is at the heart of ACT. It’s about being fully present in the here and now, embracing what’s happening in this moment without getting caught up in regrets about the past or anxiety about the future.
4. Self-as-Context – This is probably one of the hardest principles of ACT.  In many ways I view this as not identifying ourselves through our struggles.  For example, if I fail at making the painting I am working at, that does not mean that “I am a failure.” Another way of saying that is that we are the observer of our experiences, we are not our struggles.
5. Values – ACT invites us to get crystal clear about what truly matters to us. When we know our values in every area and facet of our lives, we can make choices that sync up with who we really are, even when life is hard.
6. Committed Action – So many of us, myself included, have a response to something, and get stuck in the same pattern of behavior over and over.  It may be, and often is self-destructive.  ACT encourages us to change that pattern, and consider our values, and then even when it feels uncomfortable or risky commit to an action that aligns with that value. 

With ACT, we can show up as the person that we want to be.  We can make each choice based on being that person.  Even when it’s difficult, even when our emotions are pulling us in 10 different directions.  We move forward in alignment with the self that we want to be.  Thus we live a life that is rich, meaningful, and very likely, without regrets.

One of ACT’s core concepts is psychological flexibility—the ability to feel discomfort, acknowledge struggle, and still move in the direction of what truly matters. This is huge for ADHD.

• When we hit a wall with procrastination, ACT doesn’t say “just push harder.” It says, “Can we notice this resistance with kindness and still take a small step toward what matters?”
• When we feel the shame spiral of forgetting a deadline, ACT doesn’t say “get rid of the shame.” It says, “Can we let that shame be there without letting it define us?”

And that’s what the research shows: Adults with ADHD who practice ACT experience less distress around executive function struggles and feel more empowered to take action, even when it’s messy.

Bottom Line: ACT Works Because It Meets ADHD Where It Is

ACT doesn’t ask us to be different people. It doesn’t shame us for struggling. It teaches us to sit with discomfort, accept what’s hard, and take action anyway. And when we can do that? Research shows we experience more ease, more resilience, and—most importantly—more connection to what truly matters in our lives.

So, if ADHD makes life feel like an unpredictable storm, ACT isn’t about stopping the rain—it’s about learning to dance in it.