Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT) is a mindfulness-based form of cognitive behavioural therapy that helps people stop fighting cravings, painful thoughts and difficult emotions, and start acting on what matters to them. At Calida Rehab, it is delivered by our clinical team at our Pune centre and our Mumbai Region – Karjat centre, serving patients across Pune and the Mumbai region, and it supports recovery from addiction and co-occurring mental health conditions.
- Best for: addiction recovery with co-occurring depression, anxiety or trauma-related distress
- Approach: third-wave cognitive behavioural, built on mindfulness, acceptance and personal values
- Format: individual sessions, with group and family sessions
- Care setting: residential (inpatient) care, with ACT skills practised daily and continued through aftercare
- Where: Pune centre and Mumbai Region – Karjat centre
- Clinically reviewed by: Dr. Prashant Dasud, M.D. (Psychiatry), Director and Consultant Psychiatrist
- Last updated: October 2026
What is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy is a third-wave form of cognitive behavioral therapy developed by psychologist Steven C. Hayes. Where traditional CBT often works on changing unhelpful thoughts, ACT teaches you to notice thoughts, urges and feelings, make room for them, and still choose actions that fit your values.
Its core aim is psychological flexibility: staying in contact with the present moment and acting on what matters to you, whatever you are feeling. In substance use disorder treatment this matters because many people use alcohol or drugs to escape pain, stress or cravings. ACT helps you respond to those experiences differently.
The name is also a simple recipe. Many therapists remember it as A-C-T: Accept your thoughts and feelings and stay present, Choose a valued direction, and Take action. ACT grew out of behavioural science in the 1980s, when Steven Hayes and colleagues began testing ways to change a person’s relationship with their thoughts rather than the thoughts themselves. It belongs to the “third wave” of behaviour therapy, alongside approaches such as DBT and mindfulness-based therapies.
The six core processes of ACT
- Acceptance: making room for cravings, emotions and sensations without pushing them away
- Cognitive defusion: seeing a thought as a thought, not as a command or a fact
- Present-moment awareness: staying with what is happening now through mindfulness
- Self-as-context: recognising that you are more than your addiction, your worst day or your harshest thoughts
- Values: getting clear on what you want your life to stand for
- Committed action: taking steady, practical steps towards those values, even when it is uncomfortable
How the six processes work together
| Process | When it is missing | When it is built |
|---|---|---|
| Acceptance | Avoiding feelings, and drinking or using to escape them | Willingness to feel cravings and emotions without acting on them |
| Cognitive defusion | Thoughts such as “I am a failure” feel like facts | Thoughts are seen as passing words and images |
| Present moment | Living in regret about the past or fear of the future | Flexible attention to what is happening now |
| Self-as-context | Identity shrinks to “addict” or “failure” | A steady sense of self that is bigger than any label |
| Values | Drifting, or living by what others expect | Clear, chosen directions such as family, health and work |
| Committed action | Impulsive or avoidant behaviour and repeated relapse | Steady steps that serve your values, even when uncomfortable |
Psychological inflexibility, being stuck in struggle, avoidance and self-criticism, is common in people with substance use problems. Psychological flexibility is the skill of staying with what you feel while still choosing what you do. It can be learned, and it is what ACT trains.
ACT has a growing research base. A 2015 meta-analysis of 10 randomised trials found a small-to-medium advantage for ACT over other active treatments on substance use outcomes, and the authors described it as promising. Evidence is still developing for some substances, which is why at Calida Rehab ACT is used alongside other treatments and not on its own.
How ACT Helps With Addiction and Cravings
Most people who struggle with alcohol or drugs have already tried very hard to control how they feel. They pushed cravings away, avoided triggers and promised themselves they would stop thinking about it. ACT starts with an honest question: has the struggle worked? If fighting cravings and painful emotions had worked, relapse would not keep returning.
The control trap
In a well-known 1987 experiment, psychologist Daniel Wegner showed that trying not to think about something, his example was a white bear, tends to make the thought return more often. Cravings and painful memories behave in a similar way. Suppression gives short-term relief, but the urge usually comes back louder. ACT calls this pattern experiential avoidance, and substance use is one of its most common forms.
What ACT changes
| When this shows up | The struggle response | The ACT response |
|---|---|---|
| A craving | Push it away, distract, give in to get rid of it | Notice it, name it, breathe, let it rise and pass while you do something that matters |
| A harsh thought (“I will never change”) | Argue with it or believe it | Notice “I am having the thought that…” and act on your values anyway |
| Shame after a slip | Hide, isolate, use again to numb it | Treat the slip with kindness, learn from it and take the next valued step |
| Stress, anger or loneliness | Escape through alcohol or drugs | Make room for the feeling and choose a healthier response |
ACT does not ask you to like your cravings or to approve of using. It asks you to stop letting them make your decisions.
ACT Techniques Used in Addiction Recovery
ACT is practical. Most of the work happens through short exercises that you learn in session, practise between sessions and use in real moments of craving. Common techniques include:
| Technique | What you do | How it helps in recovery |
|---|---|---|
| Leaves on a stream | Imagine placing each thought on a leaf and watching it float down a stream | Practises seeing thoughts such as “one drink will not matter” as passing events, not instructions |
| “I am having the thought that…” | Add this phrase in front of a painful or tempting thought | Creates a small distance from the thought, which is the heart of cognitive defusion |
| Urge surfing | Watch a craving like a wave that rises, peaks and passes, without acting on it | Shows through experience that cravings are temporary. The method grew out of the relapse prevention work of G. Alan Marlatt |
| Passengers on the bus | Picture yourself driving a bus while noisy passengers (thoughts, fears, urges) shout directions | Teaches that you can keep driving towards your values even when difficult thoughts are loud |
| Dropping the rope | Use a tug-of-war metaphor: pulling harder against a craving or memory keeps you stuck | Helps you drop the struggle without giving in to the urge |
| Values and goals worksheet | Rate how important family, health, work, friendship, faith and learning are, and how closely you are living by them | Turns recovery from “not using” into building a life worth staying sober for |
| Choice point | Sort a situation into moves that take you towards your values and moves that take you away | Gives a quick way to pause in a trigger situation and choose |
| Grounding and mindful breathing | Anchor attention in your breath, body and the five senses | Brings you back to the present when anxiety, shame or craving spikes |
These exercises are not designed to remove cravings. They are designed to give you a different choice at the moment a craving arrives.
What Does the Research Say About ACT for Addiction?
ACT is one of the better-studied third-wave therapies, and it is still being tested in addiction treatment. This is where the evidence stands.
| Study | What it looked at | What it suggests |
|---|---|---|
| Hayes, Luoma, Bond, Masuda and Lillis (2006), Behaviour Research and Therapy | A review of the ACT model, its six processes and early trials | Processes such as acceptance, defusion and values are linked to improvement across many problems |
| Lee, An, Levin and Twohig (2015), Drug and Alcohol Dependence | A meta-analysis of randomised trials of ACT for substance use | A small-to-medium advantage over other active treatments. The authors called ACT promising and asked for larger trials |
| Luoma, Kohlenberg, Hayes and Fletcher (2012), Journal of Consulting and Clinical Psychology | A randomised trial in residential addiction treatment of an ACT workshop that targeted shame | Less shame and better outcomes at follow-up than treatment as usual |
What this means in practice: ACT has promising support, especially for shame, avoidance and staying engaged in treatment, but it is not a stand-alone cure. At Calida Rehab it is one part of a wider plan that includes medical care, psychiatric review, counselling, relapse prevention and family involvement.
Who Can Benefit from Acceptance and Commitment Therapy?
ACT is most useful when cravings, painful emotions or harsh self-judgement keep pulling a person back towards alcohol or drugs, even after detox. It is commonly used for:
- Alcohol use disorder
- Drug and substance use disorders
- Cannabis dependence
- People who found CBT helpful but still feel stuck with persistent thoughts or cravings
- Clients with co-occurring depression or anxiety
- People with trauma-related distress, including PTSD
- People struggling with shame, guilt or harsh self-criticism after addiction
- People preparing for life after rehab who want to rebuild around their values
ACT also suits people who like practical exercises more than long discussions, and people who feel that arguing with their own thoughts has not worked. Your psychiatrist and psychologist decide whether ACT is the right fit, and how it should be combined with other therapies such as CBT, DBT and relapse prevention.
Why Choose Calida Rehab for Acceptance and Commitment Therapy?
Many people in recovery have tried to push cravings and painful thoughts away, only to find they return stronger. At Calida Rehab, ACT is used to build a different relationship with those experiences, with skills practised in therapy while support is close by.
What our approach includes
- Individual ACT sessions led by our psychologists together with our psychiatry team
- Values work that connects recovery to family, work and health goals
- Mindfulness and defusion exercises practised in session and between sessions
- Integration with CBT, DBT, Relapse Prevention Therapy, group therapy and family therapy
- Support for co-occurring depression, anxiety and trauma-related distress
- Care across our Pune centre and Mumbai Region – Karjat centre
What ACT looks like in residential care
Because care at Calida Rehab is residential, ACT skills are not left in the therapy room. You can practise them in the moments that test them: a craving after a difficult phone call, a wave of guilt in the evening, a restless night. Staff are close by, and what you learn in individual sessions is reinforced in group and family sessions. Your plan for life after discharge is built around your values, so the skills carry on at home.
How Acceptance and Commitment Therapy Works at Calida
Acceptance and Commitment Therapy at Calida Rehab follows a step-by-step process, adapted to each client.
How ACT compares with other therapies
| Therapy | Main focus | Often used for |
|---|---|---|
| Acceptance and Commitment Therapy | Accepting inner experiences and acting on personal values | Cravings, anxiety, depression and shame that keep returning |
| CBT | Changing unhelpful thoughts and behaviours | Addiction, depression, anxiety |
| DBT | Emotion regulation and distress tolerance | Intense emotions and impulsive behaviour |
| Relapse Prevention Therapy | Spotting triggers, managing cravings, handling a lapse | Staying sober after detox and rehab |
1. Assessment & Goal Setting
- Review of substance use, mental health history and current symptoms
- Understanding what you have already tried to control or avoid difficult feelings
- Agreeing the goals of therapy together
2. Acceptance & Cognitive Defusion
- Learning to notice cravings and thoughts without acting on them
- Defusion exercises that loosen the grip of thoughts such as I cannot cope without it
- Practising willingness to feel discomfort without using
3. Mindfulness & Present-Moment Skills
- Breathing and grounding exercises
- Mindful awareness of urges, including urge surfing
- Observing thoughts and feelings without judgement
4. Values Clarification
- Identifying what matters most: family, health, work, faith and relationships
- Seeing how addiction has pulled you away from those values
- Setting meaningful long-term goals that recovery can serve
5. Committed Action & Aftercare
- Turning values into small, specific steps
- Handling setbacks without self-blame
- Linking ACT skills with your relapse prevention plan, group therapy, family sessions and follow-up after discharge
What to Expect in Your First ACT Sessions
ACT starts with understanding, not with homework. Early sessions are about your story, what you have already tried, and what you want your life to look like. Here is how it usually unfolds.
| Stage | What happens | What you may notice |
|---|---|---|
| Sessions 1 to 2 | Your therapist reviews your substance use, mental health and what you have tried to control or escape. You discuss what recovery would let you do. | Relief at being asked what matters to you and not only what is wrong |
| Sessions 3 to 5 | You learn mindfulness, defusion and willingness skills such as leaves on a stream and urge surfing, and practise them in session. | Cravings feel less like orders and more like events that rise and pass |
| Sessions 6 and on | You clarify values and turn them into small steps, then test those steps in group and family sessions and in daily routines. | More energy for rebuilding relationships, health and work |
| Before discharge | Skills and values are linked to your relapse prevention plan and aftercare. | A clear plan for what to do on a hard day |
An illustrative example (not a real patient): a person in early recovery notices the thought I cannot cope tonight without a drink. In ACT they learn to say I am having the thought that I cannot cope, notice where the craving sits in the body, breathe, and then do the thing they value, such as calling their sister or joining the evening group. The craving may still be there. It simply no longer decides what happens next.
Sessions are collaborative. You are never asked to force a feeling or pretend a thought away. Your team adjusts the pace to your health and stage of recovery.
How Families Can Support ACT-Based Recovery
Families often feel they must push, persuade or watch constantly. ACT-informed family sessions help relatives step out of that struggle too, and support the person in a way that fits recovery.
| Instead of | Try | Why it helps |
|---|---|---|
| Why can you not just stop? | I can see how hard this is. What would help today? | Shame fuels cravings. Warmth makes it easier to ask for help |
| Checking, questioning and monitoring all day | Agreeing a few clear check-ins together | Constant monitoring can raise stress and secrecy |
| Waiting for the person to feel ready | Encouraging one small valued step, such as a walk or a family meal | Action often comes before motivation |
| Hiding your own worry | Naming your feelings calmly and getting your own support | Family members have their own pain to carry |
Relatives are welcome in family therapy sessions at Calida Rehab, where they learn how addiction affects the whole household and how to support recovery without taking over.
Myths and Facts About Acceptance and Commitment Therapy
| Myth | Fact |
|---|---|
| Acceptance means accepting addiction or giving up. | Acceptance means making room for cravings and feelings without obeying them. The goal is still recovery and a valued life. |
| ACT is only meditation. | Mindfulness is one part. ACT also uses values work, defusion exercises and planned action. |
| ACT removes cravings. | It does not promise that. It changes how you respond when a craving arrives. |
| ACT is a quick fix. | Skills take practice. Most people use ACT over weeks of treatment and keep practising in aftercare. |
| ACT replaces medical treatment. | It does not. Detox, medicines when prescribed, psychiatric care and other therapies remain part of the plan. |
Acceptance and Commitment Therapy in Our Programs
Acceptance and Commitment Therapy is not a one-time session. Its skills are practised across every stage of care at Calida Rehab and continue after you go home.
Calida Rehab offers ACT within residential care only. A structured, substance-free setting with clinical staff close by gives new skills the best chance to take hold before you return home.
Inpatient Residential Program
ACT begins once detox and stabilisation are complete. Clients learn acceptance and mindfulness skills, clarify their values and practise them in individual and group sessions in a safe, structured setting.
Aftercare & Follow-up
Recovery continues after discharge. We help clients and families keep using ACT skills and update goals as life changes, with follow-up contact and support.
When ACT Alone Is Not Enough
ACT is a talk therapy. It works best as one part of complete care, and some situations need other treatment first or alongside it:
- Physical dependence: alcohol, benzodiazepine and opioid withdrawal can be medically risky and need supervised detoxification before therapy can begin properly.
- Severe depression, suicidal thoughts or psychosis: these need urgent psychiatric assessment and treatment.
- Medicines: where your psychiatrist advises medicines for withdrawal, cravings or a co-occurring condition, ACT is used alongside them.
Call 112 for emergencies. Tele-MANAS, India’s government mental health helpline, is available on 14416. You can also call the Calida Rehab 24-hour confidential helpline shown on this page.
Sources and Further Reading
Clinical content reviewed by Dr. Prashant Dasud, M.D. (Psychiatry). This page is for information and is not a substitute for medical advice.
- Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., and Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25.
- Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639-665.
- Lee, E. B., An, W., Levin, M. E., and Twohig, M. P. (2015). An initial meta-analysis of ACT for treating substance use among adults. Drug and Alcohol Dependence, 155, 1-7.
- Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., and Fletcher, L. (2012). Slow and steady wins the race: a randomized clinical trial of ACT targeting shame in substance use disorders. Journal of Consulting and Clinical Psychology, 80(1), 43-53.
- Wegner, D. M., Schneider, D. J., Carter, S. R., and White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5-13.
- Hayes, S. C., Strosahl, K. D., and Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford Press.
Take the First Step - Contact Calida Rehab
If you or a loved one is struggling with cravings, painful emotions or the feeling of being stuck in recovery, speak to our team for a confidential assessment.
Related therapies
Cognitive Behavioral Therapy | Dialectical Behavioral Therapy | Relapse Prevention Therapy | Behavioral Therapy | Group Therapy | Family Therapy | Detoxification
Where we offer it (Pune and the Mumbai region)
De-addiction Centre in Pune | De-addiction Centre in Mumbai | Alcohol Rehabilitation in Pune | Alcohol Rehab in Mumbai | Rehabilitation Centre in Karjat
10K +
Patients Serviced with Complete Care
NABH
Guidelines Compliant
170 +
Beds Capacity
24/7
Residential Staff
Call our 24-hour free confidential helpline.
Treatments
Therapies
Acceptance and Commitment Therapy at Calida Rehab - FAQs
What is Acceptance and Commitment Therapy in simple words?
ACT teaches you to stop fighting difficult thoughts, feelings and cravings and to put your energy into actions that match your values. You learn to notice an urge without obeying it, and to keep moving towards the life you want.
How is Acceptance and Commitment Therapy different from CBT?
CBT mainly works on changing unhelpful thoughts and the behaviours linked to them. ACT leaves the thoughts as they are and changes your relationship with them through acceptance, mindfulness and values-based action. The two share a foundation and are often used together at Calida Rehab.
Does acceptance mean accepting addiction or giving up?
No. Acceptance in ACT means making room for cravings, emotions and memories without struggling against them. It does not mean accepting substance use. The commitment part of the therapy is about choosing actions that support recovery.
Is Acceptance and Commitment Therapy effective for addiction?
Research suggests ACT is a promising treatment for substance use disorders. A meta-analysis of 10 randomised trials found a small-to-medium benefit over other active treatments, though evidence is still developing for some substances. At Calida Rehab it is used alongside other treatments and not in place of them.
How long does Acceptance and Commitment Therapy take?
It depends on the person, the substance and the stage of recovery. Skills are introduced during treatment and practised over time, and goals are reviewed during aftercare. Our team will discuss a plan after your assessment.
Is Acceptance and Commitment Therapy the same as meditation?
No. Mindfulness is one part of ACT, but the therapy also includes values work, defusion exercises and planned action. You do not need any meditation experience.
Can Acceptance and Commitment Therapy be used with medicines?
Yes. ACT is a talk therapy and does not replace medicines. Where your psychiatrist advises medicines for withdrawal, cravings, depression or anxiety, ACT is used alongside them.
Can ACT help with anxiety, depression or trauma along with addiction?
Yes. ACT was built to work on the struggle with painful thoughts and feelings, which is common to addiction, anxiety, depression and trauma-related distress. Your team plans treatment for all of them together.
Can family members take part in ACT-based care?
Yes. Relatives are welcome in family sessions, where they learn how to support recovery without pressure, blame or constant monitoring.
What do I practise between ACT sessions?
Short exercises such as mindful breathing, noticing a craving without acting on it, writing down your values, and taking one small step that fits them each day.
What Patients and Families Say About Calida Rehab
Read what people have shared about their experience with our team.
Experts Who Will Guide Your Recovery
Dr. Prashant Dasud
Designation: M.D. (Psychiatry)
Experience: 14+
Illnesses:
Depression & Mood Disorders, Anxiety Disorders, Bipolar Disorder, Schizophrenia & Psychotic Disorders, OCD, Drug & Alcohol Addiction, Sleep Disorders
Geriatric Mental Health Issues
Dr. Santosh Pawar
Designation: M.D. (Radiodiagnosis)
Experience: 12+
Illnesses:
CT / MRI, Dementia & Memory Disorder, Neuro-radiological Evaluation, pine & Nerve Imaging,Head Injury & Neurological, Diagnostic Support for Mental Health
Dr. Neha Shetty
Designation: M.D. (Psychiatry)
Experience: 11+
Illnesses:
Depression, Anxiety Disorders, Bipolar Disorder, Schizophrenia & Psychosis, OCD, Drug Addiction,Mental Health Issues
