Robyn D Walser Steven C Hayes

Acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999) is a behaviorally based intervention designed to target and reduce experiential avoidance and cognitive entanglement while encouraging clients to make life-enhancing behavioral changes that are in accord with their personal values. Although ACT has been applied to a wide variety of problems, it is well suited to the treatment of trauma. Individuals who have been diagnosed with posttraumatic stress disorder (PTSD) are often disturbed by traumatic memories, nightmares, unwanted thoughts, and painful feelings. They are frequently working to avoid these experiences and the trauma-related situations or cues that elicit them. In addition to the symptoms of PTSD, the painful emotional experience and aftermath of trauma can often lead traumatized individuals to view themselves as "damaged" or "broken" in some important way. These difficult emotions and thoughts are associated with a variety of behavioral problems, from substance abuse to relationship problems.

Although most trauma survivors recover naturally without professional intervention, a small percentage develops problems in living and trauma-associated disorders. The job of the professional is to help these traumatized individuals heal from the effects of the traumatic experiences. The word "heal" comes from a word meaning "whole." In an important sense, the client has come to the therapist to be made "whole" once again. Often clients believe that healing somehow involves forgetting or getting away from past traumas—cutting them out of their lives. Clients may work to avoid all emotional, psychological, and physical experiences associated with the trauma. From an ACT perspective the task is very nearly the opposite. ACT helps clients make room for their difficult memories, feelings, and thoughts as they are directly experienced, and to include these experiences as part of a valued whole life.

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