Acceptance and Commitment Therapy (ACT) in Colorado

Acceptance and commitment therapy (ACT) is an evidence-based psychotherapy that teaches people to accept difficult thoughts and feelings rather than fighting them, while committing to actions guided by their personal values. Often described as a "third-wave" cognitive behavioral therapy, ACT starts from a different premise than traditional CBT: instead of working to change the content of distressing thoughts, it changes your relationship to them, so they hold less power over what you do.

The overall goal is psychological flexibility, the capacity to experience discomfort and still move toward what matters, whether that is connection, health, work, or family. Research supports ACT across a range of conditions, including anxiety and depression. Dr. Stern integrates ACT into her psychiatric practice for eating disorders and anxiety, offering it in person in Fraser, CO and through telepsychiatry across Colorado.

ACT works by building psychological flexibility through six interconnected processes, so difficult thoughts and feelings stop dictating your behavior. Rather than treating anxiety, shame, or self-criticism as problems to eliminate, ACT teaches skills for carrying them differently:

• Acceptance and defusion: allowing difficult feelings to be present and creating distance from unhelpful thoughts so they lose their grip
• Present-moment awareness: attending to experience as it actually is, not as the mind insists it should be
• Self-as-context: recognizing you are more than your thoughts or history
• Values and committed action: identifying what truly matters and building behavior patterns that align with it, even when discomfort shows up

Change comes from practicing these skills in real situations until valued action becomes the default. Dr. Stern uses ACT within her broader psychiatric care, combining it with evaluation and medication management when that serves treatment.

ACT is used for a broad range of conditions, including anxiety disorders, depression, chronic stress, eating disorders, and chronic pain. Because it targets the common processes underneath many diagnoses, especially avoidance of uncomfortable thoughts and feelings, researchers describe it as a transdiagnostic treatment, and research supports its use across these areas.

ACT is especially valuable for anxiety, where it helps people stop organizing their lives around avoiding feared situations and internal sensations, and instead build engagement and purpose. It is also a powerful fit for eating disorders, where shame, rigidity, and avoidance are central: rather than battling every thought about food and body, patients learn to observe those thoughts and act on their values, such as nourishment, connection, and health. These two areas are the focus of Dr. Stern's practice, where ACT complements CBT, ERP, and medication management within a single treatment plan.

ACT is comparably effective to CBT for many conditions; meta-analyses generally find similar outcomes for anxiety and depression, with neither approach consistently outperforming the other. The more useful question is usually which approach fits you. Traditional CBT suits people who respond well to analyzing and restructuring thoughts. ACT often fits people who feel they have already argued with their thoughts for years without relief, who struggle with chronic avoidance, or whose distress centers on shame and self-judgment that resists logical challenge.

The two are not rivals in practice; many clinicians blend them, and ACT complements exposure-based work well. Since Dr. Stern offers both cognitive behavioral therapy and ACT, along with ERP and psychodynamic therapy, she can recommend an approach after your evaluation and shift the emphasis over time based on how you respond rather than locking you into one model.

No, ACT does not aim to get rid of negative thoughts; it changes your relationship to them so they carry less power over your behavior. This is one of the most common misconceptions about the approach. Decades of research on thought suppression suggest that trying to force thoughts away often makes them louder, and many people arrive in treatment exhausted from exactly that fight. ACT offers a different move: through defusion techniques, you learn to notice a thought as a thought ("I'm having the thought that I'll embarrass myself") rather than as a fact demanding obedience.

Paradoxically, when thoughts are held more lightly, they often become quieter and less frequent on their own; that is a welcome side effect rather than the goal. Dr. Stern teaches these defusion and acceptance skills as part of ACT-informed treatment for anxiety and eating disorders across Colorado.

An ACT session is active and experiential, built around exercises, metaphors, and values work rather than only talking about problems. A typical session might open by checking in on committed actions from the previous week, then move into practice: a brief mindfulness exercise to ground attention, a defusion exercise such as repeating a sticky thought until it loses its charge, or a metaphor that reframes the struggle (passengers on a bus you keep driving, or quicksand you stop fighting). Values work is woven throughout, clarifying what you want your life to be about and translating it into one or two concrete actions to take before the next session.

Expect to participate rather than just report. In Dr. Stern's 45- and 60-minute appointments, ACT work can also sit alongside psychiatric evaluation and medication management within the same visit when needed.