What Is the Difference Between ACT and CBT?

Cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are both effective, evidence-based talk therapies. Both methods are widely used to help people manage anxiety, depression, and other emotional challenges. But while they share some similarities, ACT and CBT differ in important ways.

Understanding the difference between ACT and CBT can help you decide which therapeutic approach may be the best fit for you. It can also help you better understand the work you’re already doing in therapy, if you’re already seeing a therapist.

What is cognitive-behavioral therapy?

CBT is a structured, skills-based form of therapy that focuses on helping people change unhelpful patterns of thinking and behavior that contribute to emotional distress. It works by giving people the skills to:

• Identify negative or inaccurate thought patterns
• Understand how thoughts influence emotions and behaviors
• Practice new ways of thinking and responding to challenging situations

Unlike some other forms of therapy, CBT mostly focuses on the present rather than exploring the past. The goal is to build practical skills that can be used in everyday life to manage stress, emotions, and behavioral patterns more effectively. CBT can be used for depression, anxiety, PTSD, and many other mental health conditions.

CBT is goal-oriented and collaborative. It can even be used in group settings, where CBT skills can be applied so participants can learn from shared experiences and practice strategies together.

What is acceptance and commitment therapy?

ACT is also a behavior-based therapy, but it takes a different approach to thoughts and emotions.

Rather than trying to change or eliminate uncomfortable thoughts and feelings, ACT encourages people to change their relationship to those experiences. It aims to increase psychological flexibility, which means being able to stay present, open, and engaged in life—even when things feel difficult. Skills learned in ACT sessions include:

• Acceptance of internal experiences rather than constant control or avoidance
• Mindfulness and present-moment awareness
• Clarifying personal values
• Taking committed action aligned with what matters most

The goal of ACT is within its name: accept that experiences or reactions won’t always be ideal, but commit to staying on track with actions that back your values. One of the benefits of an ACT program is that it’s highly effective for helping people with many types of mental health conditions, like anxiety, depression, and even addiction recovery.

Is ACT a type of CBT?

Sometimes, ACT is described as a “third-wave” behavioral therapy. This means it grew out of earlier cognitive and behavioral approaches, including CBT, but expanded the focus beyond trying to change thoughts.

While traditional CBT often works to challenge and restructure thoughts, ACT emphasizes acceptance, mindfulness, and values-based action. Both approaches are grounded in behavioral science and are considered evidence-based, but they use different strategies to promote change. However different they are, ACT and CBT can be used together and are complementary, since they teach different skills.

What are the differences between ACT and CBT?

Although ACT and CBT share common roots, their core differences lie in how they work with thoughts, emotions, and behavior.

CBT

• “Is this thought accurate or helpful?”
• Identifying and changing unhelpful thoughts
• Developing coping skills and problem-solving strategies
• Reducing distress by modifying thinking and behavior patterns

ACT

• “Can I make room for this experience and still move toward what matters to me?”
• Accepting thoughts and feelings rather than fighting them
• Developing mindfulness and psychological flexibility
• Clarifying values and committing to meaningful action

How ACT and CBT sessions feel different

The difference between ACT and CBT might become clearest to you in how therapy feels session-to-session.

CBT Sessions

Here’s what you can expect in CBT sessions:

• Learning specific tools and strategies
• Practicing skills like thought-challenging or behavior experiments
• Tracking patterns between thoughts, emotions, and actions

ACT Sessions

ACT sessions, on the other hand, will guide you through:

• Noticing thoughts and feelings without trying to eliminate them
• Practicing mindfulness and present-moment awareness
• Identifying personal values and taking small, meaningful steps forward

Neither approach is better or worse—just different. Some people find structure and skills especially helpful, while others benefit from learning how to stop struggling with their internal experiences.

What does the research say?

Research consistently shows that both ACT and CBT are effective. A 2023 study comparing ACT and traditional CBT found that:

• Traditional CBT showed a small advantage for reducing anxiety symptoms in both short- and long-term follow-up
• ACT showed a short-term advantage for increasing mindfulness skills
• Dropout rates were similar between ACT and CBT

The researchers also noted that outcomes may vary depending on individual characteristics and treatment goals. These findings support the idea that different therapeutic processes can be helpful for different people at different times.

Which one is right for you?

Choosing ACT or CBT doesn’t mean you’re looking for the “better” therapy. You’re looking for the right fit at the right time. And your therapist may recommend having both types of sessions in your treatment plan.

When CBT may be right

• You want structured tools and strategies
• You prefer a more problem-solving, skills-focused approach
• You feel overwhelmed by persistent negative thinking

When ACT may be right

• You feel stuck fighting your thoughts or emotions
• You want to focus on values, meaning, and long-term life direction
• You’re interested in mindfulness-based approaches

Find the right mental health therapy at our Massachusetts treatment center.

How we use both ACT and CBT at Rockland Recovery Behavioral Health

At Rockland Recovery Behavioral Health, we use both ACT and CBT in our group-based, outpatient programs. Our approach is trauma-informed, evidence-based, and non-shaming.

Rather than rigidly adhering to a single model, our clinicians thoughtfully apply ACT and CBT principles based on what will best support each group and individual. Mindfulness practices are woven throughout our programming, helping clients build awareness, flexibility, and resilience.

Our programs are designed for adults who need meaningful mental health support without putting their entire lives on hold. You can start therapy at our Sharon, MA, location by calling 855.520.0531 or messaging us online now. Or, drop by and meet our staff to find out if we’re the right fit for your life.