ACT now for children?

Emily Kruger writes.

Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that helps one accept the difficulties that come with everyday life. Supporters of ACT are keen to help people understand that they’re not governed by thoughts or feelings, or their emotional reactions to things, and their mental ill health does not define who they are as an individual. Thus, although ACT does not completely eliminate difficulties, it is thought that as people learn to accept their thoughts and feelings as constructs rather than facts, they will experience a reduction in psychological distress.

With around 3000 empirical studies to support its effectiveness to date, acceptance-based approaches have also more recently been defined as ‘third wave behavioural therapies’, due to the fact that such methods are not overly concerned with changing thought patterns, and instead aim to change the way individuals relate to mental events, thoughts and feelings whilst being aware of the present moment. Such approaches also draw upon ideas from ancient practices, Buddhism, and meditations, which are combined with psychological frameworks and aspects of cognitive behavioural therapy (Chiesa & Malinowski, 2011).

Despite its credibility in adult populations, research is currently limited in regards to the application of ACT with children and young people. This is despite the fact that there is increased concern over internalising disorders such as depression and anxiety in children and adolescents, with a recent report finding the demand for child and adolescent services to have increased in recent years, with current level of access being insufficient (Frith, 2016). However, a recent paper found evidence for ACT being effective in reducing psychological distress such as anxiety in children (Swain et al., 2015). Similarly, a further study found that ACT approaches outperformed CBT methods, in treating depression in adolescent inpatients (Hayes, Boyd, & Sewell, 2011). It has even been suggested by some professionals that psychological therapies, such as ACT, should be applied universally in schools rather than clinics, to make them more accessible for children whose parent may find it difficult to attend appointments (Wolpert et al., 2011).

Most recently, Gillard, Flaxman and Hooper (2018) discussed guidance for schools in terms of promoting wellbeing in children, with ACT being defined as a coherent model that has the potential to support schools in promoting wellbeing in children due to its clear health benefits. However, this is yet to be a formal approach which is carried out in schools as part of promoting health in children. Is ACT therefore the best option we have in reducing the difficulties which many children face in school, such as anxiety, low-self-esteem and self-limiting beliefs?

Emily Kruger

- Find out more about ACT in our trio of interviews with key figures.


Chiesa, A., & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67, 404-424.

Gillard, D., Flaxman, P., & Hooper, N. (2018) Acceptance and commitment therapy: Applications for educational psychologists working with schools. Educational Psychology in Practice, 32(2).

Wolpert, M., Deighton, J., Patalay, P., Martin, A., Fitzgerald-Yau, N., Demir, E., …Meadows, P. (2011). Me and My School: Findings from the National Evaluation of Targeted Mental Health in. London. Retrieved from

Frith, E. (2016). CentreForum commission on children and young people’s mental health: state of the nation.

Hayes, L., Boyd, C. P., & Sewell, J. (2011). Acceptance and Commitment Therapy for the Treatment of Adolescent Depression: A Pilot Study in a Psychiatric Outpatient Setting. Mindfulness, 2(2), 86–94.

Swain, J., Hancock, K., Dixon, A., & Bowman, J. (2015). Acceptance and Commitment Therapy for children: A systematic review of intervention studies. Journal of Contextual Behavioral Science, 4(2), 73–85.

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