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CBT and ACT: Two Therapy Approaches and How They Can Work Together

  • Writer: Raven Rinas
    Raven Rinas
  • Sep 9, 2025
  • 2 min read
A woman in a white top and jeans sits on a gray couch in a bright room, looking out a window. Mood is reflective.

Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are two evidence-based approaches that are used to treat a range of mental health concerns. Although they differ in some of their underlying principles, they can be integrated in therapy to meet an individual's goals and needs.


What is CBT?


Cognitive Behavioral Therapy, or CBT, is based on the idea that our thoughts, emotions, behaviours, and physical responses are interconnected. Unhelpful patterns of thinking can contribute to emotional distress and behaviours that maintain difficulties over time. CBT helps people identify these patterns and develop more balanced and helpful ways of responding.


For example, someone who thinks, "I always mess things up," might be encouraged to examine the evidence for that belief and consider whether it is accurate or whether there are alternative ways of understanding the situation.


Research has shown that CBT is effective for a range of mental health concerns, including anxiety and depression (Hofmann et al., 2012).



What Is ACT?


Acceptance and Commitment Therapy (ACT) takes a different approach. Rather than focusing primarily on changing thoughts, ACT helps people develop a different relationship with them. Difficult thoughts and emotions are viewed as a normal part of human experience rather than something that must always be eliminated.


ACT focuses on developing skills such as:

  • Mindfulness: noticing thoughts and emotions without becoming caught up in them.

  • Acceptance: making room for difficult internal experiences rather than struggling against them.

  • Values-guided action: choosing behaviours that are consistent with what matters to you, even when uncomfortable thoughts or emotions are present.


For example, someone experiencing anxiety before a social event may notice the thought, "I'll embarrass myself." Rather than trying to argue with the thought, ACT encourages acknowledging its presence while choosing actions that align with personal values, such as maintaining friendships or building new relationships.


Research also supports the effectiveness of ACT for a range of mental health concerns, including depression (Bai et al., 2020).



How CBT and ACT Work Together


CBT and ACT are often used together in practice.


CBT provides strategies for identifying and evaluating unhelpful patterns of thinking when these contribute to distress. ACT provides strategies for responding more flexibly to difficult thoughts and emotions, particularly when efforts to control or eliminate them are not helpful.


Rather than applying one approach in every situation, therapy can draw on principles from both CBT and ACT depending on your goals, preferences, and the challenges you are experiencing. This allows therapy to be tailored to your individual needs while remaining grounded in evidence-based practice.



References

Bai, Z., Luo, S., Zhang, L., Wu, S., & Chi, I. (2020). Acceptance and commitment therapy (ACT) to reduce depression: A systematic review and meta-analysis. Journal of Affective Disorders, 260, 728–737. https://doi.org/10.1016/j.jad.2019.09.040.


Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1



 
 
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