How ACT Differs From CBT in Treating Anxiety

When it comes to anxiety treatment, Cognitive Behavioral Therapy (CBT) has long been considered the standard. But it’s not the only path forward. Acceptance and Commitment Therapy (ACT) offers an alternative approach that might resonate more deeply with those who feel stuck trying to fix or eliminate their anxious thoughts.

Both CBT and ACT are evidence-based. But they differ in how they view thoughts, emotions, and change. Here’s how ACT stands apart — and how that difference might matter for you.

1. Acceptance Instead of Control

CBT often focuses on changing anxious thoughts to reduce anxiety. This might involve identifying cognitive distortions — like catastrophizing (“If I mess this up, everything will fall apart”) — and challenging them with more balanced evidence (“I’ve made mistakes before and things turned out okay.”).

ACT takes a different stance. Rather than trying to control or get rid of anxiety, it encourages acceptance. ACT helps you learn how to notice your anxious thoughts and feelings without getting swept away by them. It’s not about giving in to anxiety — it’s about letting it exist without letting it run the show.

This shift can be especially helpful when efforts to control anxiety start to feel like a second struggle layered on top of the first.

2. Values Over Symptom Elimination

In CBT, goals often center around symptom relief: reduce anxious thoughts, avoid panic, or improve functioning. ACT, while still interested in reducing suffering, places greater emphasis on moving toward what matters to you.

ACT invites you to get clear on your values — the people, principles, and goals that give your life meaning — and then take action toward those values, even when anxiety is along for the ride. This can lead to a deeper sense of purpose and motivation, especially during hard times.

3. Mindfulness and Present-Moment Awareness

Mindfulness is baked into the core of ACT. It’s about learning how to return to the present moment, especially when your mind wants to spiral into the past or future. In ACT, mindfulness isn’t used as a stress-reduction trick — it’s a daily practice in awareness, non-judgment, and grounding.

While some CBT therapists integrate mindfulness, ACT puts it front and center as a tool for living in alignment with your values, even when life feels chaotic or uncertain.

4. Defusion Instead of Thought Restructuring

CBT uses cognitive restructuring to help you change unhelpful or distorted thoughts. This works well for many people. But some find that the effort to “convince” themselves out of anxiety becomes exhausting.

ACT offers cognitive defusion, a skill that helps you unhook from your thoughts. Instead of debating whether a thought is true, ACT helps you see it as just a thought — a mental event that doesn’t necessarily require a response.

This can be freeing, especially if you’re someone whose anxiety tends to spiral the more you analyze or try to "fix" your thoughts.

5. Committed Action in the Face of Anxiety

CBT often supports gradual exposure to anxiety-provoking situations, ideally when you’ve built up enough coping skills. ACT takes a more direct approach: take meaningful action now, even if anxiety is still present.

Rather than waiting for anxiety to go away before you move forward, ACT asks: What small step can you take today that aligns with your values? This can break cycles of avoidance and create momentum in areas that matter to you.

So, Which Approach Is Right for You?

There’s no one-size-fits-all answer. Some people benefit from the structure and clarity of CBT. Others find ACT’s emphasis on acceptance and values more sustainable. Many therapists (myself included) integrate both approaches depending on your needs and what resonates most.

If you’ve tried traditional anxiety treatments and still feel stuck, or if you’re curious about a more flexible, values-based approach to therapy, ACT might be worth exploring.

You don’t have to choose between fixing yourself and giving up. ACT offers a third option: learning how to carry your anxiety with you while still creating a meaningful, fulfilling life.

Curious to explore ACT, CBT, or a blended approach in therapy? Learn more about anxiety therapy here.