CBT vs. ACT

Cognitive Behavioral Therapy (CBT) is one of most recognized forms of psychotherapy and is often used in the treatment of DGBIs. However, a growing body of research supports the use of Acceptance and Commitment Therapy (ACT) when addressing GI-related distress, which can compound the discomfort of the DGBI.

Below is a side-by-side comparison of the two theoretical orientations:

CBT	ACT
Developed by Aaron Beck	Developed by Steven Hayes
Goal: To decrease suffering	Goal: To live a values-driven life (AKA, the life you want to live)
Theory: 1.        Our thoughts/perceptions/beliefs can impact our emotions and behaviors. 2.        We can restructure our cognitions so that they can be helpful rather than destructive, which can then reduce our suffering.	Theory: 1.        Acceptance of human experiences includes both desirable and undesirable states. When we try to avoid undesirable feelings, we can create suffering. 2.        When we live a values-driven life, our behaviors and decisions make sense to us, our future life trajectory becomes more clear, and we have a better sense of our purpose in this world, 3.        Mindfulness and psychological flexibility create the pathway to a values-driven life.
Source of Suffering: Unhelpful thoughts/beliefs/perceptions “Why do I always make the same mistake over and over!” “He is judging me and I can't stand it" “If I wasn't so OCD my life would be easier"	Source of Suffering: Avoidance and lack of mindfulness “I can't spend time with loved ones because something embarrassing will happen" “I was justified in lashing out because I was angry" “I need to just work harder to ignore my sadness"
Method: 1.        Challenge and change our thoughts/beliefs/perceptions to be more helpful 2.        Experiment with different behaviors in order to help prove/disprove our beliefs	Method: 1.        Acceptance of our human-ness, including desirable and undesirable experiences 2.        Improve psychological flexibility (ability to make adjustments in an “unstuck” way) 3.        Increase mindfulness in order to live more fully in the now 4.        Identification of and commitment to values
Not as helpful if one does not have distorted thoughts or if thoughts are somewhat true – "IBS has made every aspect of my life harder" is often times a somewhat true thought and it would be invalidating to suggest that one should change that thought.	Not as helpful if the person is already living a values-driven life (they are not avoiding things that make life feel meaningful) or if decreased suffering is more important than values.