Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is another therapeutic approach that often includes mindfulness components. It aims to reduce experiential avoidance in a way that does not seek to actively change or control cognition. According to ACT, the abuse of substances like alcohol is a form of experiential avoidance, in that, drinking is often motivated by a desire to regulate unwanted private experiences (e.g., negative affect, craving, withdrawal symptoms). While ACT often includes mindfulness components, it also includes examination of life values and commitment to a valued life direction. The goal of ACT is to foster acceptance of undesirable cognition and affect, and facilitate action tendencies that will lead to improvement in life circumstances. 

Very few studies have evaluated ACT as a treatment for alcohol use disorders and there is insufficient evidence to support its use as a standalone treatment. The only randomised controlled trial in alcohol dependence found brief ACT was less effective than CBT at 5-week follow-up, but better than attention placebo.

Chapter Recommendation Grade of recommendation
9.9 Acceptance and Commitment Therapy should not be offered as a first-line psychosocial intervention for alcohol dependence. B