Demystifying ACT: A Practical Guide for Therapists

Learn how to apply ACT principles in your everyday practice.  Earn 5 CE/CME credits.

How ACT Works for OCD

By Kate Morrison, Ph.D.

This video is part of our upcoming online course about ACT for OCD.


  • Obsessive-compulsive disorder consists of 3 main components: obsessions, compulsions, and the disorder aspect.
  • ACT is an acceptance and mindfulness-based behavioral intervention and is used for OCD. It’s based on relational frame theory and rule-governed behavior.
  • Treatment goals within ACT are to have a healthy relationship with internal experiences and increase behavior patterns that align with the individual’s values.
  • ACT for OCD has a strong research base and has been found to be an effective treatment.



You’ve reached the end of Module 1. So we’re going to talk about the take-home messages from this module.

Obsessive-compulsive disorder consists of 3 main components. Distressing intrusive thoughts, images, and urges, which are the obsessions. Excessive repetitive behaviors that are mental and physical, those are the compulsions. And the disorder aspect of the word refers to that these have a negative impact on the person’s life.
OCD can look similar to other disorders. So when you are working with someone that has OCD, make sure to rule out the other potential symptoms and diagnoses that the person may have in order to guide your treatment planning.

Acceptance and commitment therapy, also known as ACT, is an acceptance and mindfulness-based behavioral intervention, and it is used often for OCD. It’s based on the basic behavioral science of language and cognition, referred to as RFT, relational frame theory, and rule-governed behavior.

ACT focuses on the ways that we interact with our internal experiences, rather than attempting to change those internal experiences which can be unchangeable.

ACT aims to increase psychological flexibility. It’s the main mechanism of change and it does that through 6 core processes. These are being in the present moment, acceptance, defusion, self-as-context, values, and committed action.

The treatment goals within ACT are to have a healthy relationship with internal experiences. So this is to be open, disentangled from them, and present and aware—and to increase behavior patterns that align with the individual’s values.

Progress in ACT is measured through behavioral measures and self-report measures. And Behavioral measures can include tracking the quantity of compulsions or problematic behaviors, and it can be used to track the engagement and valued behaviors or behaviors that are more useful or healthy for them. Self-report measures can include measures of psychological flexibility, specifically, the AAQ-II. OCD severity measures are partially inconsistent with the ACT framework—some OCD severity measures—but they still provide value and I still recommend including those as part of your assessment.

Exposure and response prevention or ERP: it’s recommended as the first behavioral treatment to use in treating OCD, just based on the robust evidence base that it has.

Yet when you have clients that don’t respond to ERP, or they choose not to participate in a course of ERP, ACT is a great option. ACT for OCD has a strong research base. It just has fewer studies than ERP at this time. ACT has been studied with and without exposures and has been found to be effective in both of those scenarios.
Congratulations for finishing Module 1 and I will see you in Module 2.

More ACT for OCD presentations