Understanding the Difference Between CBT and ACT

I speak to a lot of people who've tried therapy before. A lot of people say to me:

 "I did CBT. It was okay, but it didn't really work for me." 

Or even more honestly: 

"I didn't get on with it. I don't really want to do that again."

I understand that. And I want to say something important upfront: if CBT hasn't felt right for you, that doesn't mean therapy isn't for you. There are a number of reasons it might not have landed. Sometimes the approach itself isn't the right fit for how you think and process things, and sometimes it comes down to how the therapy was delivered. CBT is a skill, and like any clinical skill, the quality of delivery varies. A less-than-helpful experience may say more about the therapist than about the therapy itself.

There is no one-size-fits-all in therapy. Different people respond to different approaches, and finding the right fit matters enormously. CBT is not the only evidence-based therapy out there.

One of the most effective alternatives, ACT, works in a fundamentally different way.

Let me explain.

First, What Is CBT?

Cognitive Behavioural Therapy is probably the most widely known form of talking therapy, and for good reason, it has an impressive evidence base and has helped millions of people. At its core, CBT is built on the idea that our thoughts, feelings, and behaviours are interconnected. When we're struggling, it's often because we've developed unhelpful thinking patterns, catastrophising, self-criticism and avoidance. CBT helps us identify and challenge those patterns.

In practice, this means a lot of work examining the content of your thoughts. You might be asked to keep a thought diary, to identify cognitive distortions, and to practise replacing unhelpful thoughts with more balanced ones. The goal, broadly speaking, is to feel better by thinking differently.

For many people, this is genuinely transformative. But for others, it can feel like an uphill battle. Some people find that the instruction to "challenge" a negative thought just leads to more rumination. Others feel that no matter how many times they reframe their thinking, the anxiety or low mood keeps coming back. And some find the structured, somewhat analytical approach doesn't suit the way they naturally process things.

So What Is ACT?

ACT stands for Acceptance and Commitment Therapy. ACT takes a different starting point. 

Where CBT asks "how can we change these thoughts?"

ACT asks a more radical question: "what if we didn't need to?"

ACT is built on the premise that the struggle to control or eliminate difficult thoughts and feelings is often what causes us the most suffering. Not the thoughts and feelings themselves. Rather than trying to think your way out of distress, ACT invites you to change your relationship with your inner experience.

There are three central ideas worth understanding:

1. Acceptance, not resignation. ACT encourages us to make room for uncomfortable thoughts, feelings, and sensations rather than fighting them. This isn't the same as giving up or saying everything is fine. It means loosening the grip of the struggle — because when we stop pouring energy into resisting how we feel, we often find more freedom to move.

2. Defusion is creating distance from your thoughts. One of ACT's most distinctive techniques is what's called cognitive defusion: learning to observe your thoughts rather than being fused with them. Instead of "I am a failure", you might learn to notice "I'm having the thought that I'm a failure." It sounds subtle, but the shift it creates can be profound. Your thoughts become events passing through your mind, rather than facts about who you are.

3. Values and committed action. Rather than focusing primarily on reducing symptoms, ACT places enormous emphasis on what matters to you — your values — and helping you move towards the life you want to live, even in the presence of difficult feelings. This is an especially important distinction. ACT doesn't wait for you to feel better before encouraging you to live more fully.

At Towards, we have therapists who are trained in ACT, CBT, counselling and other evidence-based therapies. We take the time to match people to the approach that's most likely to fit their needs, history, and goals. There's no one-size-fits-all in therapy, and there shouldn't be.

Whether you've never tried therapy, are dipping a toe back in after a difficult experience, or are simply curious about what else is out there — we'd love to have that conversation with you.

Dr Sarah Bateup is Chief Clinical Officer at Towards, where she leads clinical training and quality across the therapy practice. If you'd like to find out more about therapy at Towards, get in touch with our team.