Do gatherings, crowds, events or parties make you nervous, and do you find yourself avoiding these situations? Do you frequently drink more than you planned to when stress becomes overwhelming? Do these ways of trying to gain control keep you from focusing on what’s actually happening in your life right now or distract you from achieving your personal goals?
VA offers a therapy that can help.
Acceptance and commitment therapy (ACT) teaches Veterans how to recognize and respond to internal experiences — such as unwanted thoughts, feelings and physical sensations — in a constructive way. ACT works by building two key processes:
- Mindfulness: Being aware of what’s happening in the moment and relating to your thoughts, feelings and physical sensations without judgement. Recognizing how you feel right now can help you build self-awareness, let go of attempts to get rid of unwanted internal experiences, and learn to live with those experiences in ways that free you to focus on being the person you want to be.
- Psychological flexibility: Making behavioral decisions based on big-picture values and goals rather than short-term reactions to thoughts, feelings and physical sensations. Clarifying what is most meaningful to you and choosing to act on these values, even during stressful moments, are important parts of ACT.
My research and the experiences of other researchers and clinicians have shown that setting intentions, brief mindfulness practice, and choosing to act in ways, even small ways, that are consistent with deeply held personal values can help Veterans living with co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) manage symptoms and improve their daily functioning and life satisfaction. Mindfulness and psychological flexibility can enhance Veterans’ ability to engage in activities that are meaningful to them, even when unwanted, internal experiences continue to occur. By practicing this way of relating to their unwanted internal experiences, their symptoms become less distressing over time.
By participating in ACT, Veterans learn to Accept those experiences they cannot change, Choose a path toward meaning and purpose, and Take concrete actions that help move them toward their goals, moment by moment.
Veterans benefiting from ACT
The ACT approach helps Veterans take an active, acceptance-based stance to experiencing unwanted thoughts, emotions and physical sensations, built on their personal goals. One Veteran participant said ACT provided a “good challenge” because, on the first day, “We sat down and established my goals.” One goal was to reduce drinking and go back to school. Through therapy and active participation in ACT, the Veteran said, “I quit the drinking, and by the end, I was accepted into [the college of my choice].”
Another Veteran said ACT provided the outlet to process all the effects of PTSD, including depression and anxiety.
In an ongoing VA-funded study called IMPACT (Intervening on Modifiable Predictors using Acceptance and Commitment Therapy), my team is testing the preliminary effectiveness of an adapted version of ACT aimed at improving the well-being of Veterans returning from war who are living with PTSD, chronic pain, depression, alcohol use problems or traumatic brain injury (TBI). This research program has previously shown that ACT is a promising treatment for promoting recovery in Veterans with PTSD and AUD. The IMPACT study will continue to reveal new insights through its conclusion in 2022.
VA is making ACT available to many Veterans across the nation whose mental health and functioning may be improved through this promising therapy.
About the VISN 17 Center of Excellence
The VISN 17 Center of Excellence for Research on Returning War Veterans is located at the Doris Miller VA Medical Center in Waco, Texas — which is part of the Central Texas Veterans Health Care System. The VISN 17 Center of Excellence was established to conduct research on the returning post-9/11 Veteran population, which includes Veterans enlisted in any of the military branches during Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn. This center conducts research on a variety of topics, including PTSD, substance use disorders, brain connectivity and TBI, and other related topics.
About the Author: Eric Meyer, Ph.D., is a clinical research psychologist specializing in functional rehabilitation. He is an investigator in the Behavioral Science Core of the VA VISN 17 Center of Excellence for Research on Returning War Veterans in Waco, Texas, at the Central Texas Veterans Health Care System. He also serves as an associate professor of psychiatry for the Health Science Center in Texas A&M University’s College of Medicine.