Benefits Of Acceptance and Commitment Therapy for Older Adults

As a caregiver or adult child of an older adult, you may be seeking ways to support their mental health. With several therapy options available, choosing an approach that speaks to the unique emotional and mental challenges of aging can feel overwhelming.

Acceptance and commitment therapy (ACT) is a form of talk therapy that helps people accept difficult thoughts and feelings rather than fighting them. It also encourages actions guided by their core values. This therapy approach doesn’t aim to “fix” every problem, but can provide healthier ways to cope with change, loss, and uncertainty. 

Key takeaways

• Acceptance and commitment therapy (ACT) helps older adults cope with unchangeable life challenges by building psychological flexibility and focusing on what still gives life meaning.
• Rather than trying to eliminate unhelpful thoughts or feelings, ACT teaches seniors practical skills to remain engaged in valued activities despite discomfort.
• ACT is an evidence-based therapy that supports seniors dealing with mental health struggles, and can also be effectively delivered virtually.

What is acceptance and commitment therapy?

Acceptance and commitment therapy, or simply ACT, is a type of psychotherapy or talk therapy. With a therapist’s support, people learn to accept negative thoughts and feelings while maintaining a commitment to personal values. 

Research shows that web-based ACT can help older adults dealing with loneliness. Loneliness is a significant risk factor for depression, anxiety, dementia, and physical problems (e.g., heart disease, stroke, high blood pressure) in seniors. Early intervention with ACT could help reduce your loved one’s risk of more severe health complications.

Seniors often feel a loss of control, likely due to declines in cognitive and physical abilities and increased dependence on others. While ACT focuses on accepting problems like these, it’s not the same as resignation. Acceptance involves recognizing the lack of control while committing to living a life aligned with a person’s values. In contrast, resignation abandons all hope, leaving a person feeling stuck and powerless. 

Why ACT is uniquely helpful for older adults

ACT is particularly helpful for older adults, as it acknowledges the reality of age-related challenges that can’t always be changed. Chronic pain, loss of friends, cognitive changes, and mobility issues are common parts of aging, yet many seniors struggle with accepting these experiences.

A core concept within acceptance and commitment therapy is psychological flexibility. It is the ability to stay present, remain open to difficult thoughts and feelings, and take action based on personal values. Developing psychological flexibility can help older adults respond to life challenges with less resistance and self-criticism, relieving emotional distress. Rather than focusing on what’s been lost, ACT supports seniors in shifting their mindset toward what is still meaningful and within their control.

How acceptance and commitment therapy differs from CBT

Cognitive behavioral therapy (CBT) is a type of talk therapy that helps individuals identify and change negative thinking patterns. While both CBT and acceptance and commitment therapy are evidence-based approaches, their goals and methods differ. CBT equips older adults with the tools to challenge and reframe unhelpful thoughts to reduce symptoms of mental health conditions. In contrast, ACT focuses on accepting difficult thoughts and feelings, while building psychological flexibility and living a values-driven life.

ACT (acceptance and commitment therapy)

• Main focus: Accepting thoughts and feelings while acting on personal values
• View of difficult thoughts and emotions: Thoughts and emotions are noticed without trying to change them
• Primary goal: Psychological flexibility and a meaningful life
• Helpful for older adults when… Stress comes from things that can’t be changed, like chronic illness or loss
• Example: An older adult notices the thought “I’m useless now,” lets it pass, and still engages in the things that matter most to them
  
  

CBT (cognitive behavioral therapy)

• Main focus: Changing unhelpful thoughts to reduce symptoms
• View of difficult thoughts and emotions: Thoughts and emotions are challenged and reframed
• Primary goal: Symptom relief and improved mood
• Helpful for older adults when… Negative thinking patterns are driving anxiety or depression
• Example: An older adult learns to challenge the thought “I’m useless now” and replace it with a more balanced one

Both types of therapy can be beneficial for a senior’s mental health. However, some may find ACT to be less frustrating than CBT — particularly when dealing with unchangeable health conditions. CBT emphasizes identifying and challenging unhelpful thoughts and feelings. Because of this, the therapy can feel discouraging if those thoughts are rooted in real limitations rather than irrational beliefs. 

Another reason some seniors may prefer ACT is its emphasis on simply noticing thoughts rather than trying to “fix” them. For older adults experiencing cognitive changes or fatigue, actively challenging thoughts may feel overwhelming. ACT encourages acknowledging thoughts as they arise without the pressure to alter them, which can feel more accessible and compassionate. 

Although ACT and CBT take different approaches, they can work well together. CBT can help older adults understand and respond to negative thoughts, while ACT supports them in accepting their experiences and living by their values.

Working with a mental health professional can help determine whether ACT, CBT, or a combination of both can best support an older adult’s mental well-being.

ACT techniques and what they look like in practice

ACT takes a values-driven approach, meaning therapy focuses on what gives a person’s life meaning rather than eliminating discomfort. For seniors, core values may include independence, connection, creativity, spirituality, dignity, or contributing to others.

In therapy, their values may be identified through guided reflection, open-ended conversations, and exercises that explore what still feels important to them despite health changes or limitations. By clarifying these values, ACT helps older adults make decisions that align with what matters most — even when circumstances can’t be changed.

Defusion

ACT teaches practical skills that help seniors stay engaged in meaningful activities even when difficult thoughts or physical discomfort arise. One core process is defusion, which involves creating distance from unhelpful thoughts by recognizing them as passing mental events rather than facts. For seniors dealing with health anxieties or regrets, defusion can reduce the pull of repetitive “what if” thoughts and lessen their emotional impact.

Mindfulness

Mindfulness is another key component of ACT, but it doesn’t require formal meditation or clearing the mind. Instead, mindfulness in ACT involves noticing thoughts, emotions, and physical sensations in the present moment without judgment or needing to change them. Alongside acceptance and self-compassion, mindfulness supports committed action — the practice of choosing behaviors that align with personal values.

For example, a senior who values connection may notice anxious thoughts or physical discomfort while conversing with family. Using acceptance and commitment techniques like mindfulness and defusion, they can acknowledge those challenging feelings without engaging with them, and refocus on the interaction itself.

What acceptance and commitment therapy is used for

Research shows that ACT can help seniors manage loneliness, depression, anxiety, grief, post-traumatic stress disorder (PTSD), and chronic pain. By strengthening psychological flexibility, ACT helps older adults navigate age-related challenges while continuing to engage in value-driven actions that support a more meaningful life.

When ACT is used with older adults, therapists may make thoughtful modifications to accommodate age-related needs. These adjustments can include:

• A slower pace
• Extended sessions
• Simplified language,
• Practical changes, such as larger fonts or bold print for worksheets and homework 

These types of adaptations help ensure acceptance and commitment therapy remains accessible, even for seniors experiencing mild cognitive changes.

When ACT may not be the best option

Although research supports the use of ACT in treating older adults, it may not be suitable for everyone. It may be less appropriate for seniors experiencing an acute mental health crisis — such as suicidal ideation, self-harm, or severe cognitive impairment. It may also not be the best fit for those who are unwilling to engage with its acceptance-based approach. In these instances, other forms of care may be more appropriate.

Online acceptance and commitment therapy for seniors

Mobility challenges can make it difficult for some older adults to access in-person care, but online ACT has shown promising results. Research indicates that online ACT interventions can significantly reduce loneliness among older adults. A case study suggests improvements in chronic pain and overall functioning in an older woman through online delivery. For many seniors, teletherapy offers a convenient and effective way to receive consistent mental health support.

If you’re the caregiver or adult child of an older adult who's struggling with their mental health, Sailor Health can help. Our team includes mental health professionals with specialized training in ACT, and we offer telehealth via computer, phone, or even landline. Plus, most Medicare patients have a $0 copay. We’re here to give seniors and their families peace of mind and support that makes a meaningful difference. Reach out today to get started.

Sources

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