Acceptance and Commitment Therapy (ACT) in Surrey BC
Not sure who to book with? Answer 5 questions and we will suggest counsellors who fit.
Many people arrive at counselling having tried very hard to think their way out of anxiety, low mood, intrusive thoughts or chronic pain. Acceptance and Commitment Therapy, usually said as one word, “act,” starts from a different place. Rather than fighting difficult thoughts and feelings, ACT helps you change your relationship with them so they take up less room, and helps you put your energy into the life you actually want.
Acceptance and Commitment Therapy (ACT) is an evidence-informed, mindfulness-based form of cognitive behavioural therapy. It builds psychological flexibility: the ability to stay present, open up to difficult inner experiences, and take action guided by your values, even when thoughts and feelings are uncomfortable.
At Sojourn Counselling and Neurofeedback in Cloverdale, Surrey, ACT is offered in person and by secure video across British Columbia. You can view therapist profiles and book online through JaneApp, or contact us if you are unsure who to book with.
What Is Acceptance and Commitment Therapy
ACT is a form of psychotherapy developed by psychologist Steven Hayes and colleagues in the 1980s and refined through several decades of research. It belongs to the “third wave” of cognitive behavioural therapies, alongside approaches such as Dialectical Behaviour Therapy and Mindfulness Based Cognitive Therapy. Where traditional CBT often focuses on identifying and changing unhelpful thoughts, ACT focuses on noticing thoughts, holding them more lightly, and choosing how to respond.
The central idea in ACT is that pain is part of being human, and that a great deal of suffering comes from the struggle against pain: avoiding, suppressing, over-analysing or organizing life around not feeling something. ACT calls this experiential avoidance. Therapy aims to loosen that struggle and build psychological flexibility, which research links to better mental health across many conditions.
ACT is not about forcing yourself to feel positive, and “acceptance” does not mean approval or giving up. It means making room for what is already here so that you can act on what matters to you.
Who Can ACT Help
ACT is a transdiagnostic approach, which means it is used across many concerns rather than for a single diagnosis. Research and clinical experience suggest ACT may be a good fit if you are living with:
Anxiety and worry. ACT can help with generalized anxiety, social anxiety, panic and health anxiety by reducing the fight with anxious thoughts and sensations and helping you re-engage with situations you have been avoiding. See our anxiety counselling hub.
Obsessive thoughts and compulsions (OCD). ACT is often combined with exposure and response prevention. It helps you notice intrusive thoughts as thoughts, rather than as commands or truths, and reduces the urge to neutralize them.
Depression and low motivation. ACT works with rumination, self-criticism and withdrawal by reconnecting you with values and small, workable actions. See depression therapy.
Chronic pain and health conditions. ACT for chronic pain has some of the strongest research support of any ACT application. The goal is not to make pain disappear but to reduce its grip on your life and improve function and mood.
Stress and burnout. ACT helps clarify what you value at work and at home and reduces the exhausting patterns of over-control and self-judgment. See burnout counselling.
Grief and loss. ACT offers a way to carry grief with tenderness rather than fighting it, while gently rebuilding a meaningful life. See grief and loss counselling.
Trauma related avoidance. ACT can support trauma recovery, often alongside EMDR or other trauma therapies, by working with avoidance, shame and disconnection from values.
Perfectionism, self-criticism and “stuckness.” ACT is well suited to people who are high functioning but feel trapped by their own standards or by a harsh inner voice.
ADHD and neurodivergent adults. ACT’s emphasis on values, self-compassion and workable action rather than willpower can be helpful for adults navigating ADHD, autism or executive functioning challenges.
Life transitions and identity questions. Career change, parenthood, relationship endings, immigration and cultural transitions all raise the question “what matters to me now?” ACT gives that question structure.
If you are not sure whether ACT fits your situation, our therapists will help you think it through in a first session. You can also read about cognitive behavioural therapy, Internal Family Systems and somatic therapy, which are often combined with ACT at Sojourn.
How Does ACT Work? The Six Core Processes
ACT builds psychological flexibility through six interrelated processes, often drawn as a hexagon called the hexaflex. In sessions, they show up as conversations, brief experiential exercises and metaphors rather than as a checklist. A simple way to remember them is Open, Aware, Engaged.
Acceptance
Making room for uncomfortable feelings, sensations and urges instead of struggling with them. Acceptance is an active skill, practised in small steps, not resignation.
Cognitive Defusion
Learning to see thoughts as thoughts, rather than as facts or orders. Defusion techniques help create a little distance from a thought like “I am going to fail” so it has less pull on your behaviour.
Present Moment Awareness
Flexible attention to the here and now, including your body and surroundings, instead of being lost in the past or future. This is mindfulness in the practical sense; formal meditation is optional. If this side of the work is what draws you, we also offer mindfulness therapy in Surrey as an approach in its own right.
Self as Context
Noticing that there is a “you” that observes thoughts and feelings and is not defined by any one of them. This perspective can loosen rigid self stories such as “I am an anxious person.”
Values
Clarifying what you care about in areas such as relationships, work, health, learning and community. Values are directions rather than goals; they guide choices even when feelings are difficult.
Committed Action
Building patterns of behaviour that move you toward your values, step by step, and returning to them when you drift. This is where change becomes visible in daily life.
Together, the first four processes help you be Open and Aware; values and committed action help you be Engaged.
What Happens in ACT Sessions at Sojourn
Your first session. You and your therapist talk about what has brought you in, what you have already tried, and what you would like to be different. Your therapist will explain how ACT works and check whether it fits your goals. There is no pressure to commit to a set number of sessions.
Experiential rather than lecture based. ACT sessions often include short exercises: noticing a difficult thought and describing it as a thought, a brief grounding practice, a values card sort, or a metaphor such as “passengers on the bus” or “leaves on a stream.” These are done collaboratively and at your pace.
Between sessions. Most people find ACT works best with small, agreed practices between sessions, such as noticing when the mind hooks you, or taking one values based step. These are chosen together and adjusted to real life.
Length and frequency. Sessions are 50 minutes. Many people work in ACT for roughly 8 to 16 sessions, though some come for a briefer, focused piece of work and others continue longer, particularly when ACT is part of trauma or chronic pain care. Weekly or biweekly sessions are common at the start.
ACT vs CBT: What Is the Difference?
ACT grew out of the cognitive behavioural tradition and shares its emphasis on evidence, skills and behaviour change. The main differences are in how each approach handles thoughts and feelings.
| Cognitive Behavioural Therapy (CBT) | Acceptance and Commitment Therapy (ACT) | |
|---|---|---|
| Main aim | Reduce symptoms by changing unhelpful thoughts and behaviours | Build psychological flexibility so symptoms have less influence on your life |
| Approach to thoughts | Identify, test and restructure distorted thinking | Notice thoughts, defuse from them, and choose whether to act on them |
| Approach to feelings | Reduce distress through skills and exposure | Make room for distress while acting on values |
| Role of mindfulness | Sometimes included | Central, in a practical form |
| Role of values | Often implicit | Explicit and central |
| Typical fit | People who want structured tools for specific symptoms | People who feel stuck in the struggle itself, or who have tried to “fix” thoughts without lasting relief |
In practice the two overlap, and many therapists blend them. Research reviews generally find ACT and CBT produce comparable outcomes for anxiety and depression, so the better question is usually which approach fits you. Sojourn also offers cognitive behavioural therapy and DBT-informed skills work.
ACT and DBT. Both are acceptance based. DBT is a structured program built for emotional dysregulation and self-harm risk, with skills modules and often group work. ACT is more flexible and values focused.
ACT and ERP for OCD. Exposure and response prevention remains the best studied treatment for OCD. ACT is frequently used to support ERP by helping people tolerate uncertainty and reduce their fight with intrusive thoughts.
Is ACT Evidence Based?
Yes. ACT is one of the most extensively researched newer forms of cognitive behavioural therapy, with well over a thousand randomized controlled trials worldwide. Here is what the current evidence suggests, stated carefully.
A 2020 review of 20 meta-analyses covering more than 12,000 participants found ACT was effective across anxiety, depression, substance use, chronic pain and mixed conditions, and generally comparable to established treatments including CBT (Gloster et al., 2020). An earlier meta-analysis of 39 randomized trials found a medium overall effect compared with control conditions and no significant difference from other established therapies (A-Tjak et al., 2015). Group ACT shows moderate benefits for anxiety and depression across 48 trials (Ferreira et al., 2022). For OCD, a 2025 meta-analysis of 46 trials of mindfulness and acceptance based programs found large reductions in symptom severity, comparable to CBT and ERP (Bürkle et al., 2025). Internet delivered ACT shows small but meaningful effects across 39 trials (Han and Kim, 2022).
The American Psychological Association’s Society of Clinical Psychology (Division 12) lists ACT as having research support for chronic pain, depression, mixed anxiety disorders, OCD and psychosis.
Honest limits. Many trials are small, results vary between studies, and for chronic pain ACT tends to improve functioning, mood and acceptance more than pain intensity itself. Researchers continue to call for larger, higher quality studies. As with any therapy, outcomes differ from person to person, and ACT is one option among several that our team offers.
References: Gloster et al. (2020) J Contextual Behav Sci 18:181–192; A-Tjak et al. (2015) Psychother Psychosom 84:30–36; Ferreira et al. (2022) J Affect Disord 309:297–308; Bürkle, Schmidt & Fendel (2025) J Anxiety Disord 110:102977; Han & Kim (2022) J Med Internet Res 24:e39727; Martinez-Calderon et al. (2024) J Pain 25:595–617; Williams et al. (2020) Cochrane CD007407; APA Division 12, Society of Clinical Psychology, psychological treatments listings.
ACT and Neurofeedback: Working From Both Directions
ACT is a “top down” approach: it works through attention, language and chosen action. Neurofeedback is a “bottom up” approach that gives the brain real-time feedback to support self-regulation. Some clients at Sojourn choose to combine them, using neurofeedback or NeurOptimal brain training to support calmer baseline arousal while ACT builds the skills to live well alongside difficult thoughts and feelings.
Neurofeedback is not a substitute for therapy or medical care, and combining approaches is not necessary for ACT to be helpful. It is simply an option that a counselling and neurofeedback clinic can offer under one roof.
Meet Our ACT Therapist
Alexandra Defazio, M.Ed
Alexandra is an Associate Therapist at Sojourn who integrates Acceptance and Commitment Therapy with Internal Family Systems, Emotionally Focused Therapy, attachment based, somatic and psychodynamic approaches. She works with young adults, adults, parents and caregivers, and older adults, and has particular interest in grief and loss, life transitions, trauma, relationship challenges and identity exploration. Alexandra is also a NeurOptimal neurofeedback practitioner and offers counselling in English and Spanish. She is available weekdays 9:00 am to 7:30 pm and Saturdays 9:00 am to 2:00 pm, in person in Cloverdale and online across BC.
View Alexandra’s profile · Book with Alexandra on JaneApp
Other Sojourn counsellors draw on acceptance and mindfulness principles within CBT, DBT-informed and Emotionally Focused work. If you are looking for a therapist with a specific focus, availability or fee range, browse our counsellors or contact us and we will help you find a good fit.
Why Choose Sojourn for ACT in Surrey
Sojourn Counselling and Neurofeedback is a team based clinic in Cloverdale, Surrey. Our counsellors are Registered Clinical Counsellors, Registered Marriage and Family Therapists, associate therapists and supervised interns, which means you can choose someone whose experience, approach, availability and fee fit your needs. Our work is trauma-informed and relational, so ACT here is offered with attention to safety, pacing and choice rather than as a rigid protocol.
Because we are also a neurofeedback clinic, we can offer options that many counselling practices cannot, including EMDR, IFS informed work, Emotionally Focused Therapy and brain training, and we help you think through what combination makes sense.
We serve Surrey, Cloverdale, Langley, White Rock and Delta in person, and clients across British Columbia online.
Online ACT Therapy Across British Columbia
ACT translates well to online therapy. Research supports video delivered ACT, and many people appreciate practising skills in their own environment. Sessions are available in person at our Cloverdale, Surrey clinic and by secure video anywhere in British Columbia, including Langley, White Rock, Delta, the Fraser Valley and beyond. See online therapy and telephone counselling.
Fees, Booking and Practical Details
Booking. New and returning clients book through JaneApp, where you can review therapist profiles, fees and availability: sojourncounselling.janeapp.com. If you are unsure who to book with, contact us at 778-381-5868 or info@sojourncounselling.com.
Fees. Registered Clinical Counsellor sessions are typically $160 to $175 per 50 minute session. Supervised intern sessions are $60, with the first session free. Current fees for each therapist are listed in JaneApp. Low cost counselling is available through our intern program.
Extended health. Many extended health plans cover Registered Clinical Counsellors. Payment is due at the time of the appointment unless otherwise arranged, and we can provide receipts for reimbursement. TELUS eClaims direct billing is available for eligible plans with a small service fee.
Cancellation. We ask for 48 hours notice to change or cancel an appointment.
Location. Unit 211, 17696 65A Avenue, Surrey, BC V3S 5N4.
Book ACT Therapy in Surrey or Online
You do not need to have everything figured out before you reach out. If you would like to explore Acceptance and Commitment Therapy, view therapist profiles and book online, or choose a counsellor whose experience and availability fit your needs. If you are unsure where to start, contact us and we can help you find a good fit.
Frequently Asked Questions About ACT
What does ACT stand for?
ACT stands for Acceptance and Commitment Therapy. It is pronounced as one word, “act,” which reflects its focus on taking action guided by your values.
Is ACT a type of CBT?
Yes. ACT is a “third wave” cognitive behavioural therapy. It shares CBT’s emphasis on skills and behaviour change but focuses on changing your relationship with thoughts rather than changing the thoughts themselves.
Does acceptance mean giving up?
No. In ACT, acceptance means willingly making room for feelings and thoughts that are already present, so that you can spend your energy on what matters instead of on the struggle. It is an active stance, not resignation.
Do I have to meditate?
No. ACT uses mindfulness in a practical, flexible way, often through brief exercises in session. Formal meditation can be helpful but is not required.
How many ACT sessions will I need?
It varies. Many people find a focused piece of ACT work takes roughly 8 to 16 sessions; some need fewer, and others continue longer, especially when ACT is part of trauma or chronic pain care. You and your therapist will review progress together.
Is ACT good for OCD and intrusive thoughts?
Research suggests ACT can help with OCD, particularly when combined with exposure and response prevention. ACT helps you relate differently to intrusive thoughts and tolerate uncertainty rather than neutralizing it.
Is ACT helpful for ADHD or autistic adults?
Many neurodivergent adults find ACT’s focus on values, self-compassion and workable action, rather than willpower or “fixing” thoughts, a good fit. Your therapist will adapt exercises to how you process information.
Can I do ACT online?
Yes. ACT translates well to video sessions, and research supports online delivery. Sojourn offers ACT online across British Columbia.
Can I combine ACT with EMDR or neurofeedback?
Yes. ACT can sit alongside EMDR for trauma or neurofeedback for self-regulation. Your therapist will help you decide whether combining approaches makes sense for you.
What if I do not know what my values are?
That is common, and it is part of the work. ACT includes structured, gentle exercises for discovering what you care about, and values often become clearer as you start taking small steps.