Acceptance and Commitment Therapy (ACT) in Maternal Mental Health

ACT is an evidence-based behavioral therapy that has shown growing efficacy in addressing perinatal mood and anxiety disorders (PMADs), birth-related trauma, and the identity shifts that occur across the reproductive lifespan. It is particularly effective for women who are navigating complex emotional experiences, including anxiety, depression, grief, and uncertainty during pregnancy, postpartum, or major life transitions.

ACT helps clients build psychological flexibility—the capacity to stay present with discomfort while taking values-aligned action. In maternal mental health, this means supporting women to move through fear, guilt, intrusive thoughts, and overwhelm with compassion, rather than avoidance or self-judgment.

Clinical Evidence Supporting ACT in Maternal Care

• Waters et al. (2020) conducted an 8-week ACT group intervention for women with moderate-to-severe perinatal anxiety and depression. Results showed significant reductions in distress (d = 1.0), depressive symptoms (d = 1.05), and increases in psychological flexibility (d = 0.93), demonstrating ACT's acceptability and impact in real-world maternal mental health settings.
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• Tunnell (2022) ran a randomized controlled trial with pregnant women using a 7-day self-directed ACT program. Participants reported lower prenatal stress, depression, and negative affect during the treatment period.
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• BMC Pregnancy and Childbirth (2020) published a study protocol for a large-scale RCT using ACT-based self-help to build resilience in pregnant women with subclinical depressive symptoms. The program targets both psychological outcomes and physiological stress markers.
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• UK Pilot Study (2021) found that even a single ACT session significantly reduced childbirth-related fear and anxiety in first-time pregnant women, with high acceptability.
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Why ACT Matters in My Practice

I use ACT with women navigating the perinatal period, trauma recovery, grief, and identity transitions. It supports clients in developing self-compassion, letting go of perfectionism, and reconnecting with their values, even when anxiety or overwhelm is present. ACT is adaptable for individual, group, or retreat-based work and can be tailored to meet each client where they are.

Whether you're navigating motherhood, loss, relationship shifts, or a deep desire to reclaim your identity, ACT offers tools that are both evidence-based and deeply human.

Acceptance and Commitment Therapy (ACT) for Women Facing Cancer

A cancer diagnosis can change everything. From the physical toll of treatment to the emotional and existential weight of uncertainty, women facing breast and gynecologic cancers often navigate fear, grief, identity loss, body image challenges, and shifting roles.

Acceptance and Commitment Therapy (ACT) is an evidence-based approach that helps women cope with the complex emotional experience of cancer—without denying the pain it brings. Rather than focusing on changing how you feel, ACT helps you change how you relate to your experience, so you can move forward with clarity, courage, and self-compassion.

ACT Offers Support for Women With Cancer By:

• Making space for painful emotions (fear, sadness, anger) without becoming overwhelmed by them

• Helping clients reconnect with their personal values—even during illness or recovery

• Supporting body image concerns and identity shifts with mindfulness and compassion

• Encouraging meaningful action, even when energy, certainty, or physical ability are limited

• Reducing emotional avoidance, which is associated with increased distress during treatment

ACT is not about “thinking positive.” It’s about making room for the truth of your experience and choosing to keep moving toward what matters most.

Clinical Research on ACT and Cancer Care

• Feros et al. (2013) studied ACT with cancer patients and found significant reductions in depression, anxiety, and stress, along with increases in quality of life and psychological flexibility. ACT was especially helpful for coping with uncertainty and fear of recurrence.
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• Hulbert-Williams et al. (2015) reviewed the use of ACT in oncology and found promising outcomes in reducing distress, improving coping, and helping patients maintain meaning and purpose throughout the cancer journey.
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• Arch & Mitchell (2016) conducted a randomized trial of ACT for women with breast cancer and found ACT significantly improved distress tolerance and reduced anxiety, even in participants facing recurrence fears.
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• Rost et al. (2012) found ACT improved psychological adjustment in cancer patients more effectively than traditional supportive therapy, particularly in enhancing quality of life and reducing experiential avoidance.
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What ACT Looks Like in My Work with Cancer Patients

ACT creates space for honest conversations about fear, identity, grief, and the unknown. We focus on how you want to live in the midst of everything—not just what’s happening to you.

Together, we may:

• Use mindfulness practices to anchor you in the present moment

• Identify values that still matter (even if goals or roles must shift)

• Explore how to relate more gently to fear, sadness, or pain

• Build a sense of agency and meaning—even when life feels out of control

ACT allows women to experience the full range of their emotions without shame, while still moving forward in ways that feel empowering and authentic.

Acceptance and Commitment Therapy (ACT) for Teen Girls

Adolescence is a time of rapid growth, deep emotions, and complex challenges. Many teen girls struggle with anxiety, depression, body image, self-criticism, or the intense pressure to “get it right.” Acceptance and Commitment Therapy (ACT) is an evidence-based approach that supports teens in building emotional resilience—not by trying to erase hard feelings, but by helping them respond to those feelings in a new, healthier way.

ACT empowers teens to:

• Understand and name their emotions without judgment

• Accept uncomfortable thoughts or feelings instead of avoiding them

• Identify their personal values—who and what really matters to them

• Take action in ways that reflect their values, even when things feel difficult

ACT is not about being positive all the time. It’s about learning how to stay grounded and make meaningful choices—even on hard days.

Through mindfulness practices, creative reflection, and open conversations, ACT helps teens:

• Reduce emotional avoidance and overwhelm

• Navigate social stress, peer pressure, or family conflict

• Reconnect to their identity and self-worth

• Shift from perfectionism and people-pleasing to authenticity

• Cope with anxiety, self-doubt, and sadness in more flexible ways

Clinical Support for ACT with Adolescents

• Swain et al. (2015) conducted a review of ACT interventions for youth and found strong support for ACT in treating anxiety, depression, and behavioral challenges in adolescents. ACT was especially effective in improving emotional regulation and psychological flexibility.
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• Livheim et al. (2015) evaluated an ACT-based group intervention for adolescents with elevated stress and depressive symptoms. They found significant improvements in well-being and functioning. ACT helped teens reduce avoidance and increase values-based actions.
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• Ciarrochi et al. (2011) published research showing ACT improved mental health and well-being in high school students. The more students connected to their values, the less likely they were to engage in avoidance or risky behaviors.
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What ACT Looks Like in My Work with Teens

When working with teen girls, I create a safe, shame-free space to explore what they’re feeling and why it matters. We talk about the stories their minds tell them, the pressure they may feel to be perfect or invisible, and the emotions they may be trying to avoid.

Through simple mindfulness, metaphor, journaling, movement, and creative expression, teens learn to:

• Accept their thoughts and emotions without letting them take over

• Define what matters to them—not what others expect

• Make values-based decisions that feel empowering and true to themselves

ACT meets teens where they are—with honesty, compassion, and real tools for real life.