CBT vs ACT: What's the Difference, and Which Fits You?

CBT helps you change unhelpful thoughts. Acceptance and commitment therapy (ACT) helps you make room for those thoughts and still act on what matters to you. ACT is part of the cognitive behavioural family and is based on the work of psychologist Steven C. Hayes. A review of 39 studies found that people who did ACT improved more than people who got no treatment or their usual care. ACT and CBT worked about equally well. So the choice often comes down to how you'd like to handle your thoughts: change them, or learn to live alongside them.

Last updated: October 2026

What is the difference between ACT and CBT?

Both help you change how hard thoughts and feelings affect your life. The difference is in how they handle the thought itself. In CBT, you check whether a thought is accurate and work to change it. In ACT, you notice the thought, let it be there, and put your energy into acting on what matters to you, because ACT targets how you relate to thoughts rather than what they say (Cochrane).

At Trillium, our therapists offer cognitive behavioural therapy and ACT in person in Waterloo and online across Ontario, and they can talk with you about which approach fits.

Is ACT a form of CBT?

Yes. ACT is a form of cognitive behaviour therapy (APA Dictionary of Psychology), and its developers describe it as part of the larger family of behavioural and cognitive therapies (Hayes et al., Behavior Therapy). It's often grouped with DBT and mindfulness-based cognitive therapy as a "third wave" approach, because these therapies focus on how you relate to your thoughts and help you accept them without judgment (Cochrane).

DBT is another member of this family. Our guide to the difference between CBT and DBT explains how it compares.

How does CBT handle difficult thoughts?

CBT teaches you to see thoughts as ideas about what's going on, rather than as facts (CAMH). You learn to catch an automatic thought, weigh the evidence for and against it, and reach a more balanced view. You also test thoughts through action, such as a behavioural experiment where you check whether what you fear actually happens.

If you've ever talked yourself down from a worst-case thought by asking "What's the evidence?", you've used a CBT skill. It suits people who find it helpful to examine a thought and update it.

How does ACT handle difficult thoughts?

ACT doesn't try to win the argument with a thought. Its goal is psychological flexibility: being present with what's actually happening, and choosing to keep going or change course in the service of what you value (Hayes et al., Behavior Therapy).

The six core processes of ACT

• Acceptance: making room for hard feelings instead of fighting them. It isn't giving up; it's a deliberate choice to approach what you feel with curiosity.
• Cognitive defusion: stepping back from a thought so it has less pull, such as saying "I'm having the thought that I'll fail" instead of "I'll fail."
• Being present: paying attention to what's happening now, inside you and around you.
• Self as context: the part of you that notices your thoughts and feelings without being defined by them.
• Values: getting clear on what matters to you and the kind of person you want to be.
• Committed action: taking steps, big or small, in the direction of those values.

You can read how our therapists use ACT on our ACT therapy page.

Does ACT or CBT work better?

Neither has been shown to work better overall. A review of 39 trials with 1,821 people found that ACT worked better than placebo comparisons and usual care, and showed no clear difference from CBT (A-Tjak et al., 2015). 

So the choice usually comes down to fit: which way of working makes sense to you, and which therapist you connect with. For more on the research behind CBT, see how well CBT works for anxiety and depression.

How do you choose between ACT and CBT?

CBT may suit you if you like structure, want to work on a specific problem such as worry or a fear, and find it helpful to test your thoughts against the evidence.

ACT may suit you if arguing with your thoughts tends to make them louder, if you're living with something that can't simply be fixed, such as ongoing stress or loss, or if you feel stuck and want to reconnect with what matters to you. You don't have to choose just one, and a therapist can help you decide where to start.

Who would help me with CBT or ACT at Trillium?

At Trillium Counselling, therapy is provided by Registered Social Workers (RSWs) and Registered Psychotherapists (RPs), including therapists trained in CBT and ACT. After a free consultation, our intake team can match you with a therapist whose experience and approach fit what you're looking for. You can meet in person at our Waterloo office or online by video from anywhere in Ontario. Your therapist will talk with you about which approach, or blend, suits your goals. Fees, insurance, and the current team are on our CBT therapy page.

If you're weighing ACT against CBT, you don't have to sort it out alone. A free 20-minute consultation with our intake team is a low-pressure way to share what you're looking for and get matched with a therapist whose approach fits you.

Learn more about CBT therapy at Trillium

Crisis Resources

If you or someone you know needs support right now, help is available:

• 988 Suicide Crisis Helpline (Canada-wide): call or text 9-8-8 — free, confidential, 24/7.
• Here 24/7 (Waterloo–Wellington crisis & mental health line): 1-844-437-3247.
• If someone is in immediate physical danger, call 911.