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
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.
| Compare | CBT | ACT |
|---|---|---|
| Hard thoughts | Check whether a thought is accurate and change it | Notice the thought, make room for it, and act on your values anyway |
| Main tools | Thought records, behavioural experiments, activity planning, and facing fears step by step | Mindfulness, defusion, values work, and committed action |
| Progress | Thoughts feel more balanced, and you face situations you used to avoid | You do more of what matters to you, even when hard thoughts show up |
| Often used for | Anxiety, depression, phobias, and many other concerns | Depression, anxiety, stress, and substance use |
| Style | Structured and time-limited, often 6 to 20 sessions | Flexible, built around six core processes |
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.
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.
Wondering whether CBT or ACT is the right approach for you? A free 20-minute consultation with our intake team is a friendly, low-pressure way to talk about what you're looking for and get matched with a therapist whose style fits you.
Book a free matching consultACT 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).
You can read how our therapists use ACT on our ACT therapy page.
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.
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.
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.
Book a Free ConsultationLearn more about CBT therapy at Trillium
Both can help with anxiety, and neither has been shown to work better across the board. CBT is particularly effective for anxiety and depression (CAMH), and ACT has been applied to anxiety, depression, stress, and substance use (APA Dictionary of Psychology). The approach that fits how you think, and what you want from therapy, is usually a good place to start.
Can you use ACT and CBT together?Yes. They come from the same family of therapies, and some therapists draw on both, such as using a thought record for one problem and values work or defusion for another. Your therapist can blend them to suit your goals.
What is cognitive defusion in ACT?Cognitive defusion means stepping back from a thought and noticing it as a thought, rather than treating it as the truth. You might say "I'm having the thought that I'll never succeed" instead of "I'll never succeed," which lowers the thought's pull without arguing with it (Hayes et al., Behavior Therapy).
Is ACT just accepting things the way they are?No. Acceptance in ACT isn't passive tolerance or resignation. It's an intentional choice to make room for hard thoughts and feelings so you can put your energy into living by your values (Hayes et al., Behavior Therapy), and committed action, taking steps toward those values, is half of the therapy's name.
If you or someone you know needs support right now, help is available:
About the reviewer — Devon Jorge, MSW, RSW, Registered Social Worker, Psychotherapist — Devon is the Clinical Director at Trillium Counselling and a Registered Social Worker who provides psychotherapy to clients. She reviews Trillium's educational articles to help ensure they remain accurate and responsible. Last reviewed in October 2026.
About this article — This article is intended for general education about mental health and the therapy process. It is not a substitute for professional diagnosis, treatment, or individualized mental health advice. If you have concerns about your mental health, please speak with a qualified health professional or contact local crisis services in an emergency.