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Acceptance and Commitment Therapy in Sacramento, CA

Acceptance and Commitment Therapy (ACT) is an evidence-based psychotherapy that builds psychological flexibility — the capacity to engage with painful thoughts, feelings, and experiences while continuing to act in line with personal values. Rather than aiming to eliminate or directly change difficult thoughts (as standard CBT does), ACT works to change the relationship to those thoughts, freeing the person to live according to what matters most. At our Cal DSS-licensed residential program in Roseville, our clinical team uses ACT alongside other evidence-based modalities for adults across Greater Sacramento and Placer County. We admit and treat directly.

ACT was developed by Steven Hayes and colleagues beginning in the 1980s and is part of the “third wave” of behavioral therapies — building on the foundation of CBT while shifting emphasis toward acceptance, mindfulness, and values-driven action. Over the past two decades, the evidence base has grown substantially, with strong empirical support for ACT in treating depression, anxiety disorders, chronic pain, OCD, substance use disorders, and as an adjunctive treatment for psychosis.

What makes ACT clinically distinctive is its philosophical departure from traditional cognitive therapy. Where standard CBT identifies and changes unhelpful thoughts, ACT recognizes that the human attempt to control internal experience is itself often what maintains suffering. ACT works through six interlocking processes — cognitive defusion (seeing thoughts as thoughts rather than literal truths), acceptance (making room for difficult feelings rather than struggling against them), present-moment awareness, self-as-context (perspective-taking on the self), values clarification, and committed action toward those values. The goal is not symptom elimination but the capacity to live a meaningful life alongside the difficult internal experiences that are part of being human.

ACT works particularly well for adults whose mental health condition has become organized around the struggle to control or eliminate distressing internal experience — the person whose anxiety is now amplified by anxiety about anxiety, the depression that has become a referendum on personal worth, the trauma response that the person believes must be eliminated before life can resume. Residential ACT provides the immersive intensity and integrated environment that this work often requires.

Conditions We Treat With ACT

ACT is a core component of treatment for several conditions our residential program addresses. The work integrates with other evidence-based modalities depending on the diagnosis.

Anxiety Disorders

ACT has strong evidence support for generalized anxiety disorder, panic disorder, social anxiety, and health anxiety. The work targets the experiential avoidance that maintains anxiety — the constant struggle against anxious thoughts and sensations that paradoxically keeps anxiety in the foreground. Learn about residential anxiety treatment.

Depression

For depression — particularly treatment-resistant or chronic depression where standard CBT has been tried — ACT often opens a different therapeutic path. The work addresses the rumination, self-criticism, and behavioral withdrawal characteristic of depression by changing the relationship to depressive thoughts rather than trying to argue with them. Learn about residential depression treatment.

OCD and Intrusive Thoughts

ACT is increasingly integrated with ERP for OCD treatment, particularly for adults with significant struggle around the intrusive thoughts themselves — the meta-anxiety of “why am I having these thoughts, what does it say about me.” Defusion work and acceptance of the thoughts as thoughts (rather than threats requiring response) supports the ERP work. Learn about residential OCD treatment.

Chronic Pain (When Co-Occurring)

ACT has substantial evidence for chronic pain — not as pain-reduction therapy, but as a framework for living a values-driven life alongside chronic pain that hasn’t fully resolved. When chronic pain is complicating treatment of a primary mental health condition, ACT principles are often integral.

Substance Use Disorders

ACT has evidence support for substance use disorders, particularly the function of substances as experiential avoidance. The work identifies what the substance use was avoiding and builds the willingness to engage with that experience while taking values-aligned action. Learn about residential SUD treatment.

Adjunctive Treatment for Psychosis

ACT-informed approaches to psychosis focus on relationship to voices and unusual experiences rather than direct symptom elimination, supporting medication-based treatment with quality-of-life-focused therapy work. Used adjunctively alongside antipsychotic treatment.

Related Conditions

Substance Use Disorder Treatment

Substance use disorder involves a pattern of substance use that causes significant impairment or distress, often co-occurring with mental health conditions.

PTSD Treatment

Post-traumatic stress disorder develops after exposure to traumatic events and involves intrusive memories, hyperarousal, avoidance, and negative mood shifts.

Schizophrenia Treatment

Schizophrenia involves persistent symptoms across positive (hallucinations, delusions), negative (flat affect, withdrawal), and cognitive domains.

Schizoaffective Disorder Treatment

Schizoaffective disorder combines features of schizophrenia (psychotic symptoms) with significant mood symptoms (depressive or bipolar).

Personality Disorder Treatment

Personality disorders are persistent patterns of thinking, feeling, and behaving that significantly impact relationships, work, and self-concept.

Psychotic Disorder Treatment

Psychotic disorders involve disruptions in thinking, perception, and reality-testing — including hallucinations, delusions, and disorganized thought patterns.

Other Conditions Treated

Beyond named diagnoses, residential mental health care can support adults with adjustment disorders, acute stress reactions, and complex co-occurring patterns.

OCD Treatment

Obsessive-compulsive disorder involves intrusive, unwanted thoughts and repetitive behaviors or mental acts that can consume hours of each day.

Mood Disorder Treatment

Mood disorders are conditions that primarily affect emotional state, including depression, bipolar disorder, and related diagnoses.

Persistent Depressive Disorder Treatment

Persistent depressive disorder is chronic depression lasting two years or more — often less acute than major depression but more pervasive.

Major Depressive Disorder Treatment

Major depressive disorder involves episodes of severe depressive symptoms lasting two weeks or longer, often recurring across the lifespan.

Depressive Disorder Treatment

Depressive disorders involve persistent low mood, loss of interest, and shifts in sleep, energy, and the capacity to function.

Co-Occurring Disorder Treatment

Co-occurring disorders — also called dual diagnosis — describe living with both a mental health condition and a substance use disorder at the same time.

Bipolar Disorder Treatment

Bipolar disorder involves shifts between depressive and elevated mood states that can disrupt sleep, judgment, and daily functioning.

Autism Spectrum Disorder

Autism spectrum disorder is a developmental condition affecting communication, sensory processing, and social interaction in adults.

Social Anxiety Treatment

Social anxiety disorder is the persistent fear of being judged or scrutinized in social situations — strong enough to shape work, relationships, and daily choices.

Anxiety Disorder Treatment

Anxiety disorders involve persistent, excessive worry and physical tension that interfere with sleep, work, and daily functioning.

Adult ADHD Treatment

Adult ADHD affects attention, planning, impulse control, and emotional regulation across work, relationships, and daily life.

Our Treatment Approach

Our clinical team integrates ACT principles and protocols across the residential program, with ACT-specific work delivered in individual sessions and reinforced through group programming. Every treatment plan is built and led by our Clinical Director, with medical oversight from our Medical Director.

How ACT Works Clinically

ACT operates through the six interlocking processes that together produce psychological flexibility. Cognitive defusion teaches the person to see thoughts as mental events rather than literal truths — “I’m noticing the thought that I’m a failure” rather than “I am a failure.” Acceptance involves making room for difficult feelings rather than struggling to eliminate them. Present-moment awareness builds the capacity to engage with current experience rather than getting pulled into rumination or worry. Self-as-context develops the perspective from which thoughts and feelings are observed rather than identified with. Values clarification identifies what matters most. Committed action commits to behavior aligned with values, regardless of what difficult thoughts or feelings show up along the way.

Why ACT Works for Treatment-Resistant Presentations

For adults whose anxiety, depression, or OCD has been organized around the struggle to control internal experience — and for whom standard cognitive approaches have either not worked or have intensified the struggle — ACT often opens a path that wasn’t visible before. The shift from “I must eliminate these thoughts and feelings to live well” to “I can live well alongside these thoughts and feelings” is sometimes the clinical inflection point that years of other treatment didn’t produce.

ACT at Sacramento Mental Health

Treatment begins with the comprehensive assessment — identifying the diagnosis, mapping the patterns of experiential avoidance, and identifying the values that have been displaced by the disorder. From there, the clinical team delivers ACT-informed individual sessions and group work, integrated with other evidence-based modalities depending on the primary diagnosis. The work is reinforced through daily programming and supported by the residential environment.

When Residential ACT-Inclusive Treatment Is the Right Step

Outpatient ACT works for many adults with moderate mental health conditions. Residential ACT-inclusive treatment becomes the right next step when severity has crossed into territory weekly sessions can’t reach.

Treatment-resistant anxiety, depression, or OCD where standard approaches haven’t worked
Significant experiential avoidance interfering with engagement in outpatient treatment
Co-occurring chronic pain or substance use functioning as avoidance
Active suicidality or self-harm in the context of meaning-of-life concerns
Recent crisis requiring structured therapy and skill-building
Need for the integrated approach residential care provides

Explore Treatment Approaches

Trauma-Informed Therapy

Trauma-informed therapy creates the safety and structure needed to address post-traumatic stress, complex trauma, and related conditions.

Relapse Prevention

Relapse prevention focuses on identifying triggers, building coping strategies, and maintaining long-term recovery after intensive treatment.

Psychotherapy

Psychotherapy supports deeper work on the patterns underneath mental health symptoms through individual and group sessions.

Motivational Interviewing

Motivational interviewing is a client-centered approach that helps resolve ambivalence about behavioral change, often used in substance use treatment.

Mindfulness-Based Stress Reduction

Mindfulness-based stress reduction trains attention and present-moment awareness as a counterweight to anxious rumination.

Life Skills

Life skills programming supports adults in rebuilding routines, executive function, and daily-living competencies that mental health symptoms have disrupted.

Holistic Therapy

Holistic therapy supports nervous-system regulation alongside clinical work through yoga, music, movement, and mindfulness practices.

Family Program

Family programming supports family members through education, communication coaching, and structured sessions during a loved one's residential treatment.

Exposure and Response Prevention

Exposure and response prevention is the gold-standard treatment for OCD — gradually exposing the individual to feared situations while preventing the compulsive response.

Dialectical Behavior Therapy

Dialectical behavior therapy combines cognitive techniques with mindfulness skills to support emotion regulation and distress tolerance.

Comprehensive Assessment

Comprehensive assessment identifies the specific mental health conditions, co-occurring concerns, and treatment history needed to build a personalized care plan.

Behavior Modification

Behavior modification uses structured techniques to identify, replace, and reinforce behavioral patterns affecting mental health and daily functioning.

Acceptance and Commitment Therapy

Acceptance and commitment therapy focuses on values-driven action rather than fighting difficult thoughts and feelings head-on.

Accelerated Resolution Therapy

Accelerated resolution therapy uses eye movements and imagery techniques to help process traumatic memories — often achieving results in fewer sessions than EMDR.

Why Choose the Mental Health Treatment and Stabilization Center of Sacramento

Choosing where to admit yourself or a family member for residential treatment when ACT-aligned work is part of the picture is a consequential decision. The right program needs clinicians trained in ACT alongside other evidence-based modalities, the willingness to deliver the philosophical shift ACT represents rather than just labeling work as ACT, integrated treatment with medication and other therapies, and the structure to support the values-driven action that completes the ACT framework. Here is what makes our Roseville program the right fit for adults needing ACT-informed care across Greater Sacramento and Placer County.

ACT-Informed Clinical Team

Our clinical team is trained in ACT alongside CBT, DBT, ERP, and other evidence-based modalities — so the choice of modality fits the presentation rather than being applied uniformly.

Integrated With Other Evidence-Based Modalities

ACT is rarely the only modality in play. Our integrated approach combines ACT principles with the other evidence-based work — ERP for OCD, CPT or PE for PTSD, Behavioral Activation for depression — depending on the primary diagnosis and clinical picture.

Values-Driven Discharge Planning

The ACT framework’s focus on values-aligned action shapes the discharge planning conversation — what does sustainable post-discharge life look like, organized around what matters most to this person? Residential is one intensive period; the work continues after.

Direct Provider, Not a Referral Service

We admit and treat adults directly at our Cal DSS-licensed residential facility. Families don’t have to navigate a referral chain or wait for someone else to call back. Cal DSS Facility License #315920208 reflects state-verified clinical, safety, and operational standards.

Placer County’s Residential Mental Health Home

Most residential mental health programs in Northern California are clustered in Sacramento proper. Our Roseville location gives Placer County residents — Rocklin, Lincoln, Loomis, Auburn — a residential option without a long drive across the county line.

Next Steps

Where you are in this matters. Find the path that fits where you are right now.

If you're ready to talk

A 15-minute call with our admissions team is the fastest way to get clarity. We’ll cover symptoms, fit, coverage, and timeline.

Call (916) 527-9606

If you're not sure residential treatment is right

Many people start by sitting with the question of whether residential care is the right next step. A comprehensive clinical assessment is the most reliable way to find out — it maps the diagnostic picture, severity, any co-occurring conditions, and the level of care that actually fits.

Learn how the comprehensive assessment works

If you're researching for a loved one

Bringing residential treatment into a family conversation is hard. Start by meeting the clinical team who would actually treat your loved one, and seeing how admissions handles family involvement.

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Coverage and Payment

Sacramento Mental Health works with families to make residential mental health care accessible. Call (916) 527-9606 to discuss coverage and payment options with our admissions team.

See What Our Clients are Saying

Tour Our Facility

The work described on this page happens in a real place. Our 6-bed residential facility in Roseville is built around the principle that residential mental health treatment should feel residential — not institutional. Tour the spaces where the daily clinical work, group programming, and wellness practices actually take place.

Frequently Asked Questions

What is Acceptance and Commitment Therapy?

How is ACT different from CBT?

Standard CBT identifies and changes unhelpful thoughts — restructuring catastrophizing, challenging cognitive distortions. ACT recognizes that the human attempt to control internal experience is often itself what maintains suffering. ACT focuses on changing the relationship to thoughts (defusion), accepting difficult feelings, and committing to values-driven action regardless of internal experience. Both have strong evidence bases; the choice depends on the presentation.

What conditions does ACT treat?

ACT has strong evidence support for depression, anxiety disorders, OCD (often integrated with ERP), chronic pain, substance use disorders, and as adjunctive treatment for psychosis. It often opens a different therapeutic path for adults whose mental health condition has become organized around the struggle to control internal experience and for whom standard cognitive approaches haven't worked.

What are the six core processes of ACT?

Cognitive defusion (seeing thoughts as thoughts rather than literal truths), acceptance (making room for difficult feelings rather than struggling against them), present-moment awareness, self-as-context (perspective-taking on the self), values clarification (identifying what matters most), and committed action (behavior aligned with values regardless of internal experience). Together these produce psychological flexibility — the central clinical goal of ACT.

When does ACT make sense versus CBT?

ACT often makes sense for treatment-resistant presentations, for adults whose suffering has become organized around the struggle to control thoughts and feelings, for chronic pain alongside mental health conditions, and for conditions where elimination of symptoms isn't a realistic goal. CBT often makes sense as a first-line approach for many depression and anxiety presentations. The two are not mutually exclusive — our clinical team integrates both depending on the clinical picture.

Is ACT mindfulness-based?

ACT incorporates mindfulness — particularly the present-moment awareness and acceptance components — but is distinct from formal mindfulness-based interventions like MBSR. ACT uses mindfulness as one component within the broader psychological flexibility framework that includes defusion, values clarification, and committed action.

How long does residential ACT-inclusive treatment last?

A typical residential stay at Sacramento Mental Health is around 30 days, followed by a coordinated step-down to outpatient care through another organization. ACT-informed work is integrated across the residential program rather than delivered as a standalone protocol. The residential window builds the foundation for ACT-aligned outpatient treatment that continues after discharge.

How do I discuss coverage and payment for residential treatment?

Coverage for residential mental health care varies significantly by situation. The clearest first step is a brief conversation with our admissions team — they can walk through coverage and payment options specific to your circumstances. Call (916) 527-9606 to discuss.

Get Treatment for Acceptance and Commitment Therapy in Sacramento, CA

If a mental health condition has crossed beyond what outpatient care can hold — particularly when the struggle to control internal experience is part of what maintains the pattern — residential ACT-inclusive treatment is the next step worth considering. Call (916) 527-9606 to talk with our admissions team about a clinical assessment, coverage, and what residential care at our Roseville facility would look like for you or your loved one.

Medically Reviewed By

Dr. Bonnie J. Mitchell DBH, LPCC

Dr. Bonnie Mitchell is a behavioral health leader, clinician, and advocate dedicated to expanding access to compassionate, evidence-based mental health and substance use treatment. She earned her Doctor of Behavioral Health degree from Arizona State University in 2018, holds a Master’s degree in Clinical Counseling for Mental Health, and a Bachelor’s degree in Psychology. She is a Licensed Professional Clinical Counselor in California. Throughout her career, Dr. Mitchell has served in executive and clinical leadership roles including Executive Director, Regional Clinical Director, and C-suite behavioral health executive.

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