The therapeutic alliance in acceptance and commitment therapy

Acceptance and Commitment Therapy (ACT) is a process-based intervention that promotes psychological flexibility by implementing six core processes. These include acceptance and awareness as well values and behavior change processes. Still, the primary vehicle for implementing these processes is the therapeutic relationship. Underscoring the importance of the relationship is paramount – it is the context in which the interventions emerge, allowing the therapist to shape psychological flexibility directly. We argue that the therapeutic alliance (TA) is co-created and is a critical factor contributing to the effectiveness of ACT. This paper focuses on the TA as a vital part of ACT treatment. We discuss the therapeutic alliance from an ACT perspective, explore different roles in implementing ACT, and conclude with a clinical case illustration. We more specifically focus on how the TA alliance and the therapeutic relationship can be a vehicle of change in ACT.