Most people living with anxiety have already tried arguing with it. They reason with the worry, reassure themselves, avoid the situations that set it off, and still find the same thoughts waiting the next morning. ACT therapy for anxiety takes a different route. Acceptance and Commitment Therapy does not try to win the argument. It helps you change your relationship with anxious thoughts so they have less say over what you do, and it puts your energy into building a life around what you value, with or without the worry along for the ride.
Why Fighting Anxious Thoughts Tends to Backfire
Anxiety is persuasive. It presents predictions as facts and urges as instructions, and the natural response is to push back: suppress the thought, check one more time, cancel the plan. In the short term, that brings relief. Over time, each round of avoidance teaches the brain that the feared thing really was dangerous, and the space your life occupies quietly shrinks.
ACT therapy starts from the premise that having difficult thoughts and feelings is a normal part of being human. They do not make you broken. The trouble comes from brooding on them, wrestling with them, and letting them decide your choices. That shift in focus is what makes ACT feel different from approaches that center on correcting the content of a thought.
Six Skills, Followed Through One Ordinary Worry
ACT is built around six connected skills. They are easiest to understand by following a single example. Imagine someone who has been dreading a presentation at work for two weeks.
Acceptance
Instead of trying to make the dread disappear before the presentation, they practice letting it be there. The racing heart and tight chest are uncomfortable, but they are not an emergency.
Cognitive defusion
The thought “I will freeze, and everyone will see” gets noticed as a thought, not a forecast. A simple shift, such as “I am having the thought that I will freeze,” puts a little distance between the person and the story their mind is telling.
Being present
Attention keeps sliding to a dozen imagined disasters. Mindfulness practice brings it back to what is actually happening right now, which is usually far more manageable.
Self as context
They begin to see themselves as larger than the anxious episode: a whole person who is having a hard moment, not a person who is defined by it.
Values
Why does the presentation matter at all? Perhaps because they care about their work and want to contribute. Naming that value gives the discomfort a purpose.
Committed action
They prepare, show up, and give the presentation with the anxiety present, rather than waiting for it to leave first. That step, repeated across many situations, is where change accumulates.
ACT or CBT for Anxiety? A Way to Decide
Cottonwood Psychiatry offers both approaches, and both have solid research behind them. The difference is mainly one of emphasis. Cognitive behavioral therapy asks whether a thought is accurate and helps you restructure it. ACT asks whether holding onto the thought is helping you live the way you want, and works on your relationship with it instead.
ACT can suit people who have already tried to reason their way out of anxiety and still feel stuck, or whose anxiety is tangled up with perfectionism and long habits of avoidance. CBT can suit people who want a highly structured way to test and challenge specific beliefs.
Inside an ACT Session
In the first session, Dr. McGuire learns about you and what you want your life to look like, explains what to expect from therapy, and decides with you whether ACT is the right fit. If it is, she outlines a planned timeline and what you might focus on along the way.
Later sessions focus on understanding yourself and your values. Depending on the day, that may mean setting goals, practicing mindfulness, exploring thoughts and feelings, adjusting specific behaviors, or planning actions that match your values. Dr. McGuire may suggest practice between sessions so the skills carry into daily life. Sessions typically last about an hour, and how long someone stays in ACT depends on their needs. All sessions take place via secure telehealth, so there is no commute between you and the work.
For a broader picture of what anxiety care involves from the first visit onward, see what to expect from anxiety treatment.
Signs ACT Might Suit Your Anxiety
There is no checklist that settles this, but ACT is often worth exploring if several of these sound familiar:
You can explain why a worry is unlikely, and it still does not loosen its grip
Avoiding situations has started to cost you things you care about
You spend a lot of energy trying to feel calm before you allow yourself to act
Perfectionism or fear of judgment shapes many of your decisions
You want therapy to connect to what matters in your life, not only to symptom relief
If you recognize yourself here, it does not mean ACT is the only option. It means the question of how you relate to anxiety, rather than only what anxiety says, may be a useful place to start.
Where Medication Fits, and Who Decides
Anxiety care often raises a second question: should medication be part of this? At many practices, answering it means a referral to someone new. At Cottonwood Psychiatry, it does not. Dr. Colleen McGuire runs the practice as a board-certified psychiatrist who also delivers evidence-based therapy herself, ACT included. That means the physician weighing a medication decision already knows the therapy work, and the person guiding your therapy understands the medical side. You are not shuttling between two clinicians who each hold half of your story.
Alternatives to medication are a focus of Dr. McGuire’s practice, so for many people the conversation starts with what therapy can do. When medication management does make sense, it can be added within the same relationship. Her training includes a psychiatry residency at the University of Colorado, where she was Chief Resident, and years as an Attending Psychiatrist and Assistant Professor at Denver Health.
What People Ask Before Trying ACT
Does accepting anxiety mean giving up on feeling better?
No. Acceptance in ACT means making room for uncomfortable feelings instead of fighting them, so they take up less of your attention and stop dictating your choices. Many people find that as avoidance decreases, the struggle with anxiety eases too.
Is ACT just mindfulness?
Mindfulness is one of its six skills, but ACT goes further. It pairs present-moment awareness with values work and committed action, so the focus is on how you live, not only on how you observe your thoughts.
What kinds of anxiety does ACT address?
The practice uses ACT for anxiety disorders as well as related concerns such as stress, obsessive-compulsive disorder, and post-traumatic stress. Whether it is the right fit for you is something to work out during your first session.
Start with a Conversation About Your Anxiety
If you have spent a long time trying to out-think your anxiety, it may be time to try a different relationship with it. Learn more about our ACT service at Cottonwood Psychiatry and our approach to anxiety care, then contact us today.
Dr. Colleen McGuire, DO, is a Board-Certified Psychiatrist with a holistic approach to mental health. She completed her medical training at Touro University and residency at the University of Colorado, where she served as Chief Resident. Specializing in trauma, midlife hormonal issues, and alternatives to medication, Dr. McGuire integrates therapies like Acceptance and Commitment Therapy (ACT). Licensed in multiple states, she is known for her empathetic, client-centered care and dedication to mentoring. Outside work, she enjoys piano, swimming, and spending time with animals.
Schedule an Appointment
Start your journey toward the life you’ve always wanted with the help of Dr. McGuire at Cottonwood Psychiatry, and contact us today. Fill out our contact form below.
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