Acceptance and commitment therapy in Vaughan
You have learned to argue the anxious thought down, and it still arrives at six in the morning, and you still cancel the thing you had planned. Acceptance and commitment therapy in Vaughan starts from a different place, by loosening the grip a thought has on your behaviour rather than debating its content, and by getting specific about what you want your weeks to contain. Three of our Registered Psychotherapists work this way, at the Woodbridge office, in Barrie, and online.
No referral needed · in-person or online · with Registered Psychotherapists.
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20 minutes
Clinically reviewed by Svetlana Antonyshyn, Registered Psychotherapist (CRPO #001652). Last reviewed August 2026.
What is acceptance and commitment therapy, and how does it work?
Acceptance and commitment therapy is a third wave cognitive behavioural approach. Rather than disputing whether a thought is accurate, it teaches you to notice it, make room for the feeling underneath, and act on what you value anyway. Progress is measured by what you did this week.
ACT is said as a word, "act", which is a fair summary of the method. It sits inside the cognitive behavioural family, in the cluster usually called third wave, and it works on your relationship with a thought rather than its content. Four things get practised: noticing a thought as a piece of language rather than an instruction, making room for the feeling that travels with it, naming in plain words what you want your life to be about, and doing something in that direction before the next session.
This is where it parts company with classic CBT. CBT hands you a thought record, asks whether the thought holds up under evidence, and then tests it in real life, with symptom scores as the measure of progress. The question here is not whether the thought is accurate. It is whether obeying it moves you toward the week you want. Plenty of people do better with the thought testing, and if that is what you came for, that page is the better starting point.
ACT asks you to make room for feelings you may have spent years trying to shut down, and for some people that is the wrong request at the wrong moment. If your goal is to reduce one specific symptom on a defined schedule, classic CBT, or exposure and response prevention for OCD, has more direct evidence aimed at that target, and your therapist will say so in the first session rather than stretching ACT to fit. It is also not a replacement for medical care. Registered Psychotherapists do not diagnose or prescribe, so when pain, illness or medication is part of the picture we work with your family doctor rather than around them.
Sessions run 55 minutes and most people begin weekly. Nothing in the approach requires an hour of meditation at home, and if the between-session practice is not happening, that becomes the conversation rather than a failure to report.
Who provides acceptance and commitment therapy in Vaughan?
Rachel Fay (RP Qualifying, CRPO 15607) and Hafiza Dakri (RP Qualifying, CRPO 20273) both practise from the Woodbridge office, and Hafiza works with clients from age 12 upward. Hannah Smith (RP, CRPO 009501) sees clients in Barrie. All three name ACT in their own bios, which is why these are the three listed here rather than the whole team. Every registration number above can be checked on the CRPO public register in under a minute.
Rachel Fay
Hafiza Dakri
Four thoughts, and what ACT does with them
Defusion is the ACT skill of noticing a thought as a piece of language that has arrived, then choosing your next move while it is still sitting there. Pick the card that sounds most like something you have said to yourself this month.
I am going to embarrass myself in that meeting.
Try saying it as "I am having the thought that I will embarrass myself." Those five extra words put a small gap between you and the sentence, and in that gap you get to ask a different question: what would I do in the next ten minutes if this thought stayed exactly where it is? The sentence can stay. What changes is whether it gets to pick your calendar.
When fighting your own thoughts has become the problem
You turned down a dinner because of the chance you would feel panicky in the restaurant, and the list of places you quietly avoid has grown since the spring. Sessions start with what the avoiding has cost you and build back one specific outing at a time, with the anxiety allowed to come along.
You have tried to reason yourself out of thinking you are not good enough, and the argument only runs longer each time. Defusion gives you something to do with that sentence once debating it has stopped working.
You stopped playing music, cancelled the running club, and told yourself you would go back once the motivation returned. ACT reverses that order and starts with one small action tied to something you still care about, treating the mood as a passenger instead of the driver.
You have been managing back pain or a long term condition for years, and every plan so far has been aimed at making it stop. This is where ACT has its strongest research base, and the work is about what you can still do on the days the pain is present.
You replay one comment from a two o'clock meeting while you are trying to fall asleep, and Sunday evening has started to feel like Monday morning. Sessions look at the hooks that keep pulling your attention back to it, and at what you actually want your evenings to hold.
You agree to things you did not want, notice the resentment two days later, and then apologise for the mood it put you in. Values work makes the trade you keep making visible before you make it again, so the next yes is deliberate.
A separation, a layoff or a diagnosis has rearranged the plan you were living by, and the old goals no longer fit the situation you are in. ACT helps you name what still matters underneath the plan that ended, then rebuild the next set of steps from there.
Your fourteen year old rolls their eyes at being told to challenge their negative thoughts, and the homework sheets from a previous therapy went unfinished. Hafiza Dakri works with clients from age twelve and uses ACT, which puts the conversation on what your teen wants to be doing and what gets in the way.
How strong is the evidence for acceptance and commitment therapy?
ACT is among the best evidenced approaches we offer: tens of thousands of participants, and consistent gains across anxiety, depression, chronic pain and substance use. What it does not show is an advantage over CBT, which it repeatedly matches rather than beats.
participants across 39 randomized controlled trials. ACT worked better than control conditions, and showed no significant difference from established treatments such as CBT.
participants across 20 meta-analyzes. ACT was effective for anxiety, depression, substance use and pain, and generally better than waitlists, placebo and usual care.
CBT is the one comparison it did not beat.
Gloster et al., Journal of Contextual Behavioral Science, 2020
people living with chronic pain across 21 trials. Pain acceptance improved and both depression and anxiety symptoms fell, with the gains still present three months later.
adolescents across 27 trials. ACT matched CBT for anxiety and depression, and beat other active controls for depression.
Every included trial carried a high risk of bias.
participants in the Cochrane comparison of third wave therapies, including ACT, against other talk therapies for depression. They came out equally effective.
Three studies, and the evidence was rated very low quality.
What actually happens in an ACT session?
Very little of this happens on a couch in silence. Most of the work is short exercises inside the session, followed by something small you agreed to do before you come back.
ACT asks you to make room for feelings you may have spent years trying to shut down, and for some people that is the wrong request at the wrong moment.
Session one: what you have already tried
Your therapist asks what you have done to make the anxiety, the low mood or the pain smaller, and what each of those attempts has cost you. Most people arrive having tried a great deal, and the shape of that list is more useful than any questionnaire. This is also the session where a therapist tells you if ACT is the wrong fit and points you somewhere more targeted.
Weeks two to five: getting some distance
Short exercises for stepping back from a thought while it is still loud, such as saying it in a silly voice or thanking your mind for the warning it is trying to give you. Alongside that comes willingness, which in practice means staying with a physical feeling for sixty seconds instead of reaching for your phone. Most people find this strange before they find it useful, and saying so out loud is part of the work.
From there: values, and what you did about them
You put words to what you want your weeks to contain, then pick actions small enough to survive a bad morning: one phone call, twenty minutes outdoors, one honest sentence to your partner, the email you have been rewriting since Monday. Sessions turn into a review of what got done, what did not, and what got in the way. Many people move to every other week once the actions are running without much scaffolding.
What can acceptance and commitment therapy in Vaughan help you with?
You know the plane will not fall out of the sky, and you still rearrange a whole week around the flight. ACT drops the debate and works on the part where you board with the fear still present. If testing the accuracy of the thought is what you want, that work lives on our CBT therapy page. For the wider picture, see anxiety and panic.
Depression narrows a life by subtraction. The membership lapses, the friend stops getting answered, and eventually there is nothing left in the week that would lift a mood even if you had the energy for it. ACT works on the reintroduction, in pieces small enough that a bad Tuesday does not cancel them. More on depression therapy.
Pooling 21 trials with 1,298 people living with chronic pain, ACT improved pain acceptance by a standardised mean difference of 0.68 and lowered depression and anxiety scores, with the gains still present three months later (Ma et al., 2024). Sessions deal with pacing, avoidance, and what you have quietly given up. Registered Psychotherapists do not diagnose or prescribe, so this runs alongside your physician's care.
You apologise for things that are not your fault and only notice afterwards. Somewhere there is a rule, do not be a burden, do not be the difficult one, and it is quietly running your Tuesday. The attention skills used to catch it in the moment overlap with mindfulness-based therapy, though here they exist to get you moving rather than to calm you down.
What therapy costs in Vaughan
No hidden fees. Most private insurance plans cover a portion of psychotherapy fees.
Meet a therapist, ask anything, and see if this approach feels right. No obligation.
Most private insurance plans cover a portion. Your first individual appointment is a 70-minute assessment at $245.
Full-length sessions for partners and families. Your first couples or family appointment runs 90 minutes at the same rate.
Reduced-fee sessions from $125 are available with select supervised therapists in training through our affordable therapy program.
Your questions, answered
What is acceptance and commitment therapy and how does it actually work?
ACT works on the grip a thought has on you rather than on its accuracy. You practise noticing a thought as a thought, which usually loosens it enough that you can move while it is still there. You name what matters to you in ordinary words, family, health, work you can respect, and you choose small actions that match. Then you and your therapist track what you actually did between sessions. The feelings often settle later, as a by-product of the life getting wider again.
What is the difference between ACT and CBT?
Classic CBT treats a thought as a claim to be checked. You write it down, weigh the evidence on both sides, test a more accurate version in real life, and watch symptom scores for progress. ACT leaves the accuracy question alone. It works on how tightly the thought is holding you and on what you do while it is present, so progress gets counted in actions taken during the week. Both belong to the same cognitive behavioural family and both involve practice between sessions. If thought testing is what you want, our CBT therapy page is the right starting point.
Is ACT a type of mindfulness therapy or a type of CBT?
Both descriptions are partly right. ACT belongs to the cognitive behavioural family and is usually grouped with the third wave approaches, alongside mindfulness-based cognitive therapy and dialectical behaviour therapy. It borrows attention skills from mindfulness practice, though the exercises are short, often a minute or two inside the session, and they exist to help you act rather than to bring your arousal down. If the formal mindfulness route is what you are after, our mindfulness-based therapy page covers that work in more detail.
Does ACT mean I have to accept feeling anxious forever?
No. Acceptance in this approach means dropping the fight with a feeling long enough to do something you care about, because the fight itself usually costs more than the feeling does. Anxiety commonly falls as a result. In the pooled chronic pain trials, anxiety scores dropped by a standardised mean difference of 0.47 and depression by 0.59 (Ma et al., 2024), and those participants were not aiming at symptom reduction directly. What tends to change first is the range of what you are willing to do.
How many ACT sessions does it usually take before anything shifts?
There is no set course length here and no fixed package to buy. Most people start weekly, and the first thing that tends to move is behaviour, a call made, a class attended, before the feelings change much. Your therapist reviews progress with you around the fourth to sixth session and says plainly whether this is working for you. Published trials run from a handful of sessions to several months depending on the problem studied, so treat any promise of a specific number of weeks with caution.
Is acceptance and commitment therapy evidence-based?
Yes, with an honest ceiling. Across 39 randomised controlled trials with 1,821 participants, ACT beat control conditions with an effect size of Hedges' g equal to 0.57 and showed no significant difference from established treatments including CBT (A-Tjak et al., 2015). A review of 20 meta-analyzes covering 12,477 participants reached the same conclusion, with CBT the one comparison ACT did not beat (Gloster et al., 2020). For depression specifically, the Cochrane comparison of third wave therapies against other talk therapies rested on three studies and 144 participants and was rated very low quality (Hunot et al., 2013).
Can ACT help with chronic pain as well as anxiety and low mood?
Pain is one of the areas where the evidence holds up best. Pooling 21 trials with 1,298 people living with chronic pain, ACT improved pain acceptance by a standardised mean difference of 0.68 and reduced depression and anxiety symptoms, with the gains still present at three months (Ma et al., 2024). Sessions deal with pacing, avoidance and the activities you have quietly dropped. Registered Psychotherapists do not diagnose or prescribe, so this work sits alongside the care your family doctor or specialist provides.
How much does ACT cost in Vaughan and will my insurance cover it?
A 20 minute consultation costs nothing. Individual sessions are $180 for 55 minutes, and a first assessment for an adult is $245 for 70 minutes. Couples and family sessions are $280 for 85 minutes. Psychotherapy is not covered by OHIP, though most extended health plans cover a portion, and the wording to look for in your plan is coverage for a Registered Psychotherapist rather than a psychologist. We bill Sun Life, SSQ and Green Shield directly. Reduced fee sessions at $125 are offered by select supervised therapists in training.
Where to see us in person, or meet online
Three offices across Vaughan and Barrie, plus secure video sessions anywhere in Ontario. Evenings and weekends available.
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