ACT for Life: Using Acceptance and Commitment Therapy to Understand and Prevent Suicide

  • Sean M. Barnes
  • Geoffrey P. Smith
  • Lindsey L. Monteith
  • Holly R. Gerber
  • Nazanin H. Bahraini


Human beings are the only living organisms that consciously and deliberately kill themselves. Moreover, suicide is present in all societies, and internationally nearly one in ten humans will consider suicide at some point during their lives. This has left many of us asking, “What is it about being human that causes so many people to consider killing themselves?” On the surface, the answer is not a simple one. There is not one clear pathway that leads to suicide. Suicide is associated with a broad array of stressors, mental illnesses, and demographic characteristics. Acceptance and Commitment Therapy (ACT) is a transdiagnostic psychosocial treatment approach grounded in a model of psychological (in)flexibility. ACT offers a compelling explanation for why suicide is uniquely human and heterogeneous in etiology, but has been understudied in regard to its applicability to suicide prevention. In the proposed chapter, we delineate the etiology of suicidal thoughts and behaviours according to the ACT model of psychological (in)flexibility. Further, we review and synthesize the extant literature relevant to this etiological model. Topics of focus include inflexible attention, experiential avoidance, cognitive fusion, attachment to a conceptualized self, and disruption of valued living. We discuss implications for suicide risk assessment and key considerations for using ACT to manage suicide risk (e.g. how to promote the acceptance of suicidal ideation, without encouraging suicidal behaviour and ways to identify new valued directions for taking action that strengthen protective factors). Case material is presented to illustrate how ACT can be used with suicidal individuals to help them build a life they deem worth living.


Acceptance and commitment therapy Psychological rigidity Experiential avoidance Fostering emotional willingness Value-driven life 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  • Sean M. Barnes
    • 1
    • 2
  • Geoffrey P. Smith
    • 1
  • Lindsey L. Monteith
    • 1
    • 2
  • Holly R. Gerber
    • 1
  • Nazanin H. Bahraini
    • 1
    • 2
    • 3
  1. 1.Denver Veterans Affairs Medical CenterDenverUSA
  2. 2.Department of PsychiatryUniversity of Colorado School of MedicineAuroraUSA
  3. 3.Department of Physical Medicine and RehabilitationUniversity of Colorado School of MedicineAuroraUSA

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