Overwhelming Uncertainty: Acceptance and Commitment Therapy Informed Communication for Serious Illness Care

Acceptance and commitment therapy (ACT) is a psychotherapeutic model that focuses on developing psychological flexibility by encouraging patients to attune to their present moment experience, cultivate openness to those experiences, and respond to those experiences with committed action that is rooted in their values. By combining the six core processes of ACT (attention to the present moment, self-as-context, defusion, acceptance, values, and committed action) with serious illness communication skills, palliative care clinicians can nurture psychological flexibility for patients facing uncertainty and difficult internal experiences common in serious illness. This article reviews a case study with examples of language and tools clinicians can use to bring these core processes into their work with patients.