Do gatherings, crowds, events or parties make you nervous, and do you find yourself avoiding these situations? Do you frequently drink more than you planned to when stress becomes overwhelming? Do these ways of trying to gain control keep you from focusing on what’s actually happening in your life right now or distract you from achieving your personal goals?

VA offers a therapy that can help.

Acceptance and commitment therapy (ACT) teaches Veterans how to recognize and respond to internal experiences — such as unwanted thoughts, feelings and physical sensations — in a constructive way. ACT works by building two key processes:

  • Mindfulness: Being aware of what’s happening in the moment and relating to your thoughts, feelings and physical sensations without judgement. Recognizing how you feel right now can help you build self-awareness, let go of attempts to get rid of unwanted internal experiences, and learn to live with those experiences in ways that free you to focus on being the person you want to be.
  • Psychological flexibility: Making behavioral decisions based on big-picture values and goals rather than short-term reactions to thoughts, feelings and physical sensations. Clarifying what is most meaningful to you and choosing to act on these values, even during stressful moments, are important parts of ACT.

My research and the experiences of other researchers and clinicians have shown that setting intentions, brief mindfulness practice, and choosing to act in ways, even small ways, that are consistent with deeply held personal values can help Veterans living with co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) manage symptoms and improve their daily functioning and life satisfaction. Mindfulness and psychological flexibility can enhance Veterans’ ability to engage in activities that are meaningful to them, even when unwanted, internal experiences continue to occur. By practicing this way of relating to their unwanted internal experiences, their symptoms become less distressing over time.

By participating in ACT, Veterans learn to Accept those experiences they cannot change, Choose a path toward meaning and purpose, and Take concrete actions that help move them toward their goals, moment by moment.

Veterans benefiting from ACT

The ACT approach helps Veterans take an active, acceptance-based stance to experiencing unwanted thoughts, emotions and physical sensations, built on their personal goals. One Veteran participant said ACT provided a “good challenge” because, on the first day, “We sat down and established my goals.” One goal was to reduce drinking and go back to school. Through therapy and active participation in ACT, the Veteran said, “I quit the drinking, and by the end, I was accepted into [the college of my choice].”

Another Veteran said ACT provided the outlet to process all the effects of PTSD, including depression and anxiety.

IMPACT study

In an ongoing VA-funded study called IMPACT (Intervening on Modifiable Predictors using Acceptance and Commitment Therapy), my team is testing the preliminary effectiveness of an adapted version of ACT aimed at improving the well-being of Veterans returning from war who are living with PTSD, chronic pain, depression, alcohol use problems or traumatic brain injury (TBI). This research program has previously shown that ACT is a promising treatment for promoting recovery in Veterans with PTSD and AUD. The IMPACT study will continue to reveal new insights through its conclusion in 2022.

VA is making ACT available to many Veterans across the nation whose mental health and functioning may be improved through this promising therapy.

About the VISN 17 Center of Excellence

The VISN 17 Center of Excellence for Research on Returning War Veterans is located at the Doris Miller VA Medical Center in Waco, Texas — which is part of the Central Texas Veterans Health Care System. The VISN 17 Center of Excellence was established to conduct research on the returning post-9/11 Veteran population, which includes Veterans enlisted in any of the military branches during Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn. This center conducts research on a variety of topics, including PTSD, substance use disorders, brain connectivity and TBI, and other related topics.

To learn more about the study conducted by VISN 17 and Dr. Eric Meyer’s team, explore the VISN 17 website and the IMPACT study abstract.

Eric Meyer portraitAbout the Author: Eric Meyer, Ph.D., is a clinical research psychologist specializing in functional rehabilitation. He is an investigator in the Behavioral Science Core of the VA VISN 17 Center of Excellence for Research on Returning War Veterans in Waco, Texas, at the Central Texas Veterans Health Care System. He also serves as an associate professor of psychiatry for the Health Science Center in Texas A&M University’s College of Medicine.

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Published on May. 22, 2019

Estimated reading time is 3.8 min.

Views to date: 494


  1. Gabriel Anthony May 25, 2019 at 3:47 pm

    I read another post from Larry l r. Describing constant harrasment he was facing by authorities affiliated with and stakeholders of the VA. This was most interesting because for 10 years I have had very similar experiences on a daily recurring basis. I thought I was the only one. Interesting is that I have to move frequently because of the survalence and threats. After moving it typically takes the new community at least a Month before everything picks back up. I’ve even tried to use only po box and take varrious different routes when traveling. I have no social media or bills in my name because of the stalking. When I attempt to secure treatment or disability compensation they take extreme measures to ensure I can’t compete the process. The actions by the VA and their stakeholders is highly disturbing. I have contacted Atlanta Law Judges And left voicemails and had conversations regarding the VA’ s extreme tactics. They have even gone so far to as offer me money for to come in my home and conduct interviews and testing. I have been sent to C&p exams which had nothing to do with lab samples yet the VA unlawful collected my blood and DNA. Even though I have filed many complaints with the white house, inspector general and sheriff’s department, nothing seems to work. I am currently owed over 350,000 dollars from the VA and counting. My request is simple if you can’t pay me my money and leave me alone, please just kill me

  2. Keith Squires May 24, 2019 at 11:44 am

    Is sitting the posture of a hero?

    As I began my treatment, like any good Marine, I prepared myself for the task. So weeks prior to my departure date I would travel away from home, in doing so I would force my comfort level to expand. I set SMART goals that I could realistically obtain, although these goals were not easily achieved. I drove to places I didn’t want to be, sat with people I didn’t want to know, but I always had a family member or two with me. As each obstacle was completed, so was that portion of my training. There were so many small goals that I set for myself so I could achieve the main goal, such was my hope. Though these are simple task for most, yet very difficult for me. I was able to make the journey to Tampa, Florida, which was my main goal.

    Upon arrival at the James A Haley VA hospital I began my 3 week training to help me be proactive with my health issues.
    As I meet with others who are also fighting their own battles , I was inspired by their determination, strength, and motivation

    The first day of treatment didn’t go as good as I had hoped; after an afternoon of appointments and planning, my body shut down, my mind was ready but my body would not!

    If you listen to your body and treat the problem, not the symptoms, you will have success. Ultimately this means allowing the pain to pass through and through. As for me and my fight, this philosophy has kept me breathing. And if you’re breathing, you’re still in the fight!!!

    The enemy does not live and dwell within me, others around me are not the cause of my infliction, my friends and family are not the problem, it’s not their battle, they don’t need to “understand”!

    I must toil to understand what my body is going through and I must use everything I have inside of me if I am to continue this amazing life that God Himself created.

    So if you see me lying in bed for hours on end, taking long showers, praying with tears running down my face, of sitting quietly in a crowded room, please don’t be offended for I am learning.
    Sometimes sitting is the posture of a hero. It’s not a battle, it’s an understanding. As the warm tears run down my face and drip on the floor I am reminded that my mind and body are one.

    If you want to help me, pray for me, sit with me, cry with me, but don’t pity me, I am a child of God, and He will keep my heart and mind in harmony, as for my body, I have amazing doctors that are teaching me a foundation on strength.

    Keith R. Squires

  3. Keith Squires May 24, 2019 at 11:36 am

    There are moments in our lives when we all need a special someone; when we need someone to listen, give advice, sit by our side in silence, or to stand with us, or teach us.

    I have heard it said: “know thyself”! Socrates
    Recently I decided to follow that advice. I enrolled in a MINDFUL AWARENESS class offered by the VA hospital

    For as long as I can remember my life has never been about “ME”! As I focused on my life it was necessary to reflect on yesterday.

    As I recall “those days” I find it hard to breath; I am feeling empty and lonely, wondering (what if)? Most of my memories are in black and white; I am reminded of what yesterday robbed me of; how I was left wanting, needing and broken

    As I grow older and surly wiser I find myself at a crossroad.
    I want to get past this hurt and sickness; my physical and mental health has kept me a prisoner far too long, if I am to overcome these enormous obstacles I need an outlook with a realistic solution. “The fears we don’t face become our boundaries”

    my options before and after my training
    You can shed tears that your health is gone,
    or you can smile because you have lived.
    You can close your eyes and pray that your health will come back,
    or you can open your eyes with prayer and see all the possibilities
    Your heart can be empty because your life has changed
    or you can be grateful for the life you have
    You can turn your back on tomorrow and live in yesterday,
    or you can be happy for tomorrow because of yesterday.
    You can remember life as it was,
    or you can cherish the memories and allow yourself to live again

    I can’t stop the sickness, that is painfully obvious to me, but how I let it effect my life is now within my control, thanks to The Mindful Awareness training. The training is a true modern day adventure and I believe that you will never reach a level that one might say “I have arrived, or I have graduated” from mindful awareness, we will always be students of our minds and bodies; such is my hope.

    So as I look back after these very long and sometime painful six weeks, my heart is joyful again; I feel so alive that I have a smile on my face that defines my true feelings. Who could have known that a mindful awareness life would give ME the power to heal the brokenness so completely.

    Peace has found a place in my heart once again. As I wrote this letter of hope, my hands began to tremble, as the words became reality the warm tears dripped off my face and fell onto my words; these are special tears, for they are tears of joy. I am ready to continue this great and joyful life that God Himself began.

    To my instructors:
    My words fail to explain the profound impact that you have shared with me, I will be reminded of your teachings as I watch my Mind-Body- and Spirit overcome everyday obstacles
    It is with great humility and Mindful awareness that I simply say: “Thank You”!

    I have the power within me to see my life in color once again.

    Keith Randall Squires


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