For clinicians · ACT guide
ACT therapy — a clinician's guide to acceptance and commitment therapy
Acceptance and Commitment Therapy is Steven Hayes's third-wave behavioral therapy. It builds psychological flexibility through six processes — the hexaflex — and moves the client from struggle with inner experience toward values-consistent action. This guide covers each process and the printable ACT worksheets that operationalize it.
The six hexaflex processes
Cognitive defusion
See thoughts as thoughts, not literal truth. 'I'm having the thought that…', word repetition, thanking the mind. Unhooks the client from the content.
Acceptance
Willingness to make room for uncomfortable inner experience without struggling against it. The opposite of experiential avoidance, which is the shared engine of most disorders in the ACT model.
Present-moment contact
Attention to what's here, now — sensory, felt, real — as opposed to fused thought about past or future.
Self-as-context
The observer self — the you that has noticed every thought and feeling of your life without being any of them. The 'sky', not the weather.
Values
Chosen life directions — not goals, not feelings. What kind of person the client wants to be in the domains that matter.
Committed action
Values-consistent behavior, however small, however often it takes. The behavioral engine of ACT.
Core ACT worksheets
One-page audit of all six processes — where flexibility is available, where it isn't.
Open worksheet →The classic ACT metaphor as a daily practice — note the passengers (thoughts, feelings), keep driving toward values.
Open worksheet →Word-repetition defusion exercise for hooked, sticky thoughts.
Open worksheet →Untangles the two — values are directions, goals are landmarks along the direction.
Open worksheet →The values-clarification exercise — what would you want said about how you lived?
Open worksheet →For any behavior: is it moving you toward the life you want? A more useful question than 'is it good or bad?'
Open worksheet →Maps all the ways the client has tried to control inner experience — and the cost of the control agenda itself.
Open worksheet →Give shape, color, temperature, weight to a difficult emotion — a defusion + acceptance move.
Open worksheet →Frequently asked questions
- What is ACT therapy?
- Acceptance and Commitment Therapy is a third-wave behavioral therapy developed by Steven Hayes. It uses acceptance and mindfulness processes together with commitment and behavior-change processes to increase psychological flexibility — the ability to contact the present moment and choose values-consistent action, even in the presence of difficult thoughts and feelings.
- What are the six ACT processes?
- The hexaflex: cognitive defusion (unhooking from thought), acceptance (making room for feeling), present-moment contact, self-as-context (the observer self), values (chosen life directions), and committed action. Together they build psychological flexibility.
- How is ACT different from CBT?
- CBT typically works to change or restructure unhelpful thoughts. ACT works to change the client's relationship to thoughts — noticing, defusing, and letting them be — while investing energy in values-consistent action. ACT is less concerned with symptom reduction and more with a workable life.
- What is cognitive defusion?
- Defusion is the practice of seeing thoughts as thoughts rather than as literal truth. Techniques include the 'milk milk milk' word-repetition exercise, thanking the mind, singing the thought, or saying 'I'm having the thought that…' It doesn't change the thought's content — it changes the client's relationship to it.
- Are your ACT worksheets aligned with the ACT model?
- Yes. Our ACT worksheets follow the hexaflex — defusion, acceptance, present moment, self-as-context, values, committed action — and standard ACT exercises (values compass, passengers on the bus, workability audit, 80th birthday). See /resources/act.
The full ACT worksheet library
Hexaflex checks, values compasses, defusion exercises, workability audits, committed-action plans — printable one-page sheets for every hexaflex process.
Related guides
Continue with another modality — same clinician-facing format.
Beck's cognitive model, thought records, behavioral activation, exposure.
The four modules — mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness.
Shapiro's 8-phase protocol, AIP model, resourcing, and dual-attention processing.
Managers, firefighters, exiles, and Self-energy — the internal family systems model.
Polyvagal-informed practice, window of tolerance, bottom-up stabilization.