ACT Techniques: 14 Interventions &

Activities for Your Sessions

14 Jan 2022 by Jo Nash, Ph.D. 

Acceptance and Commitment Therapy

(ACT) is one of the third wave of mindfulness-based cognitive-behavioral therapies
and has accumulated a huge scientific evidence base demonstrating its effectiveness.

ACT was originally devised by Steven C. Hayes when he was seeking relief from his
own panic disorder. He tells the moving story of his own suffering and how it led to
the development of ACT in the TED Talk below.

Used as an intervention, ACT is beneficial for a range of health problems, including

managing chronic pain, addictions, anxiety, depression, obsessive-compulsive
disorder, and psychosis (Hayes, 2021).

Want to know more about these incredibly beneficial ACT techniques? We share
many interventions and videos below.

Before you continue, we thought you might like to download our three Positive
Psychology Exercises for free. These science-based exercises explore fundamental
aspects of positive psychology, including strengths, values, and self-compassion, and
will give you the tools to enhance the wellbeing of your clients, students, or
employees.

This Article Contains:

 6 Acceptance and Commitment Therapy Techniques
 3 ACT Interventions for Your Sessions
 3 Activities to Try With Your Clients
 2 ACT Group Exercises
 PositivePsychology.com’s Relevant Resources
 A Take-Home Message
 References
6 Acceptance and Commitment Therapy Techniques
ACT is based on a model of six core processes called the hexaflex.

The key objective of ACT is to alleviate suffering by optimizing psychological

flexibility. This is achieved through educating clients about the six core processes and
supporting the development of new psychological skills, including mindfulness,
cognitive defusion, and acceptance.

ACT interventions aim to overcome experiential avoidance using a combination of

mindfulness and behavioral change techniques. Each intervention activates at least
one of the six core processes, but some interventions activate multiple core processes
simultaneously.
Below are six techniques that focus on the core processes of mindful connection and
cognitive defusion that are especially helpful for managing anxiety. Feeling anxious
when under stress is normal and can help arouse the extra energy required to identify
creative solutions to problems.

However, prolonged anxiety can be exhausting and even develop into panic

attacks (Smith, 2019). The good news is that the ACT approach was developed by
Hayes to help him overcome his own anxiety and panic disorder. For a full update of
the state of the evidence (Hayes, 2021), visit the Association of Contextual and
Behavioral Science, the professional association for ACT practitioners.

In this TED Talk, Hayes shares the development of his approach:

Many ACT interventions are especially helpful for anxiety, as explained in Hayes’s
TED Talk above. We discuss several of the approaches here.

1. Anchor Breathing – Mindful grounding

When you’re stressed, you’re more susceptible to anxiety and overwhelm (Hayes,
Strosahl, & Wilson, 1999).

This can even lead to panic attacks when stress is prolonged (Smith, 2019).

When anxiety is aroused, grounding yourself through mindful breathing can help calm

you. Try this simple Anchor Breathing exercise to take a mindful stress reduction
break.

2. Cognitive defusion from unhelpful thoughts

Cognitive defusion is a technique that uses mindfulness skills to distance and detach
yourself from painful thoughts or internal commentary (Hayes & Smith, 2005).

ACT makes use of a lot of metaphors to facilitate defusion from painful thoughts and
feelings.

The ACT Defusion Metaphors worksheet contains a list of questions to determine the

difference between helpful and unhelpful thoughts (Hayes & Smith, 2005), as well as
a list of metaphors to apply during sessions if a client is stuck in a downward spiral of
negative self-judgment, harsh self-criticism, or catastrophizing.
Remind the client that their inner commentary only comprises thoughts that are just
words and use the ‘thoughts are like’ section of this worksheet to help them defuse
from painful thoughts.

3. The struggle switch

Russ Harris (2008) invented the struggle switch ACT metaphor to help his clients
defuse from anxiety by choosing to notice it and observe it mindfully, rather than
struggling with it.

He explains the metaphor and how to use it in the video below. You can also
download Harris’s worksheet on Struggle Strategies for free.

4. Observing Anxiety Mindfully

First, it is essential to help a client understand that experiential avoidance of their

anxiety actually intensifies it.

In the following video, Hayes shows a mindfulness exercise that redirects an anxious
client to become an observer of their anxiety in the context of a whole person across a
lifetime.

This therapy intervention activates four core processes – mindful connection,

cognitive defusion, acceptance, and self-as-context – in one intervention. We have
adapted the exercise into the free Observing Anxiety Mindfully worksheet.

5. Radio Doom and Gloom

Ever feel like your mind is whirring on in the background like a radio broadcasting
the Doom and Gloom Show?

When your mind gets stuck in negative self-commentary or keeps replaying negative
events, your thoughts generate painful emotions like fear and anxiety.

In the video below, Russ Harris describes a defusion exercise called “Radio Doom +
Gloom,” which helps quiet anxiety-generating thoughts. We have also adapted
Harris’s (2008) technique into a free worksheet: Radio Doom and Gloom.

6. Thank your mind and name the story

Often, when you’re experiencing anxiety, your mind will amplify it by introducing a
familiar self-judgmental storyline. When such self-defeating or self-limiting thoughts
arise, acknowledge them as the product of your mind and thank your mind for its
opinion. You can say it aloud or in your head.

When each repetitive self-defeating storyline appears (for example, “I’m not good
enough”), name it the “I’m not good enough” story, acknowledge it, then let it go.

Each time your old self-defeating storyline takes center stage in your mind, thank your
mind for the replay of the “I’m not good enough” story and let it play away in the
background while focusing on the tasks that will lead you to your goal.

Russ Harris describes thanking your mind and naming the story in the video below.

Further techniques involving other core processes are described in our article 21 ACT
Worksheets and Ways to Apply Acceptance & Commitment Therapy.

3 ACT Interventions for Your Sessions

In ACT, we practice something called front-loading the values (Hayes et al., 1999;
Hayes & Smith, 2005). In other words, the very first session you have with your client
should involve the clarification of their deepest values.

Often, clients mistake goals for values, such as “I want to be happy.” This is a goal,
albeit an emotional one. You can use goals to explore the values underpinning them
by asking something like, “So when you are happy, what will you do then?”

Another common goal is “I want to be rich.” Again, the same applies. “What will you
do when you are rich that you cannot do now, and why?” This kind of exploration can
help clients clarify their values.

For example, a common reason for wanting to be rich is freedom. In such a case, the
client values freedom, perhaps in many areas of their lives, such as freedom to travel,
freedom to work at something they enjoy, or freedom from work to enjoy other
pursuits.

The difference between values and goals is explored in this short video by Russ
Harris.

ACT practitioners have developed a range of interventions to help clients clarify their
values and make a deepening commitment to them. The exercises below provide a
map of valued life directions that can help steer a client into a life of greater
fulfillment. This is especially helpful when goals are at risk of derailment by
experiential avoidance.
Three value clarification interventions are described in the worksheets below.

1. Clarifying your personal values across 10 life domains

Try this exercise to clarify a client’s personal values across 10 valued life domains.

Download our free Personal Values Worksheet and use this simple self-reflection to

prioritize those areas of life that are most important to a client or that remain the least
fulfilled.

2. Values clarification – Write your own 80th birthday party speech

Ask your client to do this quick exercise from their heart. Ask them to imagine how
they would want somebody else to sum up their life as a life well lived. What would
they like to hear about themselves at their 80th birthday party?

You can guide your client as follows. “Consider what you want your life to stand for
as you approach your later years. What kind of person do you want to be remembered
as? An adventurer? A loving parent? A generous and charitable member of your
community? A pioneering businessperson?

“Write your own 80th birthday party speech and include what you would most like to
hear. You might want to draft the speech according to your most valued life
activities.”

This exercise can help clarify values, which are necessary to set realistic, achievable
goals.

3. Experiential avoidance – The Clean and Dirty Discomfort Diary

This exercise helps your client track their experiential avoidance strategies that
undermine goal achievement and behavioral change (Hayes et al., 1999). It enhances
self-awareness and mindfulness of the self-defeating consequences of avoidance.

The exercise helps clients distinguish between the clean discomfort of uncomfortable
emotions or thoughts, versus the dirty discomfort of avoidant behaviors such as
drinking too much, smoking, overeating, binge-watching TV, and so on.

You can download our free Clean and Dirty Discomfort Diary worksheet adapted
from Hayes and Smith (2005).

3 Activities to Try With Your Clients

 Overcoming experiential avoidance is
crucial for developing psychological flexibility.

A willingness to take committed action despite the inner obstacles that will arise is
also essential.

The following three activities follow on from the value clarification exercises above
by helping clients to prioritize their values and set action-based goals that steer their
life toward greater fulfillment.

1. Ranking Your Values and Finding Your Life Deviation Score

This exercise is best completed after a value clarification exercise. The aim is to
prioritize values and areas of your life that remain unfulfilled as those in need of
further development.

Each valued life domain is rated in terms of importance and degree of fulfillment to
find your life deviation score (Hayes & Smith, 2005). Our free Ranking Your Values
and Finding Your Life Deviation Score worksheet adapted from Hayes and Smith
(2005) provides a template and explains the exercise in detail.

2. Life Deviation Scores and Goal Setting

Once you have ranked your values and their degree of fulfillment, you will find that
the areas of your life that are most in need of attention will have higher life deviation
scores.

Use this worksheet to focus on your top three highest-scoring valued life domains and
begin setting long- and short-term goals that specify the action you will take to fulfill
your deepest values.

Download our free Life Deviation Scores and Goal Setting worksheet adapted from
Hayes and Smith (2005) for the exercise instructions and action-planning template.

3. Values-driven action planning

Committed action planning follows on from value clarification and prioritizing
exercises. This goal-setting exercise can be completed using our Commitment,
Obstacles, and Strategies worksheet.

This exercise also helps clients identify obstacles to meeting goals and plan strategies
for overcoming them.

2 ACT Group Exercises

1. Group mindfulness

Mindfulness practice in a group doesn’t have to be confined to breathing exercises or

meditation (Westrup & Wright, 2017a). In ACT, traditional sitting meditation is rarely
used.

Try this group exercise that cultivates mindfulness by adopting a nonjudgmental

mental state and experiencing an awareness of other group members while walking
around in silence. You can download our free Silent Connections worksheet for
further instructions.

2. Passengers on the bus

The ACT passengers on the bus metaphor (Harris, 2008) can also be conducted as an
experiential exercise that activates all the ACT core processes, including a willingness
to move toward value life directions, maintaining committed action through mindful
connection with the present moment, and defusing from inner events such as negative
commentary and self-judgment.

Here’s an educational video illustrating the metaphor created by members of an ACT

special interest group.

Here is an example of the exercise, adapted from Westrup and Wright (2017b):

Use chairs to form a “bus” in the middle of the room with four to six “passengers” and
one “driver,” depending on the group size. Ask for a volunteer driver, while the rest of
the group will be passengers. The driver must think of something they want to achieve
but haven’t so far due to negative self-commentary. Next, inform the driver that each
passenger represents one of the thoughts getting in their way.

The driver turns to each passenger and assigns each of them a thought, such as
“You’re incompetent,” “You’ll never amount to anything,” “You’re not good
enough,” and so on.
Next, give the bus driver the following directions: “You’ll drive your bus toward your
committed action [e.g., enroll in a new course, get a new job, go on a date, write a
book] over there [point to the wall in front of the bus]. But, before you start your
journey, you have to pick up your passengers. Look at each of them, listen to what
they have to say, and reply, ‘Please get on the bus.’

“Passengers, you sit on one of the seats and keep on commenting on the thought you
have been assigned. For example, if your driver assigned you with ‘You’re stupid,’
you can keep going on that theme with related comments. Driver, after all the
passengers are on the bus, look straight ahead, and drive your bus toward your
committed action.”

Afterward, process this activity by asking questions such as, “What did you want to
do, driver?” Typical responses include “I wanted to stop the bus and get off” or “I
wanted to turn around to shut them up.” Talk about what happens to your goals if you
do any of those things.

Also, process the passengers’ experiences. This can be difficult for them. Group
members often say they didn’t like being rude. Also, get feedback from the entire
group about what it was like to witness this activity and ask if group members can
relate it to their own experiences with their interfering thoughts.

PositivePsychology.com’s Relevant Resources

In addition to the free resources and worksheets provided above, you could try
our three Mindfulness Exercises for free.

We also offer an eight-module Mindfulness X training course consisting of the latest

science-based mindfulness interventions ready to deliver under your own branding.

More exercises are available in our related article How to Do Acceptance &

Commitment Group Therapy: 3 Activities.

If you’re looking for more science-based ways to help others enhance their wellbeing,
check out this signature collection of 17 validated positive psychology tools for
practitioners. Use them to help others flourish and thrive.

A Take-Home Message
Acceptance and Commitment Therapy continues to accumulate a scientific evidence
base showing its efficacy as an intervention for a range of life problems.
New metaphors, exercises, and techniques continue to develop and are shared freely
on the internet.

ACT is a short-term psychoeducational intervention that applies a practical approach

to cultivating psychological flexibility and overcoming the experiential avoidance that
results in chronic suffering.

It remains a vibrant area of research in the broad fields of health, education, and
personal development.

We hope you enjoyed reading this article. Don’t forget to download our three Positive
Psychology Exercises for free.

REFERENCES

 Harris, R. (2008). The happiness trap. Robinson.

 Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and
commitment therapy: An experiential approach to behavior change. Guilford
Press.
 Hayes, S. C., & Smith, S. (2005). Get out of your mind and your life – The new
acceptance and commitment therapy. New Harbinger.
 Hayes, S. C. (2021, August). State of the ACT evidence. Association for
Contextual and Behavioral Science. Retrieved November 22, 2021, from
https://contextualscience.org/state_of_the_act_evidence
 Smith, J. (2019, October 3). How does anxiety spiral into a panic attack? Dr
Julie Smith. Retrieved on November 28, 2021 from
https://doctorjuliesmith.com/how-does-anxiety-spiral-into-a-panic-attack/
 Westrup, D., & Wright, M. J. (2017a). Learning ACT for group treatment: An
acceptance and commitment therapy skills training manual for therapists. New
Harbinger.
 Westrup, D. & Wright, M. J. (2017b). Learning ACT for group treatment:
Supplemental exercises. New Harbinger.