10 ACT Therapy Activities & Exercises to do With Clients in Therapy

Acceptance and Commitment Therapy is commonly tied to the professional work of Stephen Hayes. Known widely as ACT, this therapeutic approach bears similarities to Dialectical Behavioral Therapy (Seligman, L. & Reighenberg, L.W., 2010). Moreover, ACT shares characteristics with constructivist psychology, narrative psychology, and feminist psychology (Seligman, L. & Reighenberg, L.W., 2010). Continue reading to discover 10 ACT Therapy activities and exercises you can engage in with your clients.

Explore our collection of Acceptance and Commitment Therapy Worksheets.

Acceptance and Commitment Therapy aims to assist clients in establishing a healthy relationship with their thoughts, feelings, memories, and physical sensations (Seligman, L. & Reighenberg, L.W., 2010). These changes collectively contribute to reducing distress associated with various mental health concerns.

Although we have no control over our memories and limited control over our immediate thoughts and feelings, we possess the ability to control our actions and behaviors. ACT therapy empowers individuals to modify unhealthy behaviors and develop effective coping strategies for challenging memories, thoughts, and emotions.

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Core Concepts associated with ACT, as outlined by Seligman and Reighenberg, include:

  • A- Accept and embrace thoughts and feelings
  • C- Choose a direction of life that accurately represents the client’s true self
  • T- Take steps towards making action 

Why Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT) is chosen for several compelling reasons:

  1. Evidence-Based: ACT has a strong empirical basis, with a substantial body of research supporting its effectiveness in treating various mental health issues, including anxiety disorders, depression, substance abuse, and more.
  2. Mindfulness-Based: ACT incorporates mindfulness practices that help individuals become more present and aware of their thoughts, emotions, and bodily sensations. This mindfulness fosters emotional regulation and psychological flexibility.
  3. Values-Centered: ACT helps individuals clarify their values and align their actions with what truly matters to them. It promotes a sense of purpose and fulfillment in life.
  4. Effective for a Range of Concerns: ACT is effective across a wide range of mental health concerns, making it adaptable to diverse client needs.
  5. Cognitive Defusion: ACT teaches cognitive defusion techniques, which help individuals distance themselves from unhelpful thoughts and reduce their impact on emotions and behaviors.
  6. Acceptance of Emotions: It encourages the acceptance of difficult emotions rather than avoidance or suppression, allowing individuals to build a healthier relationship with their feelings.
  7. Behavioral Activation: ACT promotes behavior change through values-driven action, helping individuals engage in meaningful activities and overcome barriers to change.
  8. Holistic Approach: ACT takes a holistic approach to well-being, addressing not only symptoms but also the broader context of an individual’s life, including relationships and values.
  9. Customized Treatment: ACT can be tailored to the specific values and goals of each individual, ensuring that therapy is personalized and relevant.
  10. Positive Therapeutic Relationship: ACT emphasizes building a strong therapeutic relationship characterized by empathy and support, creating a safe and non-judgmental space for clients to explore their thoughts and emotions.
  11. Long-Term Benefits: Many individuals who complete ACT report sustained improvements in their mental health and quality of life, with reduced risk of relapse.
  12. Transdiagnostic Application: While ACT was initially developed for specific issues, it has been adapted to address a broader range of concerns, making it suitable for clients with diverse issues.
  13. Enhanced Psychological Flexibility: ACT cultivates psychological flexibility, which enables individuals to adapt to life’s challenges more effectively and respond to them in ways that align with their values.
  14. Resilience Building: ACT equips individuals with skills for coping with stress, uncertainty, and adversity, fostering resilience and adaptability.
  15. Complementary to Other Therapies: ACT can be used alongside other therapeutic approaches, enhancing the effectiveness of treatment for various mental health concerns.

ACT is particularly well-suited for individuals seeking to increase psychological flexibility, live in alignment with their values, and overcome emotional and behavioral barriers to well-being. It offers a practical and mindfulness-based approach to promoting mental health and personal growth. Keep reading to learn ACT Therapy activities you can do with your clients.

Mental Health Concerns That Can Benefit from Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) offers an effective treatment approach for clients dealing with various mental health concerns. It has demonstrated particular success in assisting individuals struggling with anxiety disorders (Seligman, L. & Reighenberg, L.W., 2010).

Furthermore, ACT can be beneficial when working with clients facing specific phobias, depressive disorders, post-traumatic stress disorder, obsessive-compulsive disorder, panic, and other fear-related conditions that trigger avoidance behaviors (Seligman, L. & Reighenberg, L.W., 2010).

However, it is important to note that ACT is not suitable for individuals experiencing domestic violence or other forms of abuse. Accepting unhealthy behaviors within such relationships can be dangerous and may exacerbate mental health distress. Additionally, ACT therapy may not be effective for those with cognitive impairment.

ACT Therapy Activities

Acceptance and Commitment Therapy Activities can be an effective tool that gives your client an opportunity to practice skills and strategies associated with ACT. Introducing a new skill that your client is unfamiliar with can hinder your ability to effectively engage in ACT treatment interventions. Practicing the associated skills can be particularly helpful for individuals who are new to mindfulness, and those who find it challenging to apply mindfulness practices to their everyday lives. Clients may have preexisting knowledge of mindfulness which may or may not be accurate of what mindfulness truly is.

As a counselor, we can help our clients practice the associated skills and provide feedback that builds their confidence regarding mindfulness practices and work past any barriers that may be contributing to resistance.

Examples of Acceptance and Commitment Therapy Exercises that can be effective in individual therapy sessions include:

  1. Walk your client through a 10-15 minute visualization exercise. This can include a place that they have identified as safe and peaceful. After the visualization is complete, allow for time to process their experience and how the exercise impacted their thoughts and feelings. Explore ways that your client can utilize this mindfulness practice outside of their therapy sessions.
  2. Individual sessions can be a helpful time to practice skills that are commonly used in mindfulness practices. You may need to provide psychoeducation about mindfulness including what it is, how it can be practiced, and the benefits of using it in our everyday lives. Ask your client to imagine and describe to you a place that they find relaxing and/or peaceful. This can be a real or imagined place. Encourage them to think about observations they would have with their senses in this location.  Ask your client for specific details that would utilize the senses. Explain to your client that this location can be used in future guided imagery and visualization practices.
  3. Utilizing a Cognitive Defusion Worksheet can help clients recognize and work to change their thought patterns. As an example, your client would begin by identifying a hurtful or unhelpful thought that they are experiencing. The Cognitive Defusion Worksheet then walks them through steps that work towards externalizing the thought so that they become aware of its presence, rather than holding onto the thought as a truth. Encourage your client to practice this skill outside of the session when they begin to experience similar or other unhelpful thoughts and explore their experience doing so.
  4. Introduce your client to different forms of meditation. This can include guided imagery, body scans, progressive muscle relaxation, nothing, focused attention, visualization, and loving kindness. Allow for time to practice the discussed meditations and process your client’s experience. If you are working with clients who have a history of trauma and PTSD, it is important to be mindful of the forms of meditation that you introduce. Clients with histories of trauma and abuse may not be able to engage in body scans and other similar meditations in a healthy manner. Rather, they may find themselves in more distress than they did, to begin with. Allow for time to check in on your client’s ability to utilize meditation outside of therapy sessions.
  5. Many ACT Therapy exercises incorporate the client’s senses. You may find that some clients experience difficulty tapping into their senses, and benefit from practicing this level of awareness. Using a 5 Senses Worksheet can be a great way to begin practicing this level of awareness so that you can use grounding exercises as well as mindfulness exercises that utilize a client’s 5 senses.
  6. Clients who have difficulties developing realistic and attainable goals could benefit from the use of a Willingness and Action Plan Worksheet. TherapyPatron.com offers a worksheet template that breaks down a client’s goal by exploring how the goal is tied to their values, the necessary steps to achieve said goal, and identifying what experiences may arise as they work towards their goal. Additionally, they will have the opportunity to break their goal down into smaller, more bite-size pieces that can feel less overwhelming. This can be an effective tool to use for check-ins as you evaluate their progress toward their goal.
  7. The Self as Context worksheet available at TherapyPatron.com can help your client learn to distinguish between their self content, and self context. The goal of this worksheet is to help them move away from a sense of self content and move towards self-context. This can often relieve some of the distress that they are experiencing including challenging thoughts, feelings, and emotions that they have been carrying.
  8. Aligning with the goal of helping our clients live a life that reflects their true selves, ACT Bullseye Worksheet can help clients identify goals for their career and/or education, leisure activities, their relationships, and in their personal growth and health. The worksheet template available at TherapyPatron.com includes 5 steps that the client can take toward their goals. It is important that clients use goals and steps that are realistic. Depending on the client’s goals, there will likely be differences in the timeframes in that their goals can be met. It is important that the goals your client identifies are realistic and attainable.  Counselors can use the goals discussed in future sessions and highlight any thoughts and behaviors that work against their identified goals.
  9. Introduce your client to different forms of deep breathing. This can include box breathing, lions breath, pursed lips breathing, and breath focus. Allow for time to practice trying the various methods of deep breathing, and explore your client’s experience with them. Discuss the benefits of deep breathing and when your clients could benefit from engaging in these exercises in their day-to-day lives.
  10. Another ACT Therapy exercise would be to introduce your client to Maslow’s hierarchy of needs. After they gain an understanding of the pyramid, spend time exploring where they fall into the identified hierarchy.  You can pull some of their identified goals into this exercise by investigating how it could help them shift their current position. Explore where small improvements can be made that may have a large impact on their overall well-being.

Final Thoughts On Choosing Activities for ACT Therapy

Thank you for reading this resource on 10 ACT Therapy activities and exercises you can do with your clients. As mental health professionals, our goal is to provide clients with effective treatment approaches that can enhance their daily lives. Part of this involves utilizing our knowledge and skills during sessions to help clients manage their symptoms. ACT Therapy activities serve as valuable tools in both individual and group sessions. With its evidence-based status, we have confidence in ACT Therapy as an effective treatment modality for various mental health concerns.

If you’re interested in furthering your understanding of ACT Therapy or enhancing your existing knowledge, you may consider exploring ACT training workshops and engaging in continuing education opportunities. Additionally, seeking supervision can provide a supportive space to delve into your interest in learning more about ACT therapy and explore avenues for continued growth.

TherapyPatron.com helps mental health professionals better serve their clients. Our (editable, fillable, printable PDF) therapy worksheets can help you streamline your practice, effectively deliver different types of therapy, and support your clients be the best version of themselves.

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View all of our Acceptance and Commitment Therapy Worksheets

Resources:

Seligman, L. & Reichenberg, L.W. (2010). Theories of counseling and psychotherapy: Systems, strategies, and skills (3rd Edition, pp 388-397). Pearson Education, Inc. 

Kayla VanGuilder, MA, LCMHC
Author: Kayla VanGuilder, MA, LCMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression, anxiety, bipolar disorder, borderline personality disorder, and trauma.

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