Acceptance and Commitment Therapy (ACT) is an evidence-based therapeutic approach that can promote psychological flexibility and help clients stay in the present moment. Another key feature of this approach is helping clients to accept situations and experiences as they are, without judging or avoiding them. ACT can also help clients realign their behaviors with their values, thereby reducing psychological and emotional distress. Research supports the use of ACT for a range of mental health disorders, including anxiety, depression, Post-Traumatic Stress Disorder (PTSD), Obsessive-Compulsive Disorder (OCD), and chronic stress.
Continue reading as we review widespread Acceptance and Commitment Therapy techniques.
9 Acceptance and Commitment Therapy Techniques
ACT therapy techniques are methods that are used to address how a client relates to their thoughts, emotions, and experiences. ACT techniques are simple processes that can be incorporated into a range of interventions. As you continue reading, you’ll recognize which skill the techniques address and how change can promote healing and emotional well-being.
1. Thought Labeling
Thought labeling helps clients differentiate their thoughts from facts. This action addresses automatic thoughts and beliefs that support cognitive defusion. This technique is helpful for clients struggling with worry, rumination, and self-criticism.
What It Is: A defusion technique that helps clients identify thoughts as mental events rather than facts.
How It Helps Clients: Reduces rumination, worry, and self-criticism by weakening the literal meaning of distressing thoughts.
How to Do It: Ask clients to preface thoughts with “I’m having the thought that…”. Explore how emotional intensity shifts when thoughts are observed instead of believed.
2. Leaves on a Stream Visualization
This is an example of a cognitive defusion intervention that would be beneficial for clients struggling with symptoms stemming from anxiety, depression, OCD, and PTSD. For this exercise, you will encourage your client to write their thoughts and worries on leaves floating down a stream. Have them notice the leaf as it floats away, being mindful of how this affects their emotions. This can decrease rumination and over-identification of distressing thoughts.
What It Is: A guided visualization where thoughts are placed on leaves floating down a stream.
How It Helps Clients: Decreases over-identification with thoughts and promotes present-moment awareness.
How to Do It: Guide clients to place each thought on a leaf and watch it pass without forcing it away. Normalize distraction and gently redirect attention as needed.
3. Body Scans
Body scans are used to encourage clients to pay attention to different areas of their bodies, particularly the physical sensations that they have. During this time, encourage your client to simply observe their thoughts, not judge their presence. This is used to increase physical awareness and bring attention to physical reactions to stress.
What It Is: A mindfulness exercise that directs attention to physical sensations in the body.
How It Helps Clients: Increases awareness of the mind–body connection and early signs of emotional distress.
How to Do It: Slowly guide attention through the body, encouraging observation without judgment. Particularly helpful for anxiety, trauma, and stress-related concerns.
4. Acceptance
Acceptance can be incorporated into various ACT interventions to reduce a client’s struggle with unwanted internal thoughts and emotions. Clinicians provide support to clients in session as they allow complex thoughts, feelings, and physical sensations to occur without avoiding or trying to control them. Incorporating acceptance can increase a client’s ability for meaningful action.
What It Is: Allowing thoughts, emotions, and sensations to exist without avoidance or control.
How It Helps Clients: Reduces experiential avoidance and increases emotional tolerance.
How to Do It: Support clients in noticing discomfort while staying engaged in the moment. Emphasize willingness rather than liking or approving of the experience.
5. Take an Observer Perspective
For this exercise, you’ll ask your client to notice their thoughts and feelings as an observer. This can help shift their perspective to see that experiences happen to them, they do not define who they are. As an example, a client may feel anxious in the body, but they themselves are not anxiety.
What It Is: An ACT process that helps clients access a stable sense of self separate from thoughts and emotions.
How It Helps Clients: Reduces identity fusion with symptoms (e.g., “I am anxiety”).
How to Do It: Ask clients to observe thoughts and emotions as experiences they have, not who they are. Use language such as “Notice the part of you that is aware.”
6. Values Clarification Interview
Structured interviews can help you learn more about the values your clients hold. This can highlight meaningful changes they could make in their work, relationships, and health to promote personal growth. This can also help clarify their motivation for making behavioral changes.
What It Is: A structured exploration of what matters most to the client.
How It Helps Clients: Increases motivation and direction for behavior change.
How to Do It: Explore values across life domains (relationships, work, health, growth). Reflect values back and link them to actionable goals.
7. Small Steps Planning
Breaking goals into smaller steps can help make changes less intimidating. For this, you’ll help your client break down their values-based goals into small and measurable changes that they can track between sessions. This can increase consistency and encourage progression, despite discomfort.
What It Is: Translating values into realistic, measurable actions.
How It Helps Clients: Reduces overwhelm and supports consistency despite discomfort.
How to Do It: Collaboratively break values-based goals into achievable steps. Review progress and barriers in follow-up sessions.
8. Metaphor-Based Exercises
Metaphor-based exercises are a foundational component of Acceptance and Commitment Therapy and are often used to help clients grasp complex or abstract concepts in a more experiential and relatable way. Metaphors such as Passengers on the Bus, Chessboard, or Mind as Sky allow clients to explore their relationship with thoughts and emotions without becoming overly analytical or self-critical. These exercises can be especially helpful for clients who struggle with cognitive fusion or who feel overwhelmed when discussing their internal experiences directly.
What It Is: Using metaphors (e.g., Passengers on the Bus, Chessboard, Mind as Sky) to explain ACT concepts.
How It Helps Clients: Makes abstract processes like defusion and acceptance more accessible.
How to Do It: Select metaphors that match the client’s struggles and reflect together on how the metaphor applies to their experience.
9. Urge Surfing
Urge surfing is a mindfulness-based ACT exercise designed to help clients respond differently to intense urges, cravings, or impulses without immediately acting on them. Rather than attempting to suppress or eliminate urges, this intervention teaches clients to observe and tolerate discomfort while staying grounded in the present moment. Urge surfing is commonly used with clients experiencing substance use concerns, emotional eating, self-harm urges, anxiety-driven avoidance, or impulsive behaviors.
What It Is: A mindfulness-based approach to riding out urges without acting on them.
How It Helps Clients: Increases distress tolerance and reduces impulsive behavior.
How to Do It: Guide clients to observe urges like waves—rising, peaking, and falling—while staying grounded in the present moment.
8 ACT Interventions to Use in Sessions
Acceptance and Commitment Therapy interventions are structured therapeutic activities or exercises that can be incorporated into sessions to reinforce the techniques and beliefs associated with ACT. The interventions you use in therapy can vary and often be modified to your clients’ symptoms, age, and developmental capacity. While this is not an exhaustive list, it can provide you with insight into commonly used ACT therapy interventions.
1. Defusion Practice During Trigger Exposure
Encourage your client to use thought-labeling and visualization techniques when they experience symptoms or triggering experiences. When used in a safe environment, like a therapy session, you can help reduce avoidance behaviors and improve emotional tolerance for symptoms that previously prompted avoidance.
What It Is: Practicing defusion while discussing or encountering triggers.
How It Helps Clients: Reduces avoidance and builds tolerance for distressing experiences.
How to Do It: Prompt clients to label thoughts or visualize them during emotionally charged discussions.
2. Acceptance Focused Craving Management
This exercise is used with clients living with a substance use disorder. With the combination of expansion exercises and mindfulness practices, clients can practice remaining present during cravings or urges, without acting on them.
What It Is: Using acceptance and mindfulness during cravings or urges.
How It Helps Clients: Reduces reliance on avoidance or compulsive behaviors.
How to Do It: Support clients in noticing cravings without acting, emphasizing willingness and values-aligned choices.
3. Values-Based Behavioral Activation
Values-based behavioral activation can occur once you have insight into your client’s values. With this information, you can help them identify small steps they can take to increase their engagement in positive and meaningful activities. It is important to remember that these steps should align with your client’s symptoms and level of functioning to ensure they are realistic.
What It Is: Increasing engagement in meaningful activities aligned with values.
How It Helps Clients: Improves mood, motivation, and sense of purpose.
How to Do It: Identify small, value-consistent actions and monitor impact on mood and functioning.
4. Trauma Flexibility Work
For this intervention, you will help clients who over-identify trauma narratives, rigid identity beliefs, and shame-based self-concepts. You will encourage your clients to observe their thoughts and emotions from a distance, noticing that they are not defined by them. With a stronger sense of self, you can help your client process their trauma without experiencing overwhelming responses.
What It Is: ACT-based work addressing trauma-related fusion and identity beliefs.
How It Helps Clients: Reduces shame and rigid self-concepts tied to trauma.
How to Do It: Use self-as-context and mindfulness to help clients observe trauma narratives without becoming overwhelmed.
5. Mindful Awareness with Emotion Regulation
You can help your client master emotion regulation strategies so that they can increase self-awareness and recognize the early warning signs of emotional distress. You can review body scans, paced breathing, grounding, and other emotion regulation skills. This can be helpful for clients living with trauma-related disorders, some personality disorders, and mood disorders.
What It Is: Teaching mindfulness skills to identify and regulate emotions.
How It Helps Clients: Increases early detection of distress and adaptive responding.
How to Do It: Practice grounding, breathing, and body-based awareness exercises in session.
6. Choice Point Mapping
Choice point mapping is a committed action exercise that also aligns with value clarification intentions. This is a helpful exercise with clients who struggle with substance use disorders, depression, and bipolar disorders. For this, you’ll help your client create a diagram to determine whether their behaviors are moving towards or away from their values. This can promote the use of values-driven decisions and intentional actions.
What It Is: A visual tool to identify behaviors that move toward or away from values.
How It Helps Clients: Encourages intentional, values-driven decisions.
How to Do It: Create a diagram mapping current behaviors and alternative value-consistent choices.
7. Commitment Contracts
Commitment contracts can use values-based goals to identify specific behavioral changes that can be made. This includes target behaviors, timelines, and accountability strategies. Ask your client about potential obstacles and review acceptance-based coping strategies that can be used. This can help reinforce personal responsibility for change.
What It Is: A structured agreement outlining values-based behavioral commitments.
How It Helps Clients: Increases accountability and follow-through.
How to Do It: Define behaviors, timelines, obstacles, and acceptance-based coping strategies.
8. Values Compass Exercise
The values compass exercise helps clients clarify what truly matters to them across different areas of life, especially when they feel stuck, unmotivated, or disconnected from their goals. By identifying and organizing values, clients gain a clearer sense of direction that can guide decision-making and support values-consistent behavior, even in the presence of emotional discomfort. This exercise is commonly used in ACT to strengthen motivation and orient clients toward meaningful action rather than symptom avoidance.
What It Is: A structured mapping of values across life domains.
How It Helps Clients: Provides clarity and direction when clients feel stuck or unmotivated.
How to Do It: Help clients identify values in key areas and use them as a reference point for decision-making.
Other Helpful ACT Resources
When you’re incorporating ACT therapy into your sessions, you may find yourself looking for resources that can guide you in session or enhance your current skill set. TherapyByPro is a leading professional resource offering a variety of tools for mental health professionals. You can find resources for professionals, including ACT. Examples of ACT resources available include:
Final Thoughts on Using ACT Therapy in Sessions
ACT is a therapeutic approach that can offer you a flexible, compassionate lens across various treatment settings. By addressing how clients respond to distressing thoughts and emotions, you can help decrease rumination, self-criticism, and avoidance symptoms. ACT can be tailored to your client’s readiness to change, values, and current mental health symptoms. This allows you to provide personalized care that aligns with a progression that they’re comfortable with.
In closing, choosing to use ACT in therapy sessions can help clients find new meaning in their lives. This can increase motivation and introduce a new level of optimism or excitement. This approach has been shown to improve treatment outcomes and create a healthy, collaborative treatment experience.
TherapyByPro is a trusted resource for mental health professionals worldwide. Our therapy tools are designed with one mission in mind: to save you time and help you focus on what truly matters-your clients. Every worksheet, counseling script, and therapy poster in our shop is professionally crafted to simplify your workflow, enhance your sessions, reduce stress, and most of all, help your clients.
Want to reach more clients? We can help! TherapyByPro is also a therapist directory designed to help you reach new clients, highlight your expertise, and make a meaningful impact in the lives of others.
View all of our Acceptance and Commitment Therapy Worksheets
References:
- Ducasse D, Fond G. La thérapie d’acceptation et d’engagement [Acceptance and commitment therapy]. Encephale. 2015 Feb;41(1):1-9. French. Doi: 10.1016/j.encep.2013.04.017. Epub 2013 Nov 18. PMID: 24262333.
- Spencer SD, Levin ME. Introduction to Acceptance and Commitment Therapy: Theoretical, Practical, and Empirical Foundations. Psychiatr Clin North Am. 2025 Sep;48(3):429-441. doi: 10.1016/j.psc.2025.02.002. Epub 2025 Apr 3. PMID: 40738524.