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10 Acceptance and Commitment Therapy (ACT) Exercises & Activities to do with your Clients

Acceptance and Commitment Therapy is commonly tied to the professional work of Stephen Hayes. Commonly known as ACT, this treatment modality resembles Dialectical Behavioral Therapy (Seligman, L. & Reighenberg, L.W., 2010). Additionally, ACT shares characteristics with constructivism psychology, narrative psychology, and feminist psychology (Seligman, L. & Reighenberg, L.W., 2010). Keep reading to learn 10 acceptance and commitment therapy exercises and activities you can do with your clients.

View all of our Acceptance and Commitment Therapy Worksheets

Acceptance and Commitment Therapy works to help clients learn to make healthy contact with their thoughts, feelings, memories, and physical sensations (Seligman, L. & Reighenberg, L.W., 2010). Together, these changes can help reduce distress associated with a variety of mental health concerns.        

While we have no control over our memories and little control over our immediate feelings and thoughts, we do have control over our actions and behaviors. ACT therapy helps individuals learn to learn how to change unhealthy behaviors and learn to cope with challenging memories, thoughts, and feelings.  

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 

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

Acceptance and Commitment Therapy can be an effective treatment modality for clients who are living with a variety of mental health concerns. ACT has been shown to work quite well with individuals who are struggling with anxiety disorders (Seligman, L. & Reighenberg, L.W., 2010).

Additionally, Acceptance and Commitment Therapy can be effective when working with clients who are living with certain phobias, depressive disorders,  post-traumatic stress disorder, obsessive-compulsive disorder, panic, and other fears that evoke avoidance behaviors (Seligman, L. & Reighenberg, L.W., 2010).

ACT would not be appropriate for individuals who are experiencing domestic violence, and other forms of abuse. Working to accept the behaviors in unhealthy relationships is dangerous, and can lead to additional mental health distress. ACT therapy would be ineffective for those who have cognitive impairment as well.

ACT 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. 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 TherapyByPro 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.
  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. Clients who have difficulties developing realistic and attainable goals could benefit from the use of a Willingness and Action Plan Worksheet. TherapyByPro 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. 
  4. 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. 
  5. The Self as Context worksheet available at TherapyByPro 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.
  6. 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. 
  7. 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. 
  8. 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. 
  9. 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.
  10. 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. 

Final Thoughts On Choosing Activities for Acceptance and Commitment Therapy

Thank you for reading this resource on 10 acceptance and commitment therapy exercises and activities you can do with your clients. As Counselors, we strive to provide our clients with effective treatment approaches that can enhance their everyday life. A piece of this is knowing how we can utilize our knowledge and skills during sessions to help clients manage their symptoms. ACT Therapy activities can be an effective tool in both individual and group sessions. As an evidence-based treatment approach, we are confident that ACT Therapy can be an effective treatment modality for many mental health concerns.

If you are interested in learning more about ACT Therapy or boosting your existing knowledge, you can consider ACT training workshops and continuing education opportunities. Supervision can be an effective place to explore your interest in learning more about ACT therapy and investigate how you can move towards your goal of continued learning.

TherapyByPro is an online mental health directory that connects mental health pros with clients in need. If you’re a mental health professional, you can Join our community and add your practice listing here. We have assessments, practice forms, and worksheet templates mental health professionals can use to streamline their practice. View all of our mental health worksheets here.

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 Loibl, MA, LMHC
Author: Kayla Loibl, MA, LMHC

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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