40 ACT Therapy Discussion Questions to Ask Clients in Sessions

Acceptance and commitment therapy, commonly referred to as ACT, has been growing in popularity since its development.  Acceptance and commitment therapy works to help clients accept thoughts and emotions that they are unable to control. Additionally, clients are encouraged to create values in their life which can improve overall wellness. Discover 40 ACT therapy questions for sessions to help clients explore values, increase psychological flexibility, defuse from unhelpful thoughts, and take committed action toward meaningful change.

One of the beliefs associated with ACT is that sources of distress are inevitable experiences in life. This can include physical illnesses, uncomfortable emotions, and mental health concerns such as anxiety and depression. Once we accept that these challenges are a part of being human, we can work towards developing ways to adapt and cope when we experience them. With the development of these new skills, we are increasing emotional flexibility. This allows our clients to cope with their emotional distress in a healthy manner rather than avoiding or suppressing their discomfort.

Acceptance and commitment therapy would be a great clinical approach for clients who would benefit from accepting themselves as they are and learning new ways to cope when they find themselves faced with a new challenge or problem.

For more valuable resources, view our ACT Therapy Tools and Resources hub

The six core process of ACT that work towards increasing a client’s psychological flexibility includes:

• Acceptance
• Cognitive Defusion
• Being Present
• Self as Context
• Values
• Committed Action

Getting Ready for Your First Acceptance and Commitment Therapy Session with a New Client

When you know that you have a first session with a new client, you may find yourself feeling a range of emotions from curious to nervous. Taking time to ensure that you are prepared and organized can make a difference in the flow of your session and in the completion of your paperwork.

One step that you can take is to set aside time before your session to review the paperwork and other forms that you will need to complete. Depending on the type of clinical setting you work in, you may need to complete consents of release, informed consents, and particular assessments or screenings. Reviewing the necessary documents can help you develop a general plan of what you would like to spend your time on in your first ACT therapy session.  

From there, taking time to review any paperwork your client has completed prior to their session can be helpful. Your client may have indicated their concerns and goals for counseling which can have an influence on what you choose to focus on during your time together. Additionally, you may have documents completed by other professionals that can provide you with a bit of background information that may be relevant to your first session.

Another important step is to make sure that you are in a place where you can fully focus on your client. There is no denying that working as a mental health professional is rewarding, but it can also take a toll on us. Because of this, it is important that we are taking steps towards our own overall wellness. If you are short on time in your clinical setting, you can listen to a song, take a few deep breaths, or even listen to a short meditation. If you have a longer amount of time available, you may find that taking a walk gives you time to focus on yourself.

Common Questions to Ask in Acceptance and Commitment Therapy

Acceptance and commitment therapy questions play an integral role in the progression of therapy sessions. ACT questions can be used to check in with how your client is feeling in the moment, to ensure that they understand the strategies and skills that they are being introduced to, and to explore areas that they feel they would benefit from focusing on.

Examples of therapist questions to ask during ACT therapy include:

1. Can you tell me about any emotions that you find yourself avoiding? This can be intentional, or unintentional. Why do you feel that these emotions are challenging for you?
2. What are some emotions that you are comfortable sitting with and expressing? What is different with these emotions compared to the ones that you may find yourself avoiding?
3. Can you think of an emotion that you are comfortable sitting with now that you were not in the past? What changed from then to now for you?
4. What does being in the present mean for you?
5. How can you tell that you are living in the present?
6. Do you have any skills that help you be in the present moment?
7. What is an example of a value that is important to you in your life?
8. How do you feel your values influence your behaviors?
9. Are there any behaviors that you engage in that you do not feel support your values?
10. What do you feel are attributes of a good person?
11. What is an example of a short-term goal that you are working towards?
12. How does your behavior work towards your goals?
13. Are your current goals tied to any of your values?
14. What is motivating you towards the current goals that you have?
15. Can you tell me about a time that you were able to accomplish a goal that you set for yourself?
16. When you were able to accomplish your goal, what support did you have? Were there any particular skills that you utilized?
17. If you took a moment to listen to your mind, what is it telling you at this moment?
18. What would you do differently in the future?
19. Worksheets can be a great tool for counselors to use in therapy sessions. There are a number of ACT questions that can be used with this TherapyByPro Values Clarification Worksheet. This includes: What has kept you from reaching your professional goals? What kind of relationships do you think you would benefit from in your life?
20. What is your understanding of mindfulness?
21. Do you have any hesitations or reservations about engaging in mindfulness practices?
22. What barriers do you experience regarding the use of mindfulness skills?
23. Can you think of three ways that mindfulness skills can improve your mental health?
24. Do you feel as though your values have shifted over time? Can you tell me more about that?
25. After introducing your client to mindfulness skills, such as breathing strategies, acceptance, and commitment therapy questions that you could ask include: How was this experience for you? Do you see yourself using this skill when you are distressed?
26. Can you tell me about what makes you happy and sad?
27. Can you share with me what inspires you?
28. Where do you feel your most powerful motivation comes from?
29. Can you tell me what you are grateful for in your life?
30. What are some of your interests or hobbies?
31. Can you tell me about a recent time when you felt happy?
32. Can you tell me about a recent challenge that you were able to overcome?
33. Who is important to you in your life?
34. How would you describe your relationships?
35. How motivated do you feel you are towards making this change that you shared with me?
36. Can you share with me how you feel your thoughts and emotions impact your behaviors? As an example, someone who is feeling sad or down may find themselves staying home and isolating themselves from others.
37. How  likely do you feel you are to incorporate mindfulness skills into your daily life?
38. What changes would you notice in your life that you are making progress?
39. How would you describe your relationship with your emotions?
40. When you woke up this morning, was there anything that you were excited for or looking forward to?

Final Thoughts On Asking the Right Questions in ACT Therapy

Thank you for taking the time to read our blog about acceptance and commitment therapy discussion questions! We know that the questions that therapists ask during ACT therapy can guide your session in a helpful manner. With ACT therapy, you will spend time learning about what challenges your client experiences regarding their emotions, and help them find and build the values that they hold. This therapeutic approach can be helpful for clients who are living with depressive symptoms, obsessive-compulsive disorder, and post-traumatic stress disorder.

While some clients may respond to therapeutic approaches such as CBT and DBT, others benefit from a different approach. When we use a holistic lens to view our clients and their concerns, we can see that there are a range of factors that contribute to their overall level of wellness and functioning. When we include these factors in our perception, we are able to provide our clients with tailored treatment that can increase their clinical gains.

If you are interested in learning more about narrative therapy, we encourage you to seek  Continuing Education credits and other training opportunities near you. Once you have learned more about narrative therapy and developed the necessary skills, you can begin applying your new knowledge to your clinical work.

View all of our Acceptance and Commitment Therapy Worksheets

Resources:

• Dindo, L., Van Liew, J. R., & Arch, J. J. (2017, July). Acceptance and commitment therapy: A transdiagnostic behavioral intervention for mental health and medical conditions. Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509623/
• The Six Core Processes of Act | Association for Contextual Behavioral … (n.d.). https://contextualscience.org/the_six_core_processes_of_act