ACT Psychological Flexibility (Hexaflex) Worksheet

Unlike many ACT tools that focus on a single process, this worksheet takes a broader, integrative approach. Each section corresponds to one of the six core processes, allowing clients to evaluate how they relate to thoughts, emotions, attention, identity, values, and behavior.

The rating system (1–10) serves two purposes. First, it encourages honest self-assessment across domains such as present-moment awareness or willingness to experience discomfort. Second, it creates a simple, trackable metric—clients can revisit the worksheet over time to observe shifts in psychological flexibility.

What makes this clinically useful is the contrast embedded in each scale. Clients are not just rating themselves abstractly—they are comparing two ends of a spectrum (e.g., being dominated by thoughts vs. seeing thoughts as one perspective among many). This helps clarify what psychological flexibility actually looks like in practice.

The total score provides a broad snapshot, but the real value lies in the pattern across processes. For example, a client may score higher in values clarity but lower in defusion or acceptance, highlighting where intervention may be most effective.

Over time, repeated use of the worksheet supports a more balanced development of all six processes. Rather than over-relying on one skill, clients begin to build a more integrated and adaptive way of responding to internal and external experiences.

How This Worksheet Can Be Used

• During therapy sessions: Used as a structured assessment to identify strengths and gaps across the six ACT processes.
• Between sessions: Assigned periodically to track changes in psychological flexibility over time.
• Independent use: Clients can self-monitor patterns and reflect on which areas need more attention or practice.

What This Worksheet Targets

• Imbalances across ACT core processes
• Cognitive fusion and rigid thinking
• Experiential avoidance
• Lack of present-moment awareness
• Disconnection from values
• Inconsistent values-based action

Benefits of Using a Hexaflex-Based Approach

• Provides a full model overview rather than focusing on a single skill
• Helps identify precise intervention targets
• Builds awareness of how processes interact
• Encourages balanced skill development
• Creates a measurable way to track psychological flexibility over time

How to Integrate This Worksheet in Therapy

1. Introduce the model: Briefly explain the six processes and how they work together.
2. Use scores as a guide: Focus sessions on lower-rated processes.
3. Avoid over-interpretation: Treat scores as directional, not diagnostic.
4. Link to interventions: Pair low-scoring areas with specific ACT exercises (e.g., defusion, acceptance work).
5. Reassess periodically: Revisit the worksheet to reinforce progress and adjust treatment focus.

References

• Steven C. Hayes, Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford Press.
• Steven C. Hayes, Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25.
• Steven C. Hayes, Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. Guilford Press.