ACT Values Clarification Worksheet (Life Domains & Values Clarification Tool)

Clinical Rationale

A common limitation in values work is overgeneralization. Clients may endorse values like “connection” or “health,” yet show highly inconsistent behavior depending on context. This worksheet addresses that issue by separating values into functional domains.

Each domain serves a different behavioral system:

• Work and education → competence, contribution, persistence
• Relationships → attachment, communication, reciprocity
• Personal growth → self-regulation, identity development
• Leisure → reinforcement, recovery, pleasure

By mapping each domain separately, clinicians can identify specific rigidity patterns rather than global conclusions about motivation or insight.

How the Worksheet Is Structured in Practice

The tool follows a repeated clinical sequence across domains:

• Values articulation (direction setting): Clients define what matters in each domain in behavioral terms (how they want to act, not just what they want).
• Distance scaling (current alignment): Clients rate how closely their current behavior matches those values on a 1–10 continuum.
• Barrier identification (functional analysis): Clients identify what interferes with acting in alignment with values (avoidance, fear, fatigue, self-doubt, etc.).
• Committed action planning (behavior translation): Clients define small, realistic actions that reduce the gap between values and current behavior.

This sequence mirrors core ACT processes without requiring theoretical explanation during session.

Clinical Utility

This worksheet is most useful when clinicians need to:

• Identify cross-domain behavioral inconsistencies
• Distinguish between values clarity and action barriers
• Translate abstract values into observable behavior
• Support treatment planning in ACT, CBT, or integrative models
• Track progress without relying on symptom reduction alone

It is especially effective in early-to-mid treatment phases when clients can articulate values but struggle to act on them consistently.

Observed Clinical Effects Over Time

With repeated use, clinicians often observe:

• Increased specificity in values articulation (less abstract, more behavioral)
• Greater awareness of domain-specific avoidance patterns
• Improved follow-through on small behavioral commitments
• Reduced fusion with “global self-judgments” (e.g., “I never change”)
• Increased willingness to tolerate discomfort in pursuit of valued action

Importantly, progress tends to appear first as clarity, not behavior change.

Integration Guidance for Clinicians

• Use one domain per session when working with overwhelmed clients
• Revisit earlier ratings after behavioral experiments, not immediately
• Treat scores as directional indicators, not performance metrics
• Link barriers directly to acceptance and defusion work when needed
• Reframe “low scores” as information about context, not failure

The worksheet is most effective when it is revisited over time rather than completed once.

References:

1. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford Press.
2. Hayes, S. C., 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.
3. Villatte, M., Villatte, J. L., & Hayes, S. C. (2016). Mastering the Clinical Conversation: Language as Intervention. Guilford Press.