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6 ACT therapy techniques to try: An overview for mental health providers

Need fresh acceptance and commitment therapy (ACT) techniques? Get practical ideas, tips, and condition-specific adjustments — plus implementation help from Headway.

May 29, 2026

Clinically reviewed by Caitlin Pugh, LCSW

7 min read

Clinically reviewed by Caitlin Pugh, LCSW

No one can be happy, calm, and confident 100% of the time. The challenge is figuring out how to live a rich, fulfilling life even when the dark days come — and that’s where acceptance and commitment therapy (ACT) shines.

ACT is a blend of cognitive and action-oriented work, aiming to help clients accept challenging thoughts and emotions and commit to living a values-driven life. It is a versatile style of therapy that can find a place in a wide variety of treatment plans.

Need to brush up on your ACT basics? Read on.

Key insights

1

ACT helps clients accept negative thoughts and feelings, while developing tangible plans for living according to their values. It can help people dealing with depression, anxiety, and more.

2

There are six core principles in ACT, all meant to foster psychological flexibility: acceptance, cognitive defusion, presence, self as context, values, and committed action.

What is ACT?

Developed in the 1980s by psychologist Steven C. Hayes, ACT is all about helping a client accept negative thoughts and feelings — and learn to live a fulfilling, values-informed life in spite of them. 

Rather than trying to fix, suppress, or avoid difficult thoughts and emotions, ACT treats them as natural parts of life that need to be accepted and managed appropriately. That sets it apart from CBT, a popular form of therapy predicated on the idea that problematic thought patterns can be changed.

ACT is broadly applicable. It can be used with clients experiencing a range of challenges, including anxiety, depression, stress, chronic pain, and PTSD. Sometimes, it is used as a complement to other styles of therapy, rather than a first-line treatment.

What is the goal of ACT?

ACT aims to foster “psychological flexibility,” or the ability to live based on values and goals rather than knee-jerk emotional reactions. Psychological flexibility can promote resilience, adaptability, and healthy decision-making.

Successful ACT can improve quality of life and day-to-day functioning and lead to better emotional regulation, clarity, and overall mental health.

What are the pros and cons of ACT techniques?

ACT is a versatile therapeutic approach, but it’s not right for every client or situation. It may be most useful when:

  • A client feels “stuck” and needs new strategies for moving past difficult thoughts or feelings
  • A client is highly motivated by internal values or morals
  • A client has tried but not responded well to approaches focused on reducing symptoms

On the other hand, ACT may not be the best fit when:

  • Treating young children, who may struggle to grasp its more abstract concepts
  • Working with someone who has a high symptom burden that needs to be addressed directly 

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ACT technique ideas

ACT is guided by a set of six core processes, rather than hyper-specific techniques or protocols. These processes include:

1. Acceptance

Learning to accept, rather than avoid, difficult thoughts and feelings is at the heart of ACT. An ACT therapist will help their client accept that negative thoughts are a natural, and often appropriate, part of life, rather than something to be suppressed.

Tip: Acceptance often involves reframing a situation. Instead of trying to “get over” anxiety, for example, you might help your client accept that nervousness about the future is part of life.

2. Cognitive defusion

Emotions can feel all-consuming and urgent. Cognitive defusion is about dialing down the intensity by creating some distance between the client and their emotions. The idea is to help a client notice and label their feelings, treating them as morally neutral words rather than something that needs to be judged.

Tip: Techniques for promoting cognitive defusion include observing and describing thought processes (“I’m having a thought that I should be ashamed”) and singing a thought aloud — or using a silly voice when speaking — to externalize it.

3. Presence

When a client learns to stay grounded in the present moment, they’ll get better at noticing their thoughts and feelings without being overcome by them. It’s possible to accept thoughts and feelings only once they’ve been observed and labeled, and cultivating awareness is a big part of that.

Tip: Mindfulness exercises — such as visualization, sensory observation, or bodily awareness techniques — help promote presence. You’ll find more ideas in our guide to mindfulness therapy techniques.

4. Self as context

“Self as context” refers to the idea that people are more than their thoughts and emotions. Through this lens, the client can see their thoughts and feelings as temporary weather systems that pass through their environment, rather than the end-all, be-all of who they are.

Tip: Self as context is a fairly abstract idea, and one that may be best explored through experiential exercises, like imagining thoughts and feeling as objects floating down a river.

5. Values

In ACT, it’s crucial to help your client define the values they wish to live by, and what’s actually important to them. Often, this involves disentangling the client’s true values from their ingrained desires to live up to societal expectations, achieve outward trappings of success, or lessen discomfort.

Tip: To get your client thinking about values, consider asking questions like:

  • “Think about moments when you were proud of yourself. What made you proud?” 
  • “How would you like people to remember you when you are gone?”
  • “What behavior in others upsets you most? Why?” 

6. Committed action

Once the client has zeroed in on their values, it’s time to help them figure out how to put them into practice. Committed action is all about making concrete changes to lead a more value-driven, less reactive, life.

Tip: Goal-setting is likely to come into play here. Help your client envision what living according to their values would look like and how they can do so, perhaps using SMART goals.

ACT techniques for specific conditions

ACT is a flexible approach that can be adapted for a range of diagnoses, or for more general self-exploration. Here’s how to use it for specific conditions.

ACT techniques for trauma

ACT can be used to treat trauma and PTSD, often in conjunction with other approaches. When incorporating it into treatment plans for PTSD, consider techniques like:

  • Accepting that intrusive thoughts or memories will probably come up from time to time
  • Using cognitive defusion to create distance from them
  • Learning to stay grounded in the present, rather than feeling stuck in the past

ACT techniques for depression

Depression is among the most common indications for ACT. A depression treatment plan that incorporates ACT might include:

  • Exercises meant to increase awareness of and distance from depressive symptoms (i.e., shifting from “I am worthless” to “My thoughts are telling me I’m worthless”)
  • Mindfulness exercises to avoid rumination about the past
  • Setting achievable micro-goals in line with values

ACT techniques for anxiety

Anxiety is another common use case for ACT. When designing your treatment plan for a client with anxiety, think about including: 

  • Exercises focused on accepting, rather than fight against, anxious thoughts
  • Mindfulness exercises to interrupt worries or rumination cycles
  • Goal-setting focused on strategies for living in accordance with values, rather than worries

Tips for implementing ACT techniques in your practice

Now that you have some background on the philosophy of ACT, here’s how to actually incorporate it into your practice.

Session structure and planning

ACT is not as prescriptive as some other forms of therapy, allowing for flexibility in its implementation. That said, many ACT appointments will include:

  • A quick check-in to discuss progress since the last session
  • An experiential exercise meant to further its core processes
  • Practical discussion about how to set goals and make value-based decisions

The ACT matrix can be a useful tool for guiding this work, helping clients consider thoughts and behaviors that take them closer — or further — from their goals and values.

Documentation and compliance considerations

As with any style of therapy, you’ll need to carefully document your client’s diagnosis and symptoms, as well as the treatments and services you’re using to address these issues, if you plan to bill insurance. 

Headway can help. Our free EHR includes documentation templates for everything from your intake assessment to your progress notes, plus an AI assistant that turns session summaries into compliant notes in seconds.


ACT FAQs

Still have questions? See below for some of the most common clinician queries about ACT.

What does “acceptance” actually mean?

Acceptance is about learning to live alongside negative thoughts and feelings, rather than trying to avoid or minimize them. In ACT, therapists try to help clients channel that acceptance toward a life defined by values. That might look like saying, “I’m anxious about going to this party, but that’s OK. I’m going to show up anyway because I want to support my friend.” 

Is defusion just another version of cognitive restructuring? 

Cognitive restructuring, which is commonly used in CBT, is about helping people notice and change problematic thought patterns. Cognitive defusion, by contrast, isn’t seeking to change thoughts themselves, but to shift an individual’s relationship and reaction to those thoughts. Both techniques can provide mental health benefits, studies show.

How do I balance acceptance with change?

The first step in balancing acceptance and change is realizing that they are not as contradictory as they might seem. Accepting difficulty can be the first step in moving past it. In the therapy room, that could look like:

  • Identifying examples of emotional or experiential avoidance, and discussing how they held the client back from living a life in line with their values
  • Helping the client set goals that acknowledge the continued presence of negative emotions (i.e., “If I’m feeling unmotivated, I will still try to do one thing on my to-do list”)
  • Using exercises like the "helicopter view” — observing oneself from above — to gain perspective on difficult situations

Explore other therapy approaches with guides from Headway

A thriving therapist has many tools in their clinical toolbox. To brush up on other therapeutic techniques, check out our guides to:

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

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