Therapy Skills / ACT

ACT Therapy Session Coach

A clinician-facing guide that explains Acceptance and Commitment Therapy while walking you through a structured patient session — from psychological flexibility assessment to a chart-ready progress note.

OPEN · Acceptance + DefusionAWARE · Present + PerspectiveENGAGED · Values + Action

Clinical use: This is a teaching and documentation aid for trained clinicians, not a treatment manual or a substitute for supervision. Nothing here diagnoses, and the flexibility ratings are clinician impressions, not a validated instrument.

What ACT is trying to do

ACT does not aim to reduce symptoms directly. It builds psychological flexibility: contacting the present moment fully, as a conscious being, and — based on what the situation affords — persisting in or changing behavior in the service of chosen values. Symptom relief often follows, but it is a by-product rather than the target. Workability, not truth or comfort, is the yardstick for every response.

The six processes sit in three pillars: OPEN (acceptance, defusion), AWARE (present-moment contact, self-as-context), and ENGAGED (values, committed action). You do not need all six in one session — pick the one or two doing the most damage this week.

Session setup

Patient name or initials

Record number

Session date

Session number

Clinician

Modality

Face-to-face minutes

Presenting focus in the patient's words

Opening script — creative hopelessness, gently

"You've worked hard at this. Can we take stock of the strategies you've tried — and ask, honestly, what each one has cost you and what it has bought you? I'm not saying you've done it wrong. I'm asking whether the approach itself can ever get you where you want to go."

1. Orientation