What is an ACT worksheet?

An ACT worksheet is a tool from Acceptance and Commitment Therapy that helps a patient build psychological flexibility: defusing from unhelpful thoughts, clarifying values, practicing willingness to feel discomfort, and taking committed action toward what matters.

How is ACT different from CBT?

CBT works by changing the content of unhelpful thoughts. ACT changes the patient's relationship to their thoughts, holding them more lightly and acting on values regardless, rather than trying to dispute or eliminate them.

What is a values worksheet in ACT?

A values worksheet helps a patient clarify what genuinely matters to them across life domains such as relationships, work, and growth, then use those values to guide committed action.

Is the example based on a real patient?

No. The example is based on a fictional patient (Nina) and is shown for illustration only. TheraFlow does not use real patient data in these examples.

ACT · ACT

ACT Worksheet (Acceptance & Commitment Therapy)

An ACT worksheet helps patients build psychological flexibility: the ability to stay present and act on their values even when difficult thoughts and feelings show up. Acceptance and Commitment Therapy (ACT) takes a genuinely different stance from CBT, it doesn't try to change or dispute unhelpful thoughts, but to change the patient's relationship with them.

The most useful ACT worksheets move through its core processes: noticing the cost of avoidance, defusion (seeing thoughts as mental events rather than facts), values clarification, willingness to carry discomfort, and committed action toward what matters. (For how ACT compares with CBT and DBT, see our guide to CBT vs DBT vs ACT.)

Below is a complete example, a personalized ACT worksheet generated by TheraFlow from a therapist's session notes.

Example only. This worksheet is based on a fictional patient (Nina) and is shown for illustration.

The session notes behind this worksheet

Session: Nina Alvarez - Living by Values, Not by Fear (Session 4)

Nina returned for her fourth session. She describes a persistent sense of being "stuck" and of life passing her by. For years she has held back: turning down a chance to lead a project, staying quiet in meetings, avoiding a difficult conversation with her partner, all because of a loud inner voice telling her "you're not good enough" and "you'll embarrass yourself." She has tried hard to argue with these thoughts and to wait until she feels confident before acting, but says the confidence never comes and the struggle leaves her exhausted.

What stands out is how much her world has narrowed around avoiding discomfort. The more she protects herself from the possibility of failing or being judged, the smaller and flatter her life feels. She used to love designing and illustrating for its own sake, and she values creativity, close friendships, and growth, but she has drifted from all of it. "I keep waiting to feel ready, and I never do."

She is not depressed in the classic sense and denies SI/HI. The core difficulty is experiential avoidance and being fused with self-critical thoughts, at the cost of a meaningful life.

Patterns: cognitive fusion with "I'm not good enough" thoughts, experiential avoidance of discomfort, a control agenda that hasn't worked, and a growing gap between how she spends her time and what she says matters to her.

Goals she named: stop waiting to feel ready, be able to act even when the anxious thoughts show up, and reconnect with creativity and the people she cares about.

Direction: ACT. Explore how controlling and avoiding difficult thoughts has been working (creative hopelessness); introduce defusion so she can hold "I'm not good enough" more lightly; practice acceptance and willingness to feel discomfort in the service of what matters; clarify her core values (creativity, connection, growth); and set one or two small committed actions aligned with those values, taken with the anxious thoughts along for the ride.

From these notes, TheraFlow generated the worksheet below in about a minute.

Moving Toward What Matters

For Nina

Welcome

Hi Nina, in our session today you described feeling "stuck" and watching life pass by while that familiar voice tells you "you're not good enough" and "you'll embarrass yourself." You've been waiting to feel ready, but as you put it: "I keep waiting to feel ready, and I never do." The exhaustion from arguing with these thoughts, and the way your world has narrowed around avoiding discomfort, makes complete sense. This worksheet focuses on changing your relationship with those thoughts rather than trying to win the argument with them: exploring what avoidance has cost you, holding your self-critical thoughts more lightly, reconnecting with your values, and planning small steps you can take with those anxious thoughts along for the ride.

Understanding What's Happening

Psychological flexibility is the ability to stay present with your experience and take action guided by your values, even when difficult thoughts and feelings show up. It's not about eliminating anxiety or self-doubt, but about changing how you relate to them. When we're psychologically inflexible, we get "fused" with our thoughts, believing them completely, and spend enormous energy trying to avoid or control uncomfortable feelings, which often leads to a smaller, more restricted life. The alternative is learning to "defuse" from thoughts (seeing them as mental events rather than facts), practising willingness to have difficult experiences, and taking committed action toward what matters. Your thoughts don't have to change for your life to change.

Learning Objectives

Explore how avoidance and control strategies have been working for you
Practice seeing self-critical thoughts as mental events rather than facts
Clarify your core values around creativity, connection, and growth
Identify one small action you can take toward what matters this week
Rate your willingness to carry discomfort in service of your values

The Cost of Waiting to Feel Ready

You've been waiting to feel confident before taking action, but the confidence never comes. Explore what this strategy of waiting and avoiding has actually cost you over time.

Think about the project leadership opportunity you turned down. What did avoiding that discomfort cost you in growth, recognition, or satisfaction?

When you stay quiet in meetings, what opportunities for connection, creativity, or contribution do you miss?

You mentioned drifting away from designing and illustrating. How has waiting to feel good enough affected your relationship with creativity?

Noticing Thoughts as Mental Events

When we're fused with thoughts, we experience them as facts about reality. Defusion helps you step back and see them as mental events your mind produces. Complete these stems to observe your thoughts from a different angle.

Tip · If it feels strange to talk about your thoughts this way, that's normal. You're learning a new skill.

When my mind tells me 'you're not good enough,' I notice...

The story my mind likes to tell about embarrassing myself goes like this...

I'm having the thought that I need to wait until I feel ready, and...

My mind is trying to protect me by saying...

If I could hold the thought 'you'll embarrass yourself' more lightly, I might...

What Really Matters to You

You mentioned valuing creativity, close friendships, and growth. Explore what each of these means to you specifically and how you want to show up in these areas of your life.

Tip · Values are directions, not destinations. Focus on how you want to be, not what you want to achieve.

Creativity

Close friendships

Growth

Willingness to Carry Discomfort

Rate your current willingness in each area. This isn't about how much discomfort you feel, but how willing you are to have it while moving toward what matters. Write briefly about what influences each rating.

Tip · Willingness can change from moment to moment. There's no right level.

Completely unwilling to feel anxious about speaking upWilling to feel anxious if it means contributing my ideas

Why did you place yourself here?

Must avoid any risk of creative failureWilling to create imperfectly and learn from it

Why did you place yourself here?

Avoid difficult conversations at all costsWilling to have hard conversations for deeper connection

Why did you place yourself here?

Need to feel confident before taking actionWilling to act while feeling uncertain or scared

Why did you place yourself here?

One Small Step This Week

Choose one small action you can take this week that aligns with your values, even if the "you're not good enough" and "you'll embarrass yourself" thoughts show up. Make it specific and achievable.

Tip · The goal isn't to feel confident. It's to take the action with the thoughts and feelings along for the ride.

What specific action will you take? Be concrete: when, where, and how.

Which value does this action serve? (creativity, connection, growth)

What uncomfortable thoughts or feelings might show up?

How will you remind yourself that you can carry these feelings while taking action?

Carrying This Forward

Nina, what struck me most in our session was your clarity about what matters to you, and your honest recognition that waiting to feel ready has kept you from the very things you value most. This week, as you consider that small step, remember that you don't need to feel confident or have those self-critical thoughts disappear. You can carry "you're not good enough" and still create something, speak up in a meeting, or have that conversation with your partner. The thoughts are just passengers, not the driver.

A Word of Support

You've already taken a brave step by recognizing that arguing with your thoughts and waiting for readiness hasn't been serving you. That awareness is the foundation for everything else. Trust that you can learn to hold your thoughts more lightly while moving toward what truly matters to you.

Editable Printable

What makes an ACT worksheet effective

Notice what the example does not do: it doesn't try to argue the patient out of "I'm not good enough." Instead it helps her hold that thought more lightly and act on her values anyway. The willingness scales and the "one small step" exercise carry the whole ACT message: you can move toward what matters with the difficult thoughts along for the ride.

Keep the values concrete and the committed action tiny, and frame every exercise as changing the relationship with thoughts, not winning an argument with them.

Frequently asked questions

What is an ACT worksheet?: An ACT worksheet is a tool from Acceptance and Commitment Therapy that helps a patient build psychological flexibility: defusing from unhelpful thoughts, clarifying values, practicing willingness to feel discomfort, and taking committed action toward what matters.
How is ACT different from CBT?: CBT works by changing the content of unhelpful thoughts. ACT changes the patient's relationship to their thoughts, holding them more lightly and acting on values regardless, rather than trying to dispute or eliminate them.
What is a values worksheet in ACT?: A values worksheet helps a patient clarify what genuinely matters to them across life domains such as relationships, work, and growth, then use those values to guide committed action.
Is the example based on a real patient?: No. The example is based on a fictional patient (Nina) and is shown for illustration only. TheraFlow does not use real patient data in these examples.