10 practical ways to meet young people where they are
Acceptance and commitment therapy (ACT) was designed with adults in mind, but its heart, the development of psychological flexibility, is just as relevant for children and young people. The difference lies not in what we teach, but how we deliver it. Young people tend to learn through play, sensory experiences, metaphor, movement and relationship. They often can’t yet engage in lengthy insight-based discussion, but they can absolutely experience ACT processes in ways that feel natural and intuitive.
This article explores the key adaptations that help ACT come alive for children, with examples from clinical work with young people dealing with anxiety, avoidance, and a range of emotional or behavioural challenges.
1. Keep ACT concrete, sensory and play-based
Children learn through doing, not lengthy conversations. Rather than abstract metaphors, use objects, movement and sensory activities.
Clinical adaptations
- Hands-on metaphors (glitter bottles, balloons, sand trays).
- Art, crafts, comics, Lego, puppets.
- Short, experiential bursts rather than long explanations.
Example:
Using a glitter bottle to teach emotional regulation:
- Shake it: “This is your body when feelings get big.”
- Watch it settle: “Look how it calms down on its own, without us doing anything”
Even young children can learn acceptance and present-moment awareness without needing adult-level reasoning.
2. Values become “what matters to you” in their language
Children understand values best when they’re concrete, visual and short-term.
How to adapt values work
- Focus on being “a kind friend,” “a brave learner,” “a good team member.”
- Anchor values in drawings, cards, superheroes or animals.
- Keep the time horizon short: “this week,” “this afternoon,” “in your classroom.”
Example:
For a child with school avoidance, draw “braver future me” as a superhero. Ask:
- “What does this character do when school feels overwhelming?”
- “What tiny action would they take today?”
Values move from abstract ideals to visible choices. What is key is not to collude with the idea that being brave means not feeling fear , – using examples such as “superman can feel scared, and that doesn’t stop him from helping people, because it’s important to him”.
3. Use characters and externalisation for defusion
Children take thoughts literally. Defusion lands best when thoughts are turned into characters or stories.
Tools
- Draw or name the thought (“Bossy Brain,” “Worry Weasel”).
- Use a soft toy to say the difficult thought out loud.
- Turn thoughts into comic-strip villains.
Example:
A child who thinks “Nobody likes me” draws Mr Bossy Brain.
You ask:
- “What does Bossy Brain want you to do?”
- “What do you want to do that fits with being a good friend?”
Defusion becomes playful and instantly accessible.
4. Teach acceptance through the body, not words
Acceptance is much easier to experience than to explain.
Effective approaches
- Belly breathing with a teddy resting on their tummy.
- Blowing bubbles to teach slow exhalation.
- Holding ice/warm stones to explore sensations.
- Grounding games (5 things you can see/hear/feel).
Example:
For a child with anxiety, blowing a pinwheel helps them slow their breath.
You then ask:
- “What can we do now that your body feels a little steadier?”
This links acceptance and committed action seamlessly.
5. Keep committed action small and supported
Executive functioning is still developing, so steps must be tiny, specific and scaffolded by adults. It can be really helpful to include adults, where possible, and dependent on the child’s development age and support system around them.
How to structure steps
- Break tasks down into the smallest possible actions.
- Use visual progress charts or stickers.
- Involve parents and teachers in supporting each step.
Example:
For a child afraid of sleeping alone:
- Parent sits on bed.
- Parent sits by the door.
- Parent sits outside the room.
- Child falls asleep alone.
Each step is framed around “being the brave version of yourself.” You could also include their superhero / character in here if helpful.
6. ACT with children is always systemic
Children don’t exist in isolation. Parents, siblings, school and sensory environments all influence the work.
Systemic adaptations
- Coach parents in psychological flexibility.
- Reduce reassurance cycles where appropriate.
- Help schools reinforce small brave steps and values language.
- Align adults around one formulation: avoidance → fusion → values.
Example
For a child experiencing panic in school:
- Use grounding and defusion strategies, ideally working with the system at home and at school (e.g. SENCO).
- Parents model acceptance and stop providing escape / avoidance behaviours.
- Sessions include values-led conversations about learning and courage.
ACT becomes the framework that holds the system together.
7. Build self-as-context through creative identity work
Children grasp the “observing self” through imagery, stories and characters; not philosophical discussion. Remember, this can be a tricky process for lots of adults to grasp, so making it accessible is paramount to effective use of this process.
Helpful tools
- Wise Owl who watches thoughts and feelings.
- Captain of a ship choosing direction despite storms.
- Drawings of “me” and “my thoughts” as separate figures.
Example
A child with explosive anger learns:
- “The lion inside you roars when things feel unfair.”
- “The Wise Owl watches the lion without trying to stop it.”
- “Owl helps you choose what to do next.”
This gives the child perspective-taking in a developmentally accessible way.
8. Modelling psychological flexibility matters more than insight
Children learn through observing adults. Modelling is more impactful than explanation.
Therapist modelling
- Narrate your own cognitive processes: “My mind is saying this is hard…”
- Model willingness and non-avoidance.
- Normalise emotions (“My heart’s beating fast too”).
- Celebrate brave attempts rather than success.
Example
In a small exposure:
- You say: “My stomach feels fluttery too. I’ll take a breath with you.”
- You both step toward the feared situation together.
The therapeutic relationship becomes the intervention.
9. Creative hopelessness through simple games
Instead of asking “How has this been working?”, create experiential exercises where the child discovers the limits of control or avoidance.
Activities
- Holding a ball underwater (the more you push, the more it pops up).
- Tug-of-war with a rope against a “Feelings Monster.”
- Trying to carry water without spilling while running.
Example
Using the beach ball:
- Child pushes it down. It pops up.
- You say: “Your feelings are like this ball. The harder you push them down, the louder they get.”
Using the water:
- Telling the child to run carrying some water without spilling a single drop.
- Inevitably the water spills, this is like trying to avoid or control their feelings – you can say ““Just like trying not to spill the water made running harder, trying to control every anxious or angry feeling can make life harder. What if we just ran instead of keeping the water perfectly still?”
This teaches willingness far more clearly than dialogue.
10. Parents are co-therapists, not observers
Parental modelling and reinforcement determine whether ACT generalises outside sessions.
Parent-focused work
- Teach parents to label their own emotions without avoidance.
- Encourage them to use values language (“kind,” “brave,” “helpful”).
- Coach them to reduce accommodation (e.g., staying with the child through all anxiety).
- Reinforce small brave steps at home.
Example
Child avoids a party. Parent says:
- “I know this feels scary. Let’s do our grounding game, then choose the smallest brave step you can take.”
This teaches both parent and child psychological flexibility.
Bringing it together
ACT with children and young people is still ACT, it’s just delivered in a way that fits the way they naturally learn. It’s also important to consider these adaptions in line with the young person’s specific development age, and their developmental needs. Adaptations should be individualised, as with any effective therapeutic intervention. The processes themselves don’t change, but the methods do:
- More play, movement and sensory experience.
- More drawings, characters and externalisation.
- More modelling and co-regulation.
- More involvement from parents and schools.
- Smaller steps, repeated often.
When adapted well, ACT helps children develop psychological flexibility early, giving them tools for life: the ability to notice their inner world, make room for feelings, and take steps toward what matters, even when things feel hard.
We’ve taken the tips and examples in this blog and recreated it into a simple adapting ACT for children and young people ebook that you can download and keep for future reference. Find this and many other useful handouts, research and exercises as part of our ACT resource hub.