6 things the best ACT therapists do differently

Highly skilled ACT practitioners bring creativity, nuance, and a deep understanding of psychological flexibility to their therapeutic work. Beyond the foundational ACT processes, advanced practitioners refine their skills to address complex and rigid client patterns, using subtle yet powerful techniques that help clients move toward meaningful, values-guided lives. These therapists artfully blend metaphors, mindfulness, values, and behavioural interventions to create transformative therapeutic experiences. Below are six advanced skills that distinguish highly effective ACT practitioners, with tips and examples to help you bring these techniques into your own practice.

1. Pivot perspectives: Invite clients to see from a new angle

One of the most powerful moves an advanced ACT practitioner can make is helping a client see their situation from a new perspective. Clients often get stuck in rigid self-stories, such as “I’m a failure,” or inflexible relational patterns, like “Nobody cares about me.” These patterns can feel absolute and unchallengeable, but skilled therapists know how to gently shift the client’s perspective, allowing them to step outside their entrenched view and see themselves or their situation in a new light.

ACT, grounded in relational frame theory (RFT), offers a framework for flexible perspective-taking. This involves working with deictic relational frames, or the “I vs. You,” “Here vs. There” relationships that shape how we view ourselves and others. By guiding clients to shift these frames – for instance, by imagining how a compassionate friend, a future self, or even their therapist might see them – therapists help clients loosen rigid beliefs and open up to new possibilities.

For example, a client consumed by self-loathing might be invited to imagine their grandmother’s perspective. The therapist might use a two-chair exercise, asking the client to first voice their harsh inner dialogue and then respond as if they were their grandmother, offering a compassionate and loving view of their struggles. This process activates self-as-context (the “observer you”) and encourages empathy, often leading to profound insights. The client might realise that their current self-judgments are not absolute truths, but simply one perspective among many.

These shifts are especially effective when combined with experiential exercises, such as role play or guided imagery. However, they require careful timing and judgment: the therapist must assess whether the client is in a place where they can engage with a new perspective without feeling overwhelmed or invalidated. When done well, perspective pivots can reduce fusion with unhelpful narratives and create a sense of flexibility and possibility.

Tips:

• Time-travel perspectives: Encourage clients to imagine their future self, 5 or 10 years ahead, offering advice or encouragement to their present self. Alternatively, guide them to speak to their younger self, offering compassion or reassurance. These exercises are particularly helpful in trauma work, where clients often carry unresolved pain from the past.
• Leverage the therapeutic relationship: For clients who struggle with shame or self-criticism, invite them to explore how you, as their therapist, view them. For example, you might say, “I notice you think I’m judging you. Would you be willing to ask me directly what I’m feeling toward you in this moment?” This can challenge distorted beliefs and build trust.
• Tailor the exercise to the client’s readiness: If a client is highly fused with their story, start with smaller perspective shifts (e.g., imagining how a neutral observer might see them) before moving to more emotionally charged perspectives.

2. Ask: Is it workable?

The concept of workability is central to ACT, and skilled practitioners use it as a compass throughout the therapeutic process. Rather than debating whether a thought, behaviour, or belief is “true” or “right,” workability shifts the focus to whether it is helpful in the context of the client’s values. This approach encourages clients to explore the consequences of their patterns with curiosity, rather than defensiveness, and to consider whether those patterns are truly serving them.

For instance, a client who uses substances to numb trauma memories might acknowledge that while the strategy provides short-term relief, it also leads to long-term consequences such as strained relationships, poor health, and shame. By exploring this pattern collaboratively, the therapist helps the client see the trade-offs they are making and opens the door to creative hopelessness – the realisation that their current strategies, though understandable, are not effective in the long run. This often creates a natural motivation to try alternative approaches.

Workability checks can also be applied to thoughts and beliefs. For example, a client might insist, “The world is unsafe, and I can’t trust anyone.” Rather than arguing against this belief, the therapist might ask, “Let’s assume that’s 100% true. When you hold onto that thought, does it help you build a life of safety and connection, or does it lead to isolation?” This approach bypasses the need to debate the literal truth of the thought and instead focuses on its impact.

Workability is a delicate skill that requires timing and tact. Clients may initially resist exploring their patterns, especially if those patterns provide short-term comfort or relief. An advanced ACT therapist creates a safe and non-judgmental space for these conversations, normalising the client’s strategies while gently highlighting their limitations.

Tips:

• Use visual aids: Collaboratively create a chart with the client to map out the short-term benefits and long-term costs of a behaviour. Seeing this visual representation can help clients connect the dots and create their own motivation for change.
• Apply workability to thoughts and rules: For clients with rigid rules (e.g., “I must be perfect”), explore the impact of those rules. Ask, “How has striving for perfection affected your life? Has it brought you peace, or has it created stress and dissatisfaction?”
• Adopt a curious and compassionate tone: Workability is not about telling clients what they should or shouldn’t do. Instead, it’s about inviting them to explore what works for them in the context of their values. Frame it as a collaborative inquiry: “Help me understand – when you do X, what are you hoping for, and what actually happens?”

3. Work in the here and now

Some of the most transformative moments in ACT happen when therapists invite clients to engage with the present moment during the session itself. Advanced practitioners are attuned to what is happening in the room – the client’s emotions, body language, avoidance patterns, and relational dynamics – and use these here-and-now experiences as opportunities for mindfulness, acceptance, and self-as-context.

For instance, if a client with social anxiety shares a vulnerable story and then becomes visibly tense and avoids eye contact, the therapist might say, “I notice as you’re telling me this, your shoulders are hunched and your voice has softened. What’s happening for you right now?” This simple observation brings the client’s attention to their immediate experience and creates an opportunity to explore their emotions and avoidance strategies in real time.

Here-and-now work also strengthens the therapeutic relationship. When clients voice fears of being judged, therapists can respond with openness and validation, offering a corrective experience that challenges the client’s assumptions. For example, a client might say, “I feel like you must think I’m weak,” and the therapist might reply, “Actually, I feel admiration for your courage in sharing this with me.” This disconfirms the client’s negative predictions and builds trust.

By working in the present moment, therapists help clients practice mindfulness and acceptance in a safe, supportive environment. The session becomes a microcosm of the client’s broader life, where they can experiment with new ways of being and relating.

Tips:

• Notice and name process: Gently point out what you observe in the moment, such as changes in posture, tone, or emotion. For example, “I notice you’ve gone very quiet – what are you feeling right now?”
• Balance process and content: If the session becomes too focused on storytelling, shift to the client’s present experience. Conversely, if the client feels overwhelmed by their emotions, grounding them in concrete content can provide relief.
• Model acceptance and self-compassion: If difficult emotions arise in the moment, guide the client to make room for them. For example, “Notice that tightness in your chest. Let’s take a breath and allow it to be there while we continue talking.”

4. Build bridges from values to action

One of the most important roles of an advanced ACT practitioner is to help clients connect their values to real-life actions. Committed action is where insight meets behavioural change, and skilled therapists guide clients in taking concrete, meaningful steps toward their goals, while addressing the inevitable barriers that arise. This process is not just about giving clients “homework” but about collaborating with them to design realistic, values-driven actions and supporting them through the challenges of follow-through.

ACT emphasises that values are like a compass – they provide direction, but they can never fully be “achieved.” Goals, on the other hand, are the specific steps we take in that direction. For instance, a client who values connection might set a goal of texting an old friend or attending a social event. The therapist helps them identify these steps and prepares them for the obstacles they might encounter, such as self-doubt, fear of rejection, or procrastination. By integrating mindfulness, defusion, and acceptance strategies, therapists ensure that clients are equipped to move forward even when discomfort arises.

For example, a client with depression might express a desire to rebuild their social life but feel overwhelmed by the idea of reaching out to others. The therapist might help them break this goal into small, achievable steps, such as sending a simple text to a friend. Anticipating barriers, the therapist might ask, “What thoughts or feelings might show up when you sit down to do this?” If the client predicts anxiety or self-critical thoughts, the therapist can guide them in practising defusion (“Ah, here’s my mind saying, ‘They won’t want to hear from me’”) and acceptance (“I can feel nervous and still press send”). After the client takes the action, the therapist reinforces their effort by linking it back to their values: “You showed up for connection, even though it was uncomfortable. That’s a courageous step toward the kind of life you want to live.”

Advanced ACT practitioners also know that committed action is an iterative process. Clients may succeed at some goals and struggle with others, and each outcome provides valuable learning material. If a client doesn’t follow through on a goal, the therapist explores what got in the way and uses it as an opportunity to practise skills like defusion or willingness. Over time, this process builds the client’s confidence and resilience, helping them create patterns of effective action that align with their values.

Tips:

• Start small: When clients feel stuck, begin with small, manageable steps to build momentum. For instance, instead of “Exercise every day,” start with “Take a 5-minute walk twice this week.” Success with small goals creates a sense of accomplishment and motivation to build on.
• Reinforce values alignment: After clients take action, ask, “How did this align with your values? What kind of person were you being when you did this?” Linking actions to values makes them more meaningful and helps clients internalise the benefits.
• Use barriers as learning opportunities: If clients struggle to take action, explore what showed up for them. For example, you might say, “It sounds like anxiety and self-doubt got in the way. How can we practise responding to those feelings next time?” This approach normalises setbacks and equips clients with tools for future challenges.

5. Redefine exposure as values-guided willingness

Exposure is a foundational intervention in behaviour therapy, but ACT takes a unique approach by rooting exposure in values and willingness rather than symptom reduction. While traditional exposure therapy focuses on habituation (reducing fear through repeated exposure), ACT reframes exposure as an opportunity to practise openness to discomfort in service of what matters. This shift in focus can make exposure exercises feel less like a battle with fear and more like a courageous step toward a meaningful life.

For example, a client with OCD who avoids touching their child due to contamination fears might be guided to engage in messy play with their child, delaying handwashing afterward. The therapist frames this not as an exercise to “get rid of” anxiety but as a way to show up as the loving parent they want to be. The therapist might say, “The anxiety is likely to show up, and that’s okay. It’s the price of admission for living your values. Let’s practise letting it be there while you focus on connecting with your child.” This approach helps clients see that discomfort is not an obstacle to be conquered but an experience they can make room for in pursuit of their goals.

Advanced ACT practitioners design exposure exercises collaboratively, tailoring them to the client’s readiness and values. They also integrate mindfulness and defusion techniques to help clients navigate the discomfort that arises during exposure. For instance, a client facing social anxiety might be coached to notice and label their thoughts (“Ah, here’s ‘They’re judging me’ again”) and practise grounding themselves in the present moment. The therapist emphasises that the goal is not to eliminate fear but to stay open and engaged despite it.

This values-guided approach transforms exposure from a mechanical exercise into a deeply meaningful process. Clients learn that they can tolerate discomfort, take action in line with their values, and create a richer and more fulfilling life.

Tips:

• Anchor exposure in values: Before starting an exposure exercise, spend time clarifying why it matters. Ask, “What’s this discomfort in the service of? What value are we moving toward here?” This ensures that the client’s motivation comes from within.
• Emphasise choice and control: Frame exposure as a collaborative process where the client has agency. For instance, you might ask, “On a scale of 0-10, how willing are you to try this? If it’s a 5, what could we adjust to make it more workable for you?” This approach evokes a sense of empowerment.
• Incorporate mindfulness and defusion: Coach clients to notice their thoughts and feelings during exposure without getting caught up in them. For example, they might practise silently labelling their thoughts (“Here’s my mind saying, ‘This is dangerous’”) or grounding themselves with slow, mindful breaths.

6. Craft bespoke metaphors

Metaphors are a hallmark of ACT, and advanced practitioners know how to tailor them to the client’s unique experiences and context. While standard metaphors like “Quicksand” or “Passengers on the bus” are powerful, bespoke metaphors resonate even more deeply because they draw from the client’s own language, interests, and struggles.

For example, a client stuck in anger might resonate with the “fish hook” metaphor: holding onto resentment is like staying on a hook to keep someone else impaled – but in doing so, you’re also keeping yourself in pain. The therapist might say, “The only way to free yourself from the pain is to let them off the hook first. I know that feels unfair, but it’s not about them – it’s about you freeing yourself.” This metaphor, paired with a discussion of the client’s values, can help them see the cost of holding onto anger and the benefits of letting it go.

Tailoring metaphors to the client’s interests can make them even more impactful. For instance, a client who is a musician might relate to an analogy about tuning a guitar: “If the strings are too tight, they snap; if they’re too slack, they don’t make music. Emotional flexibility is about finding that workable tension.” Co-creating metaphors with clients can also deepen engagement. A client might adapt an existing metaphor to fit their own experience or come up with a new one entirely.

Advanced ACT practitioners use metaphors sparingly but intentionally, revisiting them throughout therapy to reinforce key insights. A well-chosen metaphor can become a touchstone for the client, helping them remember and apply what they’ve learned long after the session ends.

Tips:

• Draw from the client’s world: Listen for their interests, hobbies, or struggles and use these as inspiration. For example, a client who loves gardening might relate to a metaphor about nurturing plants: “You can’t force a flower to bloom by pulling on it – you have to create the right conditions and let it grow in its own time.”
• Collaborate with the client: Invite them to adjust or create their own metaphor. For example, a client might reframe “Passengers on the bus” into an airplane metaphor if they’re a pilot, imagining their thoughts as distracting passengers while they focus on flying the plane.
• Revisit metaphors to reinforce insights: Use metaphors as touchpoints in later sessions. For example, you might say, “Is this a moment to drop the rope, like we talked about?” This repetition helps clients internalise the metaphor and apply it to their daily lives.
• Be cautious with client generated metaphors. Client-generated metaphors can vividly capture their experience but may also reinforce feelings of being stuck or powerless. Collaboratively expand or reshape these metaphors to open up new perspectives and highlight paths toward workable actions, while respecting the client’s lived experience.
  • Example: A client describes feeling “as if they are drowning” under the weight of stress and burnout. While this effectively conveys their emotional state, it may reinforce a sense of helplessness. The therapist could gently reshape this by introducing a metaphor about a runner in a race, sprinting endlessly out of fear that stopping will reveal they don’t belong. This reframing highlights the behaviours maintaining the problem (overworking without rest) and creates space to explore new, values-driven actions, like pausing to care for themselves.

Mastering ACT is not about following a rigid set of techniques, but about nurturing psychological flexibility within ourselves as therapists, so we can model and invite it in our clients. The most effective ACT practitioners blend clinical skill with creativity, compassion, and responsiveness, continually adapting their approach to meet the unique needs of each person they work with. By deepening your use of these advanced strategies—shifting perspectives, working with workability, staying present, bridging values to action, reframing exposure, and crafting resonant metaphors—you can create richer, more impactful therapeutic experiences. Ultimately, these skills help clients move toward lives of meaning, connection, and vitality, even in the presence of pain. 

These types of skills won’t suddenly appear overnight but they can certainly come easier through dedicated practice and extended learning. Our intermediate courses have been designed to support you in this journey, offering more than just theory and explanation, but improving your therapy through practical skills that move your ACT practice from clunky or formulaic to one with fluidity and flexibility that gets results. 

Resources related to 6 things the best ACT therapists do differently