Acceptance and commitment (ACT)

A concise ACT‑based therapeutic approach a therapist can use in session. 1. Establishing the Therapeutic Stance Adopt a validating, curious, collaborative posture Model psychological flexibility through openness and present‑moment awareness 2. Clarifying Client Values Briefly explore what matters most to the client Identify key life domains (relationships, health, work, growth) Highlight values as guides rather than goals 3. Present‑Moment Awareness Introduce brief mindfulness exercises (e.g., breath focus, noticing sounds) Use them in session to ground the client during difficult emotions Reinforce contact with the present rather than problem‑solving internal experience 4. Cognitive Defusion Teach simple defusion tools: • Labeling thoughts as “I’m having the thought that…” • Repeating difficult thoughts out loud to notice their form • Observing thoughts as mental events, not truths Apply defusion specifically to stuck or rigid thought patterns 5. Acceptance and Willingness Normalize distress as part of being human Invite willingness to experience difficult emotions when it serves values Use metaphors like “Passengers on the Bus” or “Tug‑of‑War with the Monster” 6. Self‑as‑Context Guide brief perspective‑taking exercises: • Noticing the observing self • “You are the context in which thoughts and feelings arise” Differentiate self from content of experience 7. Committed Action Identify small, values‑aligned behavioral steps Set clear, achievable commitments Track progress and adjust based on barriers—not on emotional readiness 8. Ongoing Integration Revisit values each session Reinforce use of ACT skills outside therapy Help client notice increases in psychological flexibility and life engagement

Dialectical Behavior (DBT)

Structure of a Typical DBT Session Review diary card Set agenda based on treatment targets Conduct chain and solution analyses Teach and practice skills Plan homework Review progress and reinforce motivation