ACT for GAD: How to Target Acceptance Experientially in Session


Utah State University
Boys Town Center for Behavioral Health

Key Points

  1. When doing acceptance exercises in a session, it’s important to connect them with the client’s values so they have more power and impact.
  2. Turning the attention to an emotion or sensation that happens at that moment is a great acceptance exercise, as it cultivates willingness to feel anxiety, and it’s a form of exposure.
  3. The exercise of saying yes or no to a sensation builds awareness of moments when the client is unwilling to feel anxiety, and helps them become more mindful of inner experiences.
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When targeting acceptance in session, it’s going to be more experiential and have more buy-in from the client if you’re able to connect it to a sense of realistic purpose. In Jane’s case, it’s not just about her feeling uncomfortable with or lowering her expectations of her quality of work, but also about showing up as the kind of mother she wants to be. Is she willing to feel the inherent tension and anxiety within this, if that’s the fee she must pay for consistently acting according to her stated values?

Acceptance Exercises

Notice Your Emotions

There are many exercises for helping Jane turn her attention to the emotion or anxiety that shows up in the moment. If you’re not getting some of that in session naturally, you may have her imagine being back in one of the situations on her tracking chart in which she felt anxious, so she can connect with some of that anxiety in session and practice acceptance/willingness strategies in real time.

Questions to ask include: where in your body do you feel the anxiety? Where is it the most intense? What other sensations do you notice in your body? If there was a temperature to the anxiety, what would it be? If you could touch it, what would the texture feel like? How big is it? Is there a shape to it? Notice if it moves or is still.

All of this cultivates a willingness to be with that feeling. It’s exposure, so to speak. You can see how this also targets other processes, that there’s some present moment awareness in that exercise. Many exercises do target more than one process at once.

Say No/Yes to the Sensation

Once Jane is connected to this sensation or feeling, she can be asked to imagine saying “no” to it. No, it can’t be there, just no. And observe what that feels like.

Then ask her to shift to saying “yes” to the feeling. Imagine mentally saying “yes”. Yes, there’s room for you. Yes, you can be here. And notice what that feels like.

It’s a simple but often successful exercise, quick and easy, yet quite powerful in the moment. You can set a specific but flexible practice that Jane can take out of the session, of mentally saying “yes” when a given sensation arises, or “no”. It can help her build awareness of when she’s unwilling to have anxiety, and become more mindful of what that feels like.

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ACT for GAD: How to Target Acceptance Experientially in Session

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