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Confronting Avoidance: ACT Skill

Avoidance is a common response to uncomfortable thoughts, emotions, and sensations. But what we resist tends to persist: Pushing away difficult internal states gets us more trapped in them. Once we realize this paradox, we can more effectively embrace our inner experience, including the uncomfortable parts.

The Confronting Avoidance: ACT Skill worksheet presents experiences people frequently avoid as well as the strategies they use to do this. Clients are invited to name the thoughts and feelings they avoid most, evaluate the cost of this avoidance, and examine the accuracy of their beliefs about it. Finally, they will identify concrete ways to face what they’ve been avoiding.

Use this worksheet to help clients challenge their avoidance and work toward unconditional acceptance of their inner experience. Inspired by Acceptance and Commitment Therapy (ACT), this resource pairs wonderfully with this therapeutic approach, but it’s also effective for clients with anxiety, depression, OCD, or any condition in which avoidance plays a role.

For related ACT tools, see our Thought Defusion and Becoming Psychologically Flexible worksheets.

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References

1. Dindo, L., Van Liew, J. R., & Arch, J. J. (2017). Acceptance and Commitment Therapy: A transdiagnostic behavioral intervention for mental health and medical conditions. Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics, 14(3), 546–553.

2. Fonseca, S., Trindade, I. A., Mendes, A. L., & Ferreira, C. (2020). The buffer role of psychological flexibility against the impact of major life events on depression symptoms. Clinical Psychologist, 24(1), 82–90.

3. Harris, R. (2008). The happiness trap: How to stop struggling and start living. Trumpeter Books.

4. Harris, R. (2019). ACT made simple: An easy-to-read primer on Acceptance and Commitment Therapy (2nd ed.). New Harbinger Publications

5. Harris, R. (n.d.). The complete set of client handouts and worksheets from ACT book. The happiness trap. https://thehappinesstrap.com/upimages/Complete_Worksheets_2014.pdf

6. Hayes, S. (n.d.). The six core processes of ACT. Association for Contextual Behavioral Science. https://contextualscience.org/the_six_core_processes_of_act

7. Hayes, S., & Smith, S. (2005). Get out of your mind & into your life: The new Acceptance & Commitment Therapy. New Harbinger Publications.

8. Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168.

9. Lucas, J. J., & Moore, K. A. (2020). Psychological flexibility: Positive implications for mental health and life satisfaction. Health Promotion International, 35(2), 312–320.

10. Scott, W., & McCracken, L. M. (2015). Psychological flexibility, acceptance and commitment therapy, and chronic pain. Current Opinion in Psychology, 2, 91–96.

11. Thompson, B. L., Twohig, M. P., & Luoma, J. B. (2021). Psychological flexibility as shared process of change in Acceptance and Commitment Therapy and exposure and response prevention for obsessive-compulsive disorder: A single case design study. Behavior Therapy, 52(2), 286–297.

12. Yasinski, C., Hayes, A. M., Ready, C. B., Abel, A., Gorg, N., & Kuyken, W. (2019). Processes of change in cognitive behavioral therapy for treatment-resistant depression: Psychological flexibility, rumination, avoidance, and emotional processing. Psychotherapy Research, 30(8), 983-997.

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