ACT Patient Assessment & Evaluation 2 — Questions and Answers
Question 1: Which ACT-specific assessment tool measures a client's degree of psychological flexibility across six core processes?
- Acceptance and Action Questionnaire (AAQ-II) (Correct answer)
- Beck Anxiety Inventory (BAI)
- Cognitive Fusion Questionnaire (CFQ)
- Mindful Attention Awareness Scale (MAAS)
Correct answer: Acceptance and Action Questionnaire (AAQ-II)
The AAQ-II is the primary validated measure of psychological flexibility and experiential avoidance used in ACT assessment.
Question 2: During initial ACT assessment, a therapist asks a client to describe what their life would look like if their struggles were resolved. This technique primarily assesses which area?
- Values clarification and life direction (Correct answer)
- Cognitive defusion ability
- Present-moment awareness
- Self-as-context perspective
Correct answer: Values clarification and life direction
Asking clients to describe a preferred future life directly elicits values and the life directions that matter most to them.
Question 3: A client scores high on the Cognitive Fusion Questionnaire (CFQ). What does this indicate about their psychological functioning?
- They are highly entangled with their thoughts and treat them as literal truths (Correct answer)
- They have strong mindfulness skills
- They show high acceptance of internal experiences
- They demonstrate flexible self-perspective
Correct answer: They are highly entangled with their thoughts and treat them as literal truths
High CFQ scores indicate cognitive fusion, meaning the client is dominated by their thoughts rather than observing them with distance.
Question 4: When assessing experiential avoidance in a new ACT client, which client statement most directly signals this pattern?
- 'I keep myself busy so I don't have to think about the accident.' (Correct answer)
- 'I notice feelings of sadness but try to keep moving forward.'
- 'I'm not sure why I feel this way but I'm curious about it.'
- 'Even when anxious, I can usually do what matters to me.'
Correct answer: 'I keep myself busy so I don't have to think about the accident.'
Deliberate distraction to avoid processing an experience is a hallmark behavioral marker of experiential avoidance.
Question 5: In ACT assessment, 'creative hopelessness' is introduced to help the client recognize which pattern?
- That control-based strategies have not resolved their suffering (Correct answer)
- That their problems are hopeless and untreatable
- That they lack motivation for change
- That their values are unclear or underdeveloped
Correct answer: That control-based strategies have not resolved their suffering
Creative hopelessness helps clients see that their change-control agenda has been ineffective, opening space for an acceptance-based approach.
Question 6: Which of the following best describes the purpose of a functional assessment in ACT?
- To understand how a client's behaviors function in context, including avoidance functions (Correct answer)
- To diagnose the client's DSM-5 disorder
- To measure symptom severity on standardized scales
- To identify unconscious motivations through projective techniques
Correct answer: To understand how a client's behaviors function in context, including avoidance functions
ACT functional assessment examines what behaviors serve (especially avoidance functions) rather than diagnosing topographical symptom categories.
Question 7: A therapist uses the 'Bull's-eye' exercise during assessment. What does this tool primarily evaluate?
- The gap between a client's current behavior and their stated values (Correct answer)
- The degree of cognitive fusion present
- The client's capacity for mindful breathing
- The severity of anxiety symptoms
Correct answer: The gap between a client's current behavior and their stated values
The Bull's-eye assessment maps clients' actions relative to their values across life domains, highlighting values-behavior discrepancies.
ACT Patient Assessment & Evaluation 2
Which ACT-specific assessment tool measures a client's degree of psychological flexibility across six core processes?