ACT Patient Assessment & Evaluation 3 — Questions and Answers
Question 1: Which ACT process is being evaluated when a therapist asks, 'When you have that thought, does it help you live the life you want?'
- Cognitive defusion (Correct answer)
- Experiential acceptance
- Values clarification
- Committed action
Correct answer: Cognitive defusion
Evaluating whether a thought is workable (rather than true or false) is a core defusion assessment question in ACT.
Question 2: During assessment, a client reports, 'I am my depression—it defines who I am.' This statement most strongly indicates a deficit in which ACT process?
- Self-as-context (Correct answer)
- Present-moment awareness
- Committed action
- Values identification
Correct answer: Self-as-context
Fusing identity with a diagnosis or emotional state reflects a collapse of self-as-context into conceptualized self.
Question 3: What is the primary purpose of using a timeline or life history review in ACT assessment?
- To identify patterns of experiential avoidance and pivotal values-based events across a client's life (Correct answer)
- To establish a DSM-5 differential diagnosis
- To measure treatment readiness using standardized scoring
- To assess childhood attachment patterns for psychodynamic formulation
Correct answer: To identify patterns of experiential avoidance and pivotal values-based events across a client's life
A life history review in ACT helps map long-standing avoidance patterns and moments when values were either honored or abandoned.
Question 4: A client completes the Valued Living Questionnaire (VLQ). A low importance score paired with a low consistency score in the 'family' domain indicates what?
- Family is not a priority, so values-behavior alignment in this domain is less clinically urgent (Correct answer)
- The client is avoiding family-related contact despite valuing it
- The client has high psychological flexibility in the family domain
- Family-related cognitive fusion is the primary treatment target
Correct answer: Family is not a priority, so values-behavior alignment in this domain is less clinically urgent
When importance and consistency are both low, the client may simply not prioritize family, making it a lower intervention priority than high-importance/low-consistency discrepancies.
Question 5: Which client response during assessment indicates good present-moment awareness?
- 'Right now I notice tension in my chest and a thought that I'll fail.' (Correct answer)
- 'I'm usually worried about what happened yesterday.'
- 'I can't stop thinking about what might go wrong next week.'
- 'I feel like I should be more mindful but I never manage it.'
Correct answer: 'Right now I notice tension in my chest and a thought that I'll fail.'
Noting current body sensations and thoughts in real time demonstrates flexible, non-judgmental present-moment contact.
Question 6: In ACT case conceptualization, which assessment question most directly targets a client's 'control agenda'?
- 'What have you tried to do to feel better, and how has that worked for you?' (Correct answer)
- 'How long have you been feeling this way?'
- 'What was your childhood like?'
- 'Do you have a history of trauma?'
Correct answer: 'What have you tried to do to feel better, and how has that worked for you?'
Asking about attempted solutions and their effectiveness directly maps the control agenda and whether it has reduced suffering.
Question 7: An ACT therapist assesses 'committed action' by reviewing which client behavior pattern?
- Whether the client takes values-consistent steps even in the presence of discomfort (Correct answer)
- Whether the client has learned relaxation techniques
- Whether the client can identify cognitive distortions
- Whether the client shows insight into childhood experiences
Correct answer: Whether the client takes values-consistent steps even in the presence of discomfort
Committed action is assessed by examining whether behavior aligns with values regardless of the presence of difficult internal experiences.
ACT Patient Assessment & Evaluation 3
Which ACT process is being evaluated when a therapist asks, 'When you have that thought, does it help you live the life you want?'