Dr. Steven C. Hayes, originator of Acceptance and Commitment Therapy discusses Act Therapy for Therapists this and more on Self Careapist Therapist Podcast.

Published by Lorain Moorehead, LCSW | Self Careapist Therapist Podcast | lorainmoorehead.com/podcast

You’ve Probably Been Using ACT Without Knowing It

If you’ve ever helped a client get some distance from a thought rather than argue with it, explored what they want their life to stand for, or worked on moving toward what matters even in the presence of discomfort, you’ve been doing ACT therapy for therapists long before you called it that. Acceptance and Commitment Therapy has been shaping clinical practice for 45 years, and its influence runs through DBT, mindfulness-based cognitive therapy, compassion-focused therapy, and more.

In this episode of Self Careapist Therapist, I sat down with Dr. Steven C. Hayes the clinical psychologist who developed ACT, professor emeritus at the University of Nevada, and author of more than 47 books and 700 research articles. He’s one of the most cited researchers in the behavioral sciences. He’s also, as you’ll hear, someone who is genuinely trying to give his life’s work away.

This post covers the key clinical takeaways from that conversation, including a breakdown of the six core processes of ACT, what process-based therapy means for your day-to-day work, and why Hayes believes the statistical methods underlying most of our outcome research are built on a 100-year-old error.

What Is ACT? The One-Sentence Version

Hayes can summarize ACT in a single sentence now, which he’s quick to note took 45 years to arrive at:

“Life is asking you to learn how to be more open, aware, and actively engaged in meaningful life, while scaling that to your relationships and your body.”

That’s the psychological flexibility model in one breath. The six core processes of ACT all map onto those three dimensions, openness, awareness, and engaged action and Hayes is careful to say they aren’t discrete buckets. They work together like the six sides of a box. Pull one off and you no longer have a box.

The Six Core Processes of ACT: A Clinical Overview

ACT training programs organize these processes differently, but here is how Hayes walked through them in our conversation, extended to include the body and relational dimensions he emphasized throughout.

1. Acceptance (Openness to Experience)

Acceptance in ACT isn’t resignation or passive tolerance. It’s the willingness to receive what shows up — thoughts, memories, sensations, emotions — without running away from it or clinging to it. Hayes made a point that often gets missed: both avoidance and clinging are problematic. A client who chases positive affect at the expense of full emotional contact is just as stuck as one who avoids pain entirely. He called this being a “joy junkie” — and noted it’s not actually joyful.

2. Cognitive Defusion (Openness to Thoughts)

Defusion is the process of creating distance from thoughts — seeing them as mental events rather than literal truths. Where cognitive restructuring asks whether a thought is accurate, defusion asks how a thought is functioning. Is holding this thought tightly serving the person or limiting them? This is a subtle but clinically significant shift, and it’s one of the places where ACT and CBT diverge most clearly.

3. Present Moment Awareness

Contact with the present moment is the foundation of behavioral change in ACT. Hayes framed this as more than mindfulness as a practice — it’s the orientation that allows the other processes to function. You can’t notice a thought as a thought, or make a values-based move, from inside a rumination loop.

4. Self-as-Context (Perspective-Taking)

Sometimes called the “observing self,” this process supports the client in holding their experience from a stable vantage point rather than fusing with it. The self is the context in which experiences occur — not the content of those experiences. Hayes described this as a perspective-taking capacity with deep roots in relational frame theory, and noted that it extends naturally to cultural and relational dimensions of identity.

5. Values Clarification

This is where Hayes pushed back hard on how values work is commonly done. Handing a client a values checklist — even a well-designed one — is a culturally narrow move. Hayes described spending hours with indigenous knowledge keepers in Canada exploring a seven-part relational values system that includes obligations to rocks, to ancestors, to future generations. No pre-built list captures that. His point for clinicians: values clarification has to be genuinely exploratory, driven by the client’s own language and framework, not your template.

6. Committed Action

Committed action is the behavioral dimension — taking steps toward what matters, in the presence of whatever thoughts and feelings show up. It’s not willpower-based. It’s values-grounded. And it includes making room for the inevitable failures, pivots, and re-commitments that characterize real behavior change over time.

Process-Based Therapy: What It Means for Your Clinical Work

One of the most useful frames Hayes offered was the distinction between modality-based and process-based thinking. Most of us were trained in one or more named approaches — CBT, DBT, EMDR, IFS, EFT. The modality-based view says: I am a DBT therapist, I use DBT tools. The process-based view says: I’m tracking what is actually limiting or lifting this person, and I’m drawing from whatever moves those processes.

Hayes is explicit that this isn’t anti-modality. It’s pro-person. He argues that every evidence-based method that works, works because it’s moving the same underlying processes, openness, awareness, engaged action, regardless of what it’s called. That’s why he’s happy for clinicians to integrate ACT principles into their existing work without calling it ACT. The goal isn’t brand loyalty. It’s better outcomes for the specific person in the room.

For clinicians, this reframe matters practically. It gives you permission to pull from your whole training rather than restricting yourself to one lane. It also puts a finer point on what clinical intuition actually is: the ability to notice what process is limiting this person and respond to that, in real time.

The Problem with How We Measure Outcomes

Hayes went somewhere unexpected in our conversation, and I want to make sure clinicians who read this take it seriously. He argued that the statistical tools underlying most psychotherapy outcome research — Pearson’s R, Fisher’s Z, standard deviations, the entire group-comparison infrastructure — were developed by eugenicists. Not as a historical footnote, but as a functional critique: those tools were built to describe populations, not individuals. They assume you can generalize from the average to the specific person. You can’t.

His data point: in large mediational studies designed to show how change happens in therapy, the statistical pathway that “worked” for the group wasn’t followed by a single actual participant. Not one. The aggregate finding was real. It just didn’t describe any real person.

This is the scientific basis for what Hayes calls idiographic measurement — tracking what’s actually moving for the individual client, in their words, around what they care about. It’s the philosophy behind PsychFlex, the app he co-developed with ACT master trainer Gijs Jansen, which we discuss below.

PsychFlex: What Hayes Is Building Now

PsychFlex (psychflex.com) is a HIPAA-compliant clinical app Hayes co-developed to extend therapy beyond the session. It’s built around a few core functions:

MindGrapher, a machine-learning intake and tracking tool that turns client self-report data into personalized process insights. Rather than comparing a client to population norms, it maps what’s actually shifting for them over time.

A homework and exercise library with 400+ client tools, including lessons, practices, and interventions developed by expert trainers. Clinicians can assign these with a click between sessions.

An e-learning library including real-play sessions, therapy demonstrations, and live webinars from researchers and clinicians working at the edge of the field.

ACT and Cultural Humility in Clinical Practice

One of the things that struck me in this conversation was how directly Hayes connects ACT’s framework to culturally responsive practice. The process-based approach isn’t just a clinical efficiency argument — it’s a cultural humility argument. When you’re focused on the processes that are actually limiting this person, and you’re genuinely curious about how they understand their own values and relationships, you’re less likely to impose a Western, individualized treatment framework onto someone whose context demands something different.

Hayes pointed to the growth of ACT in Iran, China, Brazil, and lower-income countries worldwide as evidence. ACT is the most-studied psychotherapy approach in lower and middle-income countries. His explanation: when the processes are the anchor, not the specific techniques or terminology, clinicians can adapt the work to fit the person’s actual life.

My Takeaway from This Conversation

What stayed with me most was the distinction between focusing on the person versus focusing on the modality. I’ve had the experience of hearing myself narrate my theoretical framework to a client rather than actually being with them. The process-based frame pulls against that. It asks what is actually happening for this person, in this session, today — and it trusts that if you can track that, you can help them move.

The point about measurement also landed differently than I expected. It’s not just a methodological critique. It’s an argument for taking the individual seriously. If the research doesn’t reflect any real person, the question of what’s working for the specific client in front of you isn’t answered by the literature. It’s answered by paying attention.

Listen to the Full Episode

The full conversation with Dr. Steven C. Hayes is available on Self Careapist Therapist Podcast on all major platforms and on YouTube at @selfcareapist. CE credit details are at lorainmoorehead.com/podcast.

If this episode was useful to you, share it with a colleague who is ACT-curious or who works with clients where values work, avoidance, or psychological flexibility are central to the case.