Session Overview / Presenting Concerns
The client, a 32-year-old female, attended the session to address ongoing anxiety related to her recent job transition. She reported feeling overwhelmed by the new responsibilities and expressed a desire to manage her stress more effectively. Since the last session, she has started a new role as a project manager and is adjusting to the increased workload.
ACT Hexaflex Components
Acceptance
The client acknowledged her anxiety about the new job without attempting to suppress it. We used the metaphor of 'riding the wave' to help her accept the discomfort as a natural part of the transition.
Defusion
We practiced labeling thoughts by using the phrase, "I’m noticing I’m having the thought that I’m not good enough for this role." This helped her to see these thoughts as separate from her identity. She remarked, "It feels less overwhelming when I can step back and just notice the thought."
Contact with the Present Moment
We engaged in a mindfulness exercise focusing on her breath to anchor her in the present moment. She noted feeling more grounded and less scattered after the exercise.
Self-as-Context
The client reflected on her ability to observe her thoughts and feelings without being defined by them. She recognized, "I am more than just my anxiety."
Values
The client identified her core values as career growth and maintaining a healthy work-life balance. She reaffirmed the importance of these values in guiding her decisions and actions.
Committed Action
She committed to setting boundaries at work to ensure she has time for self-care. Her homework includes practicing saying "no" to additional tasks that do not align with her priorities.
Additional Interventions / Home practice
The client agreed to try a daily mindfulness practice using a guided meditation app. We also planned to review her progress with boundary-setting in the next session.
Therapist Reflection / Next Steps
The client is making progress in recognizing and accepting her anxiety. However, she still faces challenges in maintaining present-moment awareness. The next session will focus on deepening her mindfulness practice and exploring further strategies for defusion.
(This note is to be from the perspective of an acceptance and commitment therapist trauma therapist. It is important that you note that the details of the topics discussed in the transcript may vary greatly between patients, as a large proportion of the information intended for placeholders in square brackets in the template or structure below may already be known and well established in the context of the relationship between the clinician and the patient. Do not hallucinate or make up any information for a placeholder in the template or structure below if it is not mentioned or present in the transcript. The topics discussed in the transcript by mental health clinicians are often not well-defined clinical disease states or symptoms and are often just aspects of the patient's life that are important to them and they wish to discuss with their clinician. Therefore it is vital that the entire transcript is used and included in the clinical note or document that you output, as even brief topic discussions may be an important part of the patient's mental health care. Remember to use as many bullet points as you need to capture the relevant details from the transcript for each section. Do not respond to these guidelines in your output, you must only output the clinical note or document as instructed.This is an ACT-based therapy session. Please structure the note under headings for each of the six ACT processes in the Hexaflex (Acceptance, Defusion, Contact with the Present Moment, Self-as-Context, Values, and Committed Action). Under each heading, capture the specific details, insights, or interventions related to that process, as discussed in the transcript. If a particular process is not clearly addressed in the conversation, include a brief note stating it was not covered or not applicable this session.Sections to Include:)
Session Overview / Presenting Concerns
[Briefly summarize why the client attended (main issue, reason for referral, or continuing issue).
Capture relevant life updates since last session]
ACT Hexaflex Components
Acceptance
[Describe how the client approached or struggled with difficult thoughts/feelings.
Any key metaphors or exercises used (e.g., acknowledging discomfort without attempting to change it)]
Defusion
[Describe Specific strategies aimed at helping the client see thoughts as separate from self] (e.g., labeling the thought, “I’m noticing I’m having the thought…”).
(Any client quotes that illustrate stepping back from cognitive content.)
Contact with the Present Moment
[Mindfulness exercises or prompts that encouraged present-moment awareness.]
(How the client responded or any observations about attention/focus during session).
Self-as-Context
[Statements or reflections about observing self versus conceptualized self.]
(Any moments where the client recognized they are more than their thoughts/feelings.)
Values
[Client’s core life directions or personally meaningful domains] (e.g., relationships, career, health).
(Notable insights or reaffirmations about what truly matters to the client.)
Committed Action
[Steps the client has taken or plans to take in line with their values.
Homework tasks or real-life experiments that support behavioural change.]
Additional Interventions / Home practice
[Any further exercises, handouts, or next-session planning]
(Identify which tasks the client agreed to try between sessions.)
Therapist Reflection / Next Steps
[Any brief therapist observations (e.g., client’s progress, barriers to change).
Plans for the following session, including focus on any of the six processes that need deeper work]