From grimoire
Applies Acceptance and Commitment Therapy (ACT) to reduce psychological suffering from avoidance, fusion, or values-behavior disconnection. Useful for anxiety, depression, chronic pain, or stress.
How this skill is triggered — by the user, by Claude, or both
Slash command
/grimoire:apply-acceptance-commitment-therapyThe summary Claude sees in its skill listing — used to decide when to auto-load this skill
Use ACT's six core processes to build psychological flexibility and help people act in accordance with their values despite difficult thoughts and feelings.
Use ACT's six core processes to build psychological flexibility and help people act in accordance with their values despite difficult thoughts and feelings.
Adopted by: Association for Contextual Behavioral Science (ACBS, 8,000+ members worldwide), VA healthcare system (standard care for PTSD and chronic pain), NHS England (recommended for anxiety and depression), APA Division 12 list of empirically supported treatments
Impact: A-Tjak et al. (2015) meta-analysis of 39 RCTs (n=1,821) found ACT significantly outperforms control conditions (g=0.65) across anxiety, depression, chronic pain, and substance use; Öst (2014) systematic review confirmed ACT is as effective as CBT for most conditions with superior outcomes for chronic conditions where acceptance is more adaptive than control-based strategies
Why best: ACT targets psychological flexibility — the ability to contact the present moment fully as a conscious human being, and to change or persist in behavior when doing so serves valued ends. Unlike purely symptom-reduction approaches, ACT improves functioning even when symptoms persist, making it superior for chronic, treatment-resistant, or recurrent conditions.
Sources: Hayes, Strosahl & Wilson "Acceptance and Commitment Therapy: The Process and Practice of Mindful Change" 2nd ed. (2012); Hayes "Get Out of Your Mind and Into Your Life" (2005); A-Tjak et al. (2015) "A meta-analysis of the efficacy of ACT" in Psychotherapy and Psychosomatics; ACBS World Conference proceedings; Öst (2014) in Behaviour Research and Therapy
Assess psychological inflexibility and valued directions — Begin with the AAQ-II (Acceptance and Action Questionnaire) and a values clarification exercise. Identify which of the six inflexibility processes are most active: experiential avoidance, cognitive fusion, attachment to the conceptualized self, lack of contact with the present moment, unclear values, or inaction/impulsivity. The hexaflex map shows where to focus intervention.
Introduce the creative hopelessness conversation — Explore the person's history of controlling or eliminating unwanted thoughts and feelings. Ask: "What have you tried? Did it work long-term? What did it cost you?" This reveals the workability problem — control strategies often increase suffering or restrict life. Establish that the problem is not the content of inner experience but the struggle with it.
Teach acceptance as an active stance — Distinguish acceptance from resignation. Acceptance means willingness to have an experience without unnecessary struggle — making room for difficult thoughts, feelings, and sensations rather than fighting or fleeing them. Use the Passengers on the Bus metaphor: you drive the bus (your life), passengers (difficult thoughts/feelings) yell instructions, but you choose the direction.
Practice defusion from unhelpful thoughts — Cognitive defusion separates the person from the literal content of thoughts. Techniques include: prefixing thoughts with "I'm having the thought that..."; repeating a distressing word aloud rapidly until it loses meaning (Titchener's repetition); thanking the mind for a thought without obeying it; giving the inner critic a silly name or voice. The goal is to see thoughts as mental events, not facts.
Strengthen present-moment contact — Use mindfulness exercises to build flexible attention to here-and-now experience. The "Notice 5 things" exercise, brief body scans, and mindful breathing all train observing experience without evaluation. Present-moment contact interrupts rumination (past-focused) and worry (future-focused) that fuel anxiety and depression.
Develop the observer self — Help the person contact the transcendent sense of self — the perspective from which they observe thoughts and feelings without being defined by them. The Chessboard metaphor: the self is the board, pieces (thoughts/feelings) move but the board is unchanged. This stable sense of self allows engagement with difficult content without identity threat.
Clarify and connect to values — Values are freely chosen, ongoing directions for living — not goals to achieve but qualities to embody. Use the Funeral Exercise (what would you want said about you?) or the VLQ-2 (Valued Living Questionnaire) to identify values across domains: relationships, work, health, community, personal growth. Values are the "why" that gives ACT its direction.
Set committed actions aligned with values — Translate values into specific, short-term behavioral commitments. Use SMART goal format: "This week I will call my brother twice, even if anxiety says not to." Anticipate barriers: what thoughts, feelings, or external obstacles might arise? Apply defusion and acceptance skills preemptively. Committed action is the behavioral engine of ACT.
Practice with real-life exposure tasks — Assign graduated values-based exposures: small steps first, increasing difficulty. Unlike traditional exposure aimed at reducing anxiety, ACT exposures are valued actions done willingly despite anxiety — anxiety reduction is welcomed but not the goal. Document what the person notices during the task vs. what they expected.
Review progress using the ACT matrix or hexaflex — At each session, map current functioning: toward vs. away moves, fusion vs. defusion, avoidance vs. acceptance, self-as-context vs. self-as-content, valued vs. unclear direction, action vs. inaction. Celebrate any movement toward flexibility regardless of symptom level. Titrate skill emphasis based on which processes remain most rigid.
Chronic pain patient: Fused with "I can't live a good life while in pain." Defusion: "I notice my mind saying I can't live a good life." Acceptance exercise: body scan without trying to change sensation. Value identified: being present for grandchildren. Committed action: attend grandson's recital despite pain, using breath-based acceptance during flares. Outcome: same pain level, significantly improved functioning and life satisfaction.
Social anxiety: Avoidance history — declined 12 social invitations in 3 months. Creative hopelessness: avoidance reduced anxiety short-term but cost friendships. Defusion: named inner critic "The Judge." Values: connection, authenticity. Committed action hierarchy: text one friend → coffee with one person → attend group event. Weekly reviews tracked toward-moves, not anxiety scores.
npx claudepluginhub jeffreytse/grimoire --plugin grimoireGuides systematic identification and restructuring of distorted thinking patterns and avoidant behaviors using evidence-based CBT strategies.
Provides DSM-5 diagnostic criteria, evidence-based therapy modalities (CBT, DBT, EMDR, ACT, etc.), treatment planning, and progress measurement for mental health documentation.
Routes to the right mindset tool based on your situation — stoic, growth, positive, reframe, or flow. Use when stuck in thought loops, treating failure personally, or wanting to flourish.