ACT worksheet
Values Clarification
An Acceptance and Commitment Therapy exercise for naming what truly matters to you and turning it into direction — not another set of pass/fail goals.
How to use this worksheet
Rate your life domains
For each area, rate two things from 0 to 10: how IMPORTANT it is to you, and how CONSISTENTLY you have been living by it lately. Gaps between the two are where committed action helps most.
Choose one domain that matters
Pick a domain that feels important but where the gap is uncomfortable. Which one, and why does it matter to you?
Describe the valued direction
In this area, what kind of person do you want to be? What qualities do you want to bring — regardless of whether you ever “arrive”? (e.g. patient, honest, present, brave.)
What gets in the way?
Which thoughts, feelings, memories, or urges show up and pull you off course? In ACT, the aim is to make room for these rather than fight or obey them.
One committed action
A small, specific, doable step you could take this week that moves you toward this value — something you control, not an outcome.
Willingness check
On a scale of 0–10, how willing am I to take this step and make room for the discomfort that comes with it?