Acceptance and Commitment Therapy (ACT) for Kids and Teens
Helping young people make room for worry and move toward what matters.
Mindfulness-Based
Making room for hard feelings and moving toward what matters
Acceptance and Commitment Therapy (ACT) helps kids and teens relate differently to anxious thoughts and feelings. Instead of fighting or arguing with worry, they learn to notice it, make room for it, and keep doing the things that matter most to them.
How it works
Building psychological flexibility
Many anxious kids spend a lot of energy trying to get rid of scary thoughts and feelings, which often makes them louder. ACT teaches a different skill: noticing thoughts and feelings without letting them take charge.
The goal of ACT is psychological flexibility, the ability to stay present with difficult inner experiences while still choosing actions based on one's values. In our practice, ACT is often woven into CBT or ERP to make brave practice feel more meaningful and doable.
- Noticing thoughts as thoughts. Kids learn to step back from sticky thoughts ("I'm having the thought that...") instead of treating them as facts or commands.
- Making room for feelings. Uncomfortable emotions become something we can carry, not something we have to escape.
- Staying present. Simple, age-friendly mindfulness helps kids ground themselves in the here and now.
- Discovering values. We explore what your child cares about, such as friends, family, learning, creativity, or sports.
- Committed action. Kids take small, concrete steps toward their values, even when anxiety comes along for the ride.
Who it helps
- Kids and teens caught in cycles of worry or rumination
- Perfectionism and fear of making mistakes
- Intrusive thoughts that feel hard to "argue with"
- Kids who feel stuck despite learning coping skills
- Anxiety that shows up alongside low mood
- Teens who want to live by their own goals, not their fears
What sessions look like
ACT sessions are active and experiential. We use metaphors (like "passengers on the bus"), short mindfulness exercises, drawing, and role-play, matched to your child's age.
Each session connects skills to real life, with a small values-based action to try during the week.
When ACT is combined with CBT or ERP, it often helps kids feel more willing to take on hard challenges.
Tailored to your child
How we adapt it by age
Ages 7 to 10
Concrete metaphors, stories, games, and movement. Parents learn the same language to use at home.
Ages 11 to 13
Kids begin exploring their own values and practice noticing thoughts, often through creative activities.
Teens
ACT fits teens especially well. We focus on identity, independence, and what kind of person they want to be.
The parent's role: We'll share ways to model acceptance of tough feelings, validate your child's experience without rushing to fix it, and encourage the values-based goals your child chooses. Many parents find these skills helpful for themselves, too.
The evidence
What the research says
ACT has a younger research base in children than CBT, but it is growing quickly. Randomized trials and meta-analyses show that ACT reduces anxiety and depression symptoms in young people and can perform comparably to CBT.
Both ACT and CBT produced similar improvements in child anxiety, and both clearly outperformed a waitlist, in a trial of 193 children.
Hancock et al., 2018 [1]A 2025 meta-analysis of 27 randomized trials with 2,860 adolescents found moderate-to-large reductions in anxiety and depression symptoms compared with no treatment.
López-Pinar et al., 2025 [2]Improvements from ACT were maintained at follow-up in the child anxiety trial.
Hancock et al., 2018 [1]- In a randomized trial of 193 anxious children (average age 11), a 10-week ACT program and a CBT program both led to significant, clinically meaningful improvement, with some evidence that ACT had larger effects on quality of life[1].
- A 2025 meta-analysis found that ACT reduced both anxiety and depression symptoms in adolescents compared with inactive controls, with benefits still present at follow-up[2].
- An earlier systematic review of ACT for children found promising results across a range of conditions, while noting the need for more large trials[3].
- Because CBT and ERP have the strongest evidence for anxiety and OCD, we typically use ACT alongside them rather than instead of them.
Research results describe averages across groups of children. Every child is different, and we track your child's progress with standardized measures throughout treatment.
Common questions
Is ACT the same as mindfulness?
Mindfulness is one part of ACT. ACT also focuses on values and committed action, so kids learn not only to notice difficult feelings but also to keep moving toward what matters.
Can young children do ACT?
Yes, with adaptation. We use concrete metaphors, stories, and play for younger children, and involve parents closely.
Will ACT replace CBT or ERP for my child?
Usually not. For anxiety and OCD, CBT and ERP have the most research support. ACT skills often make that work easier and more meaningful.
Is ACT helpful for teens with perfectionism?
It can be. ACT helps teens loosen their grip on rigid rules and harsh self-talk, and reconnect with why their goals matter to them.
References
- Hancock, K. M., Swain, J., Hainsworth, C. J., Dixon, A. L., Koo, S., & Munro, K. (2018). Acceptance and Commitment Therapy versus cognitive behavior therapy for children with anxiety: Outcomes of a randomized controlled trial. Journal of Clinical Child & Adolescent Psychology, 47(2), 296–311. View study
- López-Pinar, C., Lara-Merín, L., & Macías, J. (2025). Process of change and efficacy of acceptance and commitment therapy (ACT) for anxiety and depression symptoms in adolescents: A meta-analysis of randomized controlled trials. Journal of Affective Disorders, 368, 633–644. View study
- Swain, J., Hancock, K., Dixon, A., & Bowman, J. (2015). Acceptance and Commitment Therapy for children: A systematic review of intervention studies. Journal of Contextual Behavioral Science, 4(2), 73–85. View study