Choice point worksheet: ACT tool for therapy sessions

Key Takeaways

The choice point worksheet is an ACT tool helping clients distinguish between towards moves (value-consistent actions) and away moves (avoidance behaviors).

Originally created by Ann Bailey, Joseph Ciarrochi, and Russ Harris in 2013 for The Weight Escape. Choice Point 2.0 refined the model with clearer decision-making frameworks.

Mental health practitioners use the choice point worksheet to build psychological flexibility and align client actions with their deepest values.

Pabau’s digital forms and clinical documentation features streamline choice point administration and outcome tracking within therapy sessions.

Therapy clients often feel stuck between two paths: moving toward what matters to them, or moving away from discomfort. The choice point worksheet is a structured tool that makes this invisible decision process visible, helping practitioners guide clients toward value-consistent living.

What is the choice point worksheet?

The choice point worksheet is a therapeutic aid used in Acceptance and Commitment Therapy (ACT). It maps the moment when a client faces a decision: do they respond in a way that aligns with their values (towards move), or do they respond to escape discomfort (away move)?

Created by Joseph Ciarrochi, Ann Bailey, and Russ Harris, the choice point worksheet emerged from evidence-based ACT research. The original version appeared in The Weight Escape (2013) and has since become standard in therapy practices across mental health, coaching, and wellness settings. Harris developed Choice Point 2.0 in 2017 as a refined iteration, adding clarity to how clients visualize the relationship between their thoughts, feelings, and chosen actions.

How to use the choice point worksheet

The worksheet guides clients through five structured steps that unfold naturally within a therapy session. Each step builds toward psychological flexibility: the ability to notice difficult thoughts and feelings while choosing to act on values.

1. Identify the situation — the client describes the triggering event or circumstance (e.g., “My partner criticized my weight”).
2. Notice the hook — explore the uncomfortable thoughts and feelings that arise (e.g., shame, self-doubt, or urges to withdraw).
3. Recognize the choice point — name the two paths available: towards moves (aligned with values, often harder) or away moves (avoidance, temporary relief).
4. Clarify personal values — anchor the choice to what genuinely matters to the client (e.g., intimacy, growth, health), not social pressure or past habits.
5. Commit to action — decide which move to take and name one concrete behavior that reflects that choice.

Practitioners using practice management software like Pabau can run the worksheet on digital forms during a session, so the client completes it on screen and it saves straight to their record. Pabau Scribe, our AI scribe, then drafts the session note, capturing the client’s chosen towards move and committed action without extra typing.

At the choice point itself, the Choice Point 2.0 worksheet adds a short STOP skill that helps clients unhook in the moment: Slow down (anchor with the breath or press the feet into the floor), Take note of the thoughts and feelings showing up, Open up to make room for that discomfort, and Pursue values by choosing one small towards move. Walking a client through STOP out loud gives them a repeatable skill for the moments of difficulty that happen between sessions, not just on the page.

Towards moves vs away moves

The choice point worksheet’s core distinction rests on two types of behavior.

• Towards moves: Actions that reflect client values, even when uncomfortable. Example: “I’ll tell my partner honestly how I feel” (vulnerability toward intimacy, despite anxiety).
• Away moves: Behaviors driven by escaping discomfort, often creating long-term distance from values. Example: “I’ll avoid the conversation” (temporary comfort, but damages the relationship).

Many clients initially gravitate toward away moves because relief is immediate. The worksheet’s power lies in revealing the cost: short-term ease buys long-term disconnection from what matters. By naming this trade-off explicitly, clients gain clarity and agency.

Values and committed action

ACT assumes that lasting behavior change flows from contact with core values, not from logic, willpower, or fear. The choice point worksheet anchors every decision to the client’s stated values. Before choosing a towards move, clients articulate why it matters: “This feels scary, but it matters because I value connection with my partner.”

Committed action emerges once values are clear. Instead of vague intentions (“I should be more honest”), clients name a specific behavior (“I will tell my partner one vulnerable thought by Friday”). This turns insight into action. Storing completed worksheets in client records enables practitioners to track progress across sessions and reinforce committed actions during follow-ups.

Who is the choice point worksheet helpful for?

The choice point worksheet serves multiple professional and client populations.

• Mental health therapists and counselors: Deliver ACT-based interventions for anxiety, depression, PTSD, and relationship issues, often alongside validated outcome measures such as the GAD-7 anxiety assessment and the Beck Depression Inventory. Therapy practice management systems allow easy distribution and storage of worksheets.
• Coaches (life, executive, health): Use the choice point to guide clients toward behavior aligned with personal or professional goals, not circumstance-driven reactions.
• Substance abuse and addiction treatment: Clients in recovery use choice point worksheets to identify triggers and recommit to sobriety-aligned actions when cravings arise, often pairing them with a relapse prevention plan worksheet.
• Grief and bereavement counselors: The worksheet helps grieving clients distinguish between healthy grief processing (towards) and prolonged avoidance (away), complementing structured tools like the 7 stages of grief template.
• Organizational development and wellness practitioners: Apply choice point logic to workplace stress and burnout, helping employees align daily choices with career values. Psychology practice software enables seamless client record management for these diverse use cases.

Benefits of using the choice point worksheet

Clarifies decision-making in the moment. Clients often feel paralyzed by difficult emotions. The worksheet creates structure, reducing decision fatigue and supporting psychological flexibility.

Strengthens the values-action connection. By explicitly linking behavior to values, clients internalize that growth and meaning emerge from towards moves, not avoidance. This shift often persists beyond the session.

Builds accountability and tracking. Completed worksheets become clinical documentation that supports review and progress measurement across multiple sessions, key for demonstrating outcomes.

Reduces stigma and shame. Naming the choice point as a universal human experience, not a personal failure, normalizes struggle and invites agency. The worksheet is a permission slip to be human.

Integrating choice point into digital practice

Many practitioners now administer the choice point worksheet digitally. Telehealth platforms let clients complete worksheets during virtual sessions, and a shared screen keeps the conversation collaborative in real time. After the session, practice management systems securely store completed worksheets in the client record, enabling practitioners to reference insights and committed actions during follow-up appointments.

Digital workflows also reduce paperwork, allowing automated reminders to prompt clients to review their choice points between sessions, reinforcing committed action. Some practitioners track whether clients are acting on their chosen towards moves, then adjust the therapeutic approach accordingly.

Use the book a demo link below to explore how Pabau’s digital forms and clinical documentation tools streamline choice point administration and outcome tracking within your therapy practice.

See how Pabau simplifies ACT worksheet administration

Pabau's digital forms and client records help therapists distribute, complete, and track choice point worksheets, all within a HIPAA-compliant, integrated practice management system.

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Choice point in ACT therapy and related frameworks

The choice point worksheet is rooted in Acceptance and Commitment Therapy (ACT), a third-wave cognitive-behavioral approach developed by Steven Hayes and colleagues. ACT teaches six core processes: acceptance, cognitive defusion, being present, self-as-context, values, and committed action. The choice point worksheet is a practical delivery vehicle for all six.

Related ACT tools include the ACT Matrix (mapping towards and away moves across different life domains) and values clarification exercises. However, the choice point worksheet is uniquely suited to in-the-moment decision-making during sessions or between-session moments of difficulty. For a deeper walkthrough of the tool, Russ Harris’s Choice Point 2.0 overview shows how practitioners use it to explain the model, take a history, and set a session agenda.

Documentation and clinical records

Completed choice point worksheets are clinical documents. They document the client’s decision-making process, identified values, and committed actions-key information for continuity of care, supervision, and legal protection. Store worksheets in encrypted clinical systems with secure audit trails, ensuring HIPAA compliance and easy retrieval for follow-up sessions. Safer clinical notes practices apply equally to choice point documentation: keep records clear, dated, and objective.

Conclusion

The choice point worksheet is a powerful, evidence-based tool for therapy. By making the invisible decision process visible, it helps clients recognize that they have agency, even amid discomfort. Every towards move, no matter how small, strengthens psychological flexibility and draws clients closer to a life aligned with their values. When clinicians store completed worksheets within a secure practice system, they create a lasting record of client progress and reinforce committed action across multiple sessions. Book a demo with Pabau today to streamline your choice point workflow.

Continue your research

Planning longer-term care? Psychology treatment plan template helps structure goals and interventions beyond a single choice point.

Onboarding a new therapy client? Psychotherapy intake form template captures the history and values context that make choice point work more targeted.

Working with trauma? Trauma timeline worksheet maps the events that often drive today’s away moves.

Continue your research

• Addiction treatment plan template
• 8-week group counseling plan
• ICD-10 code for anxiety
• Major depression, single episode (ICD-10 F32.9)
• Post-traumatic stress disorder (ICD-10 F43.1)
• Psychotherapy for crisis (CPT code 90839)
• Coping skills for depression
• Accelerated resolution therapy for trauma

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