Values Inside My Limits: An ACT Values and Energy-Sized Action Worksheet for Long COVID
ACT · ACT · Emerging
An ACT worksheet for finding a place for what matters in a smaller size, inside the limits set by the medical team. The client ticks two or three values, names the smallest version of each action with its energy cost, a time and a planned rest, practises carrying a sticky thought with a defusion phrase, signs a permission slip (stop at any time, planned rest is part of the plan) and looks back on what fitted. ACT has meta-analytic support in physical and mental health problems generally, and a trial of ACT for post-COVID syndrome has been registered but has not reported, so the rating is emerging and there is no Long COVID evidence yet.
Underlying mechanism: ACT Values Clarification and Committed Action Scaled to Energy for Long COVID
What it helps with
- Keeping meaning and connection in life when energy is limited, without pushing beyond the limits.
- Choosing small actions, five minutes and not five hours, with rest planned in and the client's own permission to stop.
- Carrying thoughts such as "There is no point if I can't do it properly" with a defusion phrase and still taking a small step.
- Reviewing how each action fitted the client's energy and resizing the next one.
How clinicians use it
- Use it in Session 7, after the CFT session on purpose.
- Invite two or three values, then size each action to current energy and to the limits set by the medical team.
- Include a planned rest with every action and treat rest as part of the plan and never a failure of it.
- At the next session look back on how each action fitted and make it smaller if it did not.
Clinical Implementation Guide
- Choose two or three values and size the smallest version of an action for each.
- Plan a rest after every action and read the permission slip aloud.
- Review how it fitted the client's energy and resize it for next time.
What the worksheet looks like
| What matters | Smallest version | Energy cost | Rest I will plan afterwards |
|---|---|---|---|
| Friends | Send one voice note to a friend | Low | Ten minutes lying down |
| Nature | Sit by the open window for five minutes | Low | A cup of tea and no screens |
Clinical cautions
This worksheet must never be used to push beyond the client's limits or to increase activity on a fixed schedule, and every action should be checked against the medical team's pacing advice. Values work can bring up grief and loss, so pace it and return to compassion-focused skills if the client is overwhelmed. This tool does not diagnose any condition and is not a substitute for individual face-to-face therapy or for emergency crisis support.
References
- A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J., & Emmelkamp, P. M. G. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30-36. https://doi.org/10.1159/000365764.
- Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25. https://doi.org/10.1016/j.brat.2005.06.006.
- Carvalho, N., Kalfas, M., Jolley, C., Rafferty, G. F., Pearson, O., Emsley, R., Metcalfe, A. J., Barrett, B., Brewin, D., Felton, L., Khan, T., Hart, N., Duncan, E. L., Nicholson, T., Witard, O. C., Evans, R. A., Beckwith, C., & Chalder, T. (2026). Randomised controlled trial assessing the efficacy of balance acceptance and commitment therapy (ACT) for post-COVID syndrome: A study protocol. BMJ Open, 16(8), e122602. https://doi.org/10.1136/bmjopen-2026-122602. Trial protocol only, no results yet.
Copyright and use in research
© 2026 Dr Richard Pomfret and Third Wave Therapy Tools. May be used in research with the author and site cited. Version 1.1, approved 21 October 2026, revised as the evidence develops.
Suggested citation (APA 7th edition): Pomfret, R. (2026). Steady Ground: A stepped, measurement-led psychological protocol for adults with Long COVID (Version 1.1) [Therapist guide and worksheets]. Third Wave Therapy Tools. https://thirdwavetherapytools.com/
Part of
Steady Ground
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