What Matters Through the Change: A Free ACT Values Worksheet for Menopause and Perimenopause
ACT · ACT · Practice-informed
A one-page ACT sheet: what the transition has made harder, hooking thoughts, three values and one small step with a smaller fallback and a rating of how far it moved the client toward what matters.
Underlying mechanism: ACT-Informed Defusion, Values Clarification and Committed Action for Midlife Role and Identity Change
What it helps with
- Reconnecting with values when symptoms and worry have been shrinking life.
- Relating to thoughts such as "I am falling apart" as thoughts and not facts.
- Planning one small, valued step that makes room for a flush, tiredness or worry.
- Measuring progress by how far a step moved the client toward what matters.
How clinicians use it
- Use it at Session 5, after the compassion session.
- Ask what the transition has made harder and listen for roles and identity.
- Practise the "I am having the thought that..." rewrite on two or three hooks.
- Agree a smaller fallback step so the plan survives a hard week.
Clinical Implementation Guide
- Tick what the transition has made harder.
- Rewrite hooking thoughts and name three values.
- Plan one small step and rate how far it moved you.
What the worksheet looks like
| Value | Small step | When and where | What I may feel and am willing to feel |
|---|---|---|---|
| Connection | Phone a friend for ten minutes | Thursday evening at home | Tiredness and a warm flush |
Clinical cautions
Not a diagnostic or medical tool. Psychological support sits alongside medical care: encourage review by a GP or menopause specialist, especially for heavy or unusual bleeding, new or sudden symptoms or any symptom that worries the client, and never advise on starting, stopping or choosing hormone therapy. Screen for depression, anxiety and suicidal thoughts with your usual risk protocol before and during the work, because mood can worsen in the transition. Avoid pathologising a normal life stage or implying that symptoms are psychological in origin, and use inclusive language. Heat, sweating and breath focus can be activating for clients with trauma or panic, so go slowly, offer choice and let the client keep their eyes open. Breathing is taught to settle the body and the fear response and must not be promised to reduce hot flushes (Huang et al., 2015). Sleep window work needs the checks in the guide: avoid or modify it for bipolar disorder, seizure disorder, safety-critical work and suspected untreated sleep apnoea, and keep time in bed at or above about five and a half hours without specialist guidance. After breast cancer treatment or surgical menopause, coordinate with the oncology or medical team.
References
- Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.
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 1.0, approved 20 October 2026, revised as the evidence develops.
Suggested citation (APA 7th edition): Pomfret, R. (2026). Steady Through the Transition: A third-wave protocol for menopause and perimenopause (Version 1.0) [Therapist guide and worksheets]. Third Wave Therapy Tools. https://thirdwavetherapytools.com/
Part of
Steady Through the Transition
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