Psychological Flexibility: The ACT Hexaflex in ABA

Psychological flexibility is the ability to take action toward what matters to you, even when hard thoughts, feelings, or doubts are present. It is the main goal of ACT (Acceptance and Commitment Training or Therapy, a behavioral approach built on six core skills). Those six skills are often drawn as a hexagon called the hexaflex.

This matters because most people wait to feel ready before they act. They wait to feel calm, sure, or confident. Flexibility lets a client, a parent, or a supervisor move forward anyway. Below, behavior analysts explain how the hexaflex works, how to put it in plain words, and how it shows up at work.

The hexaflex: six skills, each with two sides#

Dr. Tom Szabo describes ACT as a way to relate better to the past, the future, and the present. It helps people tell apart what was, what will be, and what is. It also helps them find what they truly care about. Then they aim their actions at that, not at whatever feels good right now.

He says the field has drawn this as a hexagon for about 15 years.

each point along the hexagon can be looked at both in terms of flexible and inflexible processes.

From the talk — Dr. Tom Szabo

Take acceptance as an example. Acceptance means being willing to have contact with all of life's emotions. Its flip side is experiential avoidance (working hard to escape your own thoughts, feelings, or memories). Szabo points out that this is not the avoidance most of us studied in grad school. It is not about avoiding people, places, or things. It is about avoiding the thoughts and feelings we have about them. So each point on the hexagon has a helpful pole and a stuck pole. The map shows a clinician which skill is getting in the way.

Learning to spot the six repertoires#

Knowing the six words is not the same as seeing them in real behavior. Dr. Tom Szabo is clear about the core skill a clinician needs.

You'll need to learn how to discriminate between those six repertoires of behavior that I was describing to you, discriminate behavior with respect to rules and emotions and time and self and values and action.

From the talk — Dr. Tom Szabo

A repertoire is simply a set of behaviors a person can do. Rules here link to rule-governed behavior, which is its own topic. Szabo suggests learning this the way we teach any hard skill. Find people who break it into very small units. Add units slowly. Mix easy and hard practice items together. Build up to longer samples of talk, written text, and video.

He also warns that words alone can fool you. You need to listen for "tells," meaning what people say about themselves. But you also need to look for "reads," like body language. A client might say, "Yeah, I feel just fine." Their posture may tell a different story. Spotting that gap is part of the skill.

Swapping jargon for words clients use#

The hexaflex comes with strange labels. Cognitive defusion (stepping back from your thoughts). Self as context (seeing yourself as the one who notices your thoughts, not the thoughts themselves). Willingness. Present moment awareness. Tom Sabo calls these "middle-level terms."

They're middle-level because they're not words that are precise behavioral principles, nor are they the words that you use with your clients.

From the talk — Tom Sabo

So what do you say to a client instead? Sabo offers simple phrases. Let things in. Let things go. Be here now. See yourself and others kindly. Find your why. Commit to action. You can go even simpler and call it "tuning your antennae."

He also points to Louise Hayes and her DNAV model. She built it to fit young children, who also need psychological flexibility. His message is that ACT does not have to be complicated. You can shape it to fit your setting. For ABA, he adds one firm rule. Find and use direct contingency management first (changing what happens before and after a behavior).

Starting with values: the "flexahex"#

Brian Middleton goes a step further with the language. He finds the phrase "psychological flexibility" hard to explain to people.

psychological flexibility. That's that's psychobabble. Right. It's what does that mean? OK, well, flexible engagement. That's that's a better that's better words to describe what we're looking for.

From the talk — Brian Middleton

Middleton reworked the hexaflex into what he calls the flexahex. He puts values at the top and teaches the skills in a set order. Values give purpose and direction. Defusion means learning to step back. Being present comes next, then self as context. Acceptance means nonjudgmental awareness of hard moments. Committed action means moving toward values and setting goals.

Does the order lock people in? He says no. He points to relational frame theory (a behavioral account of how people link ideas they were never directly taught).

You can teach in this order and then the individual can apply in any order they want.

From the talk — Brian Middleton

He phrases every step from the "me" point of view. If you want to use ACT, he says, start by using it on yourself. He also adds a twist on self as context. Others are context too, so the skill applies to the people around us as well.

ACT as a self-management system#

Brian Middleton warns about a narrow view of ACT. Many people only see one kind of example. They think applying ACT means a "stop and practice" exercise. He says those exercises are fine. But they are not the whole picture.

Act is a self-management system. It's strategies that you can utilize that have evidence based behind them that support that there's some consistent changes that occur when we apply this technologically.

From the talk — Brian Middleton

He shares a story to show what this looks like in the moment. A young learner was getting upset. The boy turned to the wall and hit it twice. Then he turned back to Middleton and the other tech and signed "alone time." He sat down. The adults backed off. He breathed through it, start to finish, in five minutes.

Middleton's point is that it all started with values. The learner knew what mattered to him and had a way to act on it. That is flexible engagement during a real moment of stress, not in a practice drill.

How flexibility builds trust on a team#

Jason Stauffer looks at psychological flexibility in the workplace. He sums up all six processes in one plain sentence. In his words: "I am here now accepting the way I feel and noticing my thoughts while doing what I care most about."

He says flexibility helps groups cooperate on three fronts. The first is trust.

Holding space for uncomfortable feelings allows for vulnerability, which is a necessary component when you're working with groups.

From the talk — Jason Stauffer

Stauffer explains how this builds trust. When team members share their values openly, people feel more connected. Things feel more transparent. If I know what you care about, I can guess what you are likely to do. That makes you easier to work with.

Openness also supports perspective taking (seeing a situation from another person's point of view). Stauffer says this leads to more empathy among group members. A team where people can admit what they feel, and know what others value, has a stronger base for working together.

Long-term thinking over quick rewards#

The second front in Jason Stauffer's model is long-term thinking. Clear values help people shift away from smaller rewards that come sooner. They lean toward larger rewards that come later. Stauffer notes those later rewards are usually the ones we really want.

Openness and awareness lead to reductions in impulsivity. It allows us to sit with short-term pain for long-term gain.

From the talk — Jason Stauffer

He adds a key point. You can have thoughts, ideas, and fears without letting them run your behavior. That lets you keep the bigger picture in mind.

The third front is social value orientation (caring about other people's outcomes along with your own). Stauffer says values and perspective taking build this. When you care how things turn out for your teammates, cooperation comes more easily. Taken together, trust, long-term thinking, and care for others are how flexibility makes a group work better.

Acting before you feel ready as a supervisor#

Allyson Mullins brings psychological flexibility into supervision. She defines it as taking values-aligned action while thoughts, emotions, and uncertainty are present. She also notes that values do not dictate one exact action. They give a direction for choosing behavior.

Supervisors face many inner barriers. Mullins lists a few. A fear of looking incompetent. Expecting conflict. Not wanting to disappoint someone. Uncertainty. The thought, "I just want to say this perfectly." Her audience named discomfort, uncertainty, and fear of seeming incompetent as the ones that show up most.

the goal is not to eliminate discomfort

From the talk — Allyson Mullins

In her words, you do not need to feel calm, confident, or certain before you act. She points to a pilot study suggesting flexibility may help professionals keep working well when discomfort is present. The question to ask yourself is simple. Can I take values-aligned action while this discomfort is here? Her full talk, Leadership Alignment in Supervision, walks through this in detail.

Leading with intention#

Sean Yocum ties psychological flexibility to growth as a leader. He describes leaders who wait for HR to offer a new module or for the CEU budget to open. Meanwhile, they spend time and money on streaming and vacations, not on themselves. He compares untapped skill to a muscle that starts to weaken.

Citing Castro and colleagues and Moran, he puts it this way.

leading with intention requires psychological flexibility and a commitment to personal growth even when the process is uncomfortable.

From the talk — Sean Yocum

Yocum turns that into questions for leaders. Are you reading new research, even outside your niche? Are you asking leaders you admire for advice? Are you practicing the hard talks you know you need to have? Are you using ABA on yourself by setting goals, tracking progress, and adjusting? Each of these means choosing growth while it feels awkward. That is flexibility applied to a career.

What the research says#

Published studies focus a lot on families and autistic people.

One paper speaks straight to behavior analysts. It argues that psychological flexibility and self-care are basic parts of mental health for parents. Shaping these skills may help families be more nurturing and support children's prosocial behavior. It also offers practitioners tools to build flexibility and positive parenting during COVID-19 and after (Coyne, Gould, Grimaldi, Wilson, Baffuto, & Biglan, 2020).

A systematic review looked at 26 studies on parents of children with disabilities. It found flexibility was linked to parents' mental health and to how well they function as caregivers. ACT-based programs raised parents' flexibility.

Other studies point the same way. In parents of autistic children, more inflexibility was tied to stronger emotional reactions and more parental burnout. Another study found flexibility and resilience fully explained the link between mindfulness and lower parenting stress. Among 281 autistic adults, parts of flexibility helped explain how COVID-19 health worries led to mental health concerns. And autistic youth reported lower flexibility than youth from the general community.

FAQ#

What is psychological flexibility in simple terms? It is the ability to act on what matters to you while hard thoughts and feelings are present. You do not wait to feel calm or sure first. It is the main goal of ACT.

What are the six processes of the ACT hexaflex? The six are acceptance, cognitive defusion, present moment awareness, self as context, values, and committed action. Each one has a flexible side and a stuck side. Acceptance, for example, is the opposite of experiential avoidance.

How do behavior analysts use psychological flexibility? They teach it to clients and parents, often in plain words like "let things in" and "find your why." They also use it themselves. Supervisors and leaders use it to act on their values during hard conversations and moments of doubt.