Psychological Flexibility in ABA: The ACT Hexaflex

Psychological flexibility means acting on your values even when it is hard. You notice tough thoughts and feelings. You do not let them run the show. You keep moving toward what matters to you.

This matters to BCBAs, RBTs, and the people they serve. It is a core idea in acceptance and commitment training, or ACT. ACT gives clients tools to handle hard inner moments. Those tools help them live fuller lives.

The hexaflex model#

Psychological flexibility is often drawn as a six-sided shape. Experts call it the ACT hexaflex. Each of the six points is a skill. Each skill has a flexible side and a stuck side.

Dr. Tom Szabo explains the shape and its purpose.

It's been most effectively in the last 15 years conceptualized in a hexagon format. We call this the ACT-EXA-FLEX. And as you can see, each point along the hexagon can be looked at both in terms of flexible and inflexible processes. From the talk — Dr. Tom Szabo

The model works like a map. It shows which skill is getting in a client's way. You can then aim your teaching at that spot. Szabo says the real work is learning to tell these six skills apart.

Each side of the hexagon covers a different repertoire. One is about rules and the stories we tell ourselves. Another is about emotions and how we hold them. Others cover time, the sense of self, values, and action. When you can spot which one is stuck, you know where to help.

The six named skills are the pieces of the model. Cognitive defusion means unhooking from harsh thoughts. Acceptance means making room for hard feelings. Present moment awareness means noticing the here and now. Self as context, values, and committed action round out the set. Together they add up to psychological flexibility.

Say it in plain words#

The technical terms can confuse clients and staff. Tom Sabo calls them middle-level terms. They sit between science and everyday speech. They are not for clients to hear.

This is the ACT hexaflex. Maybe you're familiar with these strange terms. We call these middle-level terms, cognitive diffusion, self as context, willingness, present moment awareness. From the talk. Tom Sabo

So you translate the terms into simple language. Brian Middleton pushes this point hard. He even renames the whole idea.

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

Flexible engagement says the goal in plain speech. It means showing up and acting on what matters. Clear words help clients actually use the skill.

Start with values#

The six skills do not have a fixed order. Middleton teaches them starting with values. He reworked the hexaflex into his own version. He explains why the order can shift.

values is at the top. And this is how I teach act skills. I teach in this order, but here's the thing about derived relational responding. Right. Relational frame theory. You can teach in this order and then the individual can apply in any order they want. From the talk. Brian Middleton

This is a helpful freedom. You pick a starting point that fits the learner. The person then uses the skills in whatever order helps them. Values give a clear reason to do the hard inner work.

You can see Middleton's values-first approach in How to Identify Learner Values Through a Neurodiversity Affirming Lens.

Flexibility builds cooperation#

Psychological flexibility is not only for one person. It also helps groups work together. Jason Stauffer describes how it supports teams. He names three ways it helps.

Psychological flexibility works towards cooperation on three fronts. From the talk. Jason Stauffer

One front is patience. Flexible people can wait for a bigger reward. Openness lowers impulsivity, so a person can sit with short-term pain for long-term gain. That patience helps teams choose the harder, better path.

Another front is trust. Being open lets people show up honestly with each other. Holding space for uncomfortable feelings makes room for that honesty. And that honesty is what groups need to function well.

The third front is perspective taking. Flexible people can see a problem through another's eyes. This builds care for the whole group, not just for oneself. Cooperation grows when people value what others need.

A self-management system#

ACT is not something done to a client. It is a set of skills a person can use. Brian Middleton frames it as a self-management system. The person becomes their own guide, not a passive target.

This fits ABA values well. You are not controlling the person. You are handing them tools they own. The skills have evidence behind them, and they work when applied with care.

The tools also flex for age and ability. Louise Hayes built a version for young children called the DNAV model. It teaches the same core skills in simpler, kid-friendly ways. Little kids need psychological flexibility too, just in a form they can grasp.

What the research says#

Psychological flexibility appears often in parent research. One paper focused on parents during the stress of the pandemic. It offered tools to build flexibility and self-care. The authors argued these skills support positive, steady parenting (Coyne, Gould, Grimaldi, Wilson, Baffuto, & Biglan, 2020).

That work fits a larger pattern in the field. Flexibility is treated as a strength to build, not a trait you either have or lack. ACT-based tools aim to grow it over time. Parents and clients can both learn the skills.

Researchers keep testing where these skills help most. Studies link higher flexibility to lower stress and burnout. That pattern shows up in parents and in autistic youth alike. It marks flexibility as a useful target for support.

FAQ#

What is psychological flexibility in simple terms?

It means acting on your values even when thoughts and feelings push back. You notice hard inner experiences without letting them control you. Then you keep moving toward what matters. Some experts call this flexible engagement.

What is the ACT hexaflex?

The hexaflex is a six-sided model of ACT skills. Each point is a skill with a flexible side and a stuck side. Together they make up psychological flexibility. Clinicians use it as a map to find where a client is stuck.

Do you have to teach the six skills in order?

No. The skills can be taught in any starting order. Some clinicians begin with values to give the work a clear reason. Once learned, a person can apply the skills in whatever order helps them.