Each card (0–XXI) is linked to:

Clinical themes: presenting struggles such as anxiety, shame, avoidance, indecision, self-criticism, or stuckness

ACT processes: fusion, experiential avoidance, attachment to conceptualized self, lack of present-moment awareness, values confusion, or unworkable action patterns

Core pain themes: feared internal experiences clients are attempting to control, suppress, or escape

In-session ACT interventions: defusion exercises, present-moment tracking, self-as-context exploration, willingness practices, values clarification, and committed action planning

For example:

The Fool: Fear of uncertainty and risk; fusion with thoughts such as “I cannot handle this”; in session focus on noticing anxiety sensations, practicing willingness, and identifying small values-based steps forward.

The Magician: Performance-based identity and self-doubt; fusion with self-judgments; in session work may include defusion from impostor thoughts, observing self exploration, and reconnecting with values beyond achievement.

The Hanged Man: Resistance to change or feeling stuck; avoidance of discomfort associated with growth; in session interventions may include creative hopelessness, examining workability, and practicing acceptance of discomfort while identifying aligned action.

This framework is designed exclusively for use during sessions to support present-moment awareness, live tracking of internal experiences, and collaborative intervention selection. Clinicians can use it to identify where a client is fused, avoiding, or disconnected from values and then immediately apply targeted ACT processes to increase flexibility and support meaningful action.