Acceptance and Commitment Therapy in Louisville, KY | ACT for Neurodiversity, Shame & Burnout

Values-based therapy that helps clients move from shame, masking, and self-criticism toward flexibility, self-understanding, and meaningful change.

At Closer Horizons, we integrate Acceptance and Commitment Therapy, often called ACT, into therapy with children, teens, adults, and families in Louisville, KY. ACT is a flexible, evidence-based therapy approach that helps clients build a different relationship with difficult thoughts, emotions, body sensations, expectations, and old patterns of self-protection.

For many neurodivergent individuals, distress is not simply about anxiety, motivation, or behavior. It is often shaped by years of being misunderstood, corrected, pressured, or expected to function in ways that did not match how their brain actually works.

Over time, those experiences can create shame, guilt, chronic self-monitoring, emotional dysregulation, and a default pattern of masking. ACT can help clients notice those patterns more clearly, loosen the grip of self-criticism, and begin making choices that are more aligned with who they are and what matters to them.

At Closer Horizons, ACT is often infused with modified CBT, emotional regulation strategies, and neurodiversity-affirming therapy. The goal is not to help clients ignore their pain or simply “think positive.” The goal is to help them recover from years of unrealistic expectations and build a more honest, sustainable way of functioning.

What Is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy is a therapeutic approach that focuses on psychological flexibility — the ability to stay connected to what matters, even when difficult thoughts, emotions, or sensations are present.

ACT does not ask clients to argue with every painful thought or force themselves to feel differently before taking action. Instead, it helps clients notice what they are experiencing, make room for difficult internal experiences, and choose actions that align with their values.

ACT often focuses on:

  • Acceptance of difficult thoughts, feelings, and sensations without being controlled by them

  • Cognitive defusion, or learning to step back from thoughts rather than treating them as facts

  • Mindfulness and present-moment awareness

  • Values clarification

  • Committed action toward what matters

  • Self-as-context, or building a more flexible sense of self beyond labels, failures, or old stories

For neurodivergent clients, ACT can be especially helpful when it is adapted with respect for sensory needs, communication style, executive functioning, emotional regulation, masking, and burnout.

Who May Benefit from ACT Therapy?

Acceptance and Commitment Therapy may be helpful for children, teens, adults, and families who are navigating:

  • Anxiety, worry, or chronic stress

  • Emotional dysregulation or shutdown

  • ADHD, autism, or other neurodevelopmental differences

  • Masking, people-pleasing, or chronic self-monitoring

  • Burnout, exhaustion, or loss of capacity

  • Shame, guilt, self-blame, or feeling “not enough”

  • Perfectionism or fear of disappointing others

  • Difficulty identifying needs, boundaries, or values

  • Avoidance, task paralysis, or feeling stuck

  • Family stress, school stress, work stress, or relationship strain

  • Adjustment after a new diagnosis or late diagnosis

ACT can be helpful when clients intellectually understand what is happening, but still feel pulled back into old patterns. It can also be useful when clients have spent years trying to push through, mask, overcompensate, or become the version of themselves that others expected them to be.

Why ACT Can Be Helpful for Neurodivergent Clients

Many neurodivergent people grow up receiving the message that their needs are inconvenient, confusing, excessive, or wrong. They may be expected to sit still, stay organized, tolerate sensory discomfort, manage transitions, read social cues, perform emotionally, or keep up with demands that exceed their actual capacity.

When this happens over time, the problem is not just the original difficulty. The problem becomes the shame and guilt built around it.

A child may learn, “I am too much.”

A teen may learn, “I have to hide what I need.”

An adult may learn, “If I cannot keep up, something is wrong with me.”

ACT helps create space between the person and those painful stories. It gives clients tools to notice the thoughts, expectations, and internal rules they have been carrying — and then ask whether those rules are still helping.

The work is not about rejecting responsibility. It is about separating responsibility from shame.

ACT, Masking, and Authentic Functioning

Masking can be a survival strategy. Many autistic, ADHD, and otherwise neurodivergent clients learn to monitor their facial expressions, suppress movement, script conversations, ignore sensory needs, over-prepare, hide confusion, or force themselves through environments that feel overwhelming.

Sometimes masking is chosen intentionally because a situation requires it. But for many people, masking becomes automatic. It becomes the default place of functioning — even when they are safe, exhausted, or no longer sure what they actually need.

ACT can help clients become more aware of masking by asking questions like:

  • What am I doing to appear okay right now?

  • What am I feeling or needing that I am trying to hide?

  • Is this mask helping me in this situation, or is it costing me more than I can sustain?

  • What would a more values-aligned choice look like here?

  • Where can I reduce performance and increase authenticity?

The goal is not to tell clients they should never mask. The goal is to help masking become a tool they can choose when needed — not a default mode that quietly drains their sense of self.

ACT and Recovery from Shame and Guilt

Many clients come to therapy carrying years of shame related to things that were never simply character flaws: difficulty starting tasks, sensory overload, emotional intensity, needing more recovery time, struggling with transitions, missing social cues, avoiding overwhelming demands, or falling apart after holding it together all day.

ACT helps clients notice the difference between a painful thought and the truth of who they are.

A thought like “I am lazy” may show up after a difficult day. A thought like “I always mess things up” may show up after a missed deadline. A thought like “I should be able to handle this” may show up when someone reaches capacity.

ACT does not require clients to fight every thought. Instead, it helps them notice: “I am having the thought that I am lazy.” “I am having the thought that I should be able to handle this.” That small shift can create enough space to respond differently.

From there, therapy can focus on what matters: rest, repair, communication, boundaries, support, self-advocacy, or values-aligned action.

How ACT Is Infused with Modified CBT at Closer Horizons

At Closer Horizons, ACT is often integrated with modified CBT. CBT helps clients understand patterns among thoughts, feelings, behaviors, and body responses. ACT adds a values-based, acceptance-oriented layer that can be especially helpful when clients feel stuck in shame, avoidance, perfectionism, or self-criticism.

Together, these approaches can help clients:

  • Understand anxiety and avoidance patterns

  • Notice thoughts without becoming fused with them

  • Build emotional regulation skills before trying to problem-solve

  • Identify unrealistic expectations and internalized shame

  • Develop more flexible thinking

  • Clarify values and priorities

  • Take small, meaningful actions even when discomfort is present

  • Reduce automatic masking and increase intentional choice

  • Build routines and supports that match actual capacity

This integrated approach is practical, but not shallow. It helps clients build insight while also learning how to live differently in the moments that usually pull them back into old patterns.

What ACT Can Look Like in Therapy

ACT is flexible and can be adapted to the client’s age, developmental stage, communication style, and needs.

For Children

ACT-informed therapy for children may focus on emotional awareness, body signals, flexible thinking, coping with big feelings, understanding what matters, and helping caregivers respond to dysregulation with more clarity and compassion.

For younger clients, the work is often concrete, visual, movement-based, and connected to real-life situations at home and school.

For Teens

ACT for teens may focus on anxiety, perfectionism, masking, identity, school pressure, friendships, self-criticism, emotional regulation, and values-based decision-making.

Many teens benefit from learning that uncomfortable feelings do not have to control their choices, and that they can build a life that reflects who they are rather than only who others expect them to be.

For Adults

ACT for adults may focus on burnout, late diagnosis, ADHD or autism-related shame, work stress, parenting, relationships, people-pleasing, masking, self-advocacy, and rebuilding a sense of self after years of overfunctioning.

For many adults, ACT provides a framework for asking: What am I carrying that was never mine to carry? What actually matters to me now? What would it look like to make choices from values rather than fear, guilt, or performance?

For Families

ACT-informed family work may help caregivers distinguish between unwillingness and overwhelm, understand how expectations affect regulation, and build routines that support connection, flexibility, and realistic growth.

ACT for Anxiety, Burnout, and Emotional Dysregulation

Anxiety and burnout often become more intense when a person is fighting their own internal experience. The harder they try to suppress worry, ignore sensory needs, push through exhaustion, or force themselves to function without support, the more depleted they may become.

ACT helps clients relate differently to difficult internal experiences. Rather than treating every anxious thought as an emergency, every uncomfortable feeling as a problem, or every moment of dysregulation as a failure, clients learn to pause, notice, name, and choose.

This can be especially helpful for clients who are recovering from years of functioning under unrealistic expectations.

Therapy may include:

  • Noticing early signs of dysregulation or overload

  • Practicing grounding and mindfulness strategies

  • Identifying shame-based thoughts and internal rules

  • Learning defusion skills to create distance from harsh self-talk

  • Clarifying values around relationships, school, work, parenting, or self-care

  • Building recovery routines after high-demand situations

  • Taking committed action in small, realistic steps

ACT for ADHD, Autism, and Neurodivergence

ACT can be a useful tool for neurodivergent clients when it is adapted thoughtfully.

For ADHD, ACT may support clients in noticing shame-based stories around inconsistency, procrastination, emotional intensity, or task initiation. It can also help clients move toward values-based action without waiting to feel perfectly motivated, organized, or confident.

For autism, ACT may support awareness of masking, sensory needs, burnout, anxiety, and the internal cost of performing neurotypical expectations. It can help clients build a more compassionate and accurate relationship with themselves.

For neurodivergent clients more broadly, ACT can support the shift from “How do I become someone else?” to “How do I build a life that works with my brain, my values, and my actual capacity?”

Individualized Care, Informed by Clinical Experience

Dr. Kenya Guarnieri is a Licensed Psychologist and Licensed School Psychologist with a Ph.D. in School Psychology and 15 years of experience across school and clinical settings. Her background gives her a strong understanding of how anxiety, ADHD, autism, executive functioning, emotional regulation, sensory processing, learning, and family systems interact across development.

Her work is grounded in evidence-based care, clinical judgment, and a strengths-based, neurodiversity-affirming approach. In addition to direct clinical care, Dr. G provides supervision to psychology trainees, reflecting her commitment to ethical practice, thoughtful clinical reasoning, and high-quality psychological care.

At Closer Horizons, ACT is not used as a script. It is a flexible framework that supports acceptance, self-understanding, values-based action, and meaningful change.

Acceptance and Commitment Therapy in Louisville, KY and Surrounding Areas

Closer Horizons provides Acceptance and Commitment Therapy, ACT-informed counseling, modified CBT, anxiety therapy, ADHD counseling, autism therapy, and neurodiversity-affirming therapy in Louisville, KY for children, teens, adults, and families.

Located in the Louisville area, Closer Horizons serves clients from Jefferson County, Jeffersontown, Middletown, East Louisville, Oldham County, and surrounding communities.

Whether you are seeking therapy for anxiety, ADHD, autism, burnout, emotional dysregulation, masking, shame, guilt, executive functioning, or family stress, ACT can help create a more flexible and values-aligned path forward.

Helpful ACT Resources

For individuals and families who want to learn more, these research-based resources may be helpful:

These resources support the use of ACT-informed approaches for neurodivergent individuals, including autistic adults and adults with ADHD. They are not a substitute for individualized therapy, counseling, or consultation with a qualified clinician.

Frequently Asked Questions About ACT Therapy

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy is a therapeutic approach that helps clients build psychological flexibility. It focuses on noticing difficult thoughts and feelings, making room for discomfort, clarifying values, and taking meaningful action even when life feels hard.

Is ACT different from CBT?

Yes, though the two approaches can work well together. CBT often helps clients understand the connection between thoughts, feelings, and behaviors. ACT focuses more on changing the relationship with thoughts and feelings, reducing avoidance, and moving toward values-based action.

How does ACT help with shame and guilt?

ACT helps clients notice shame-based thoughts without automatically treating them as truth. It creates space between the person and the story they have learned about themselves, which can support self-compassion, more flexible choices, and values-aligned action.

Can ACT help with masking?

Yes. ACT can help clients become more aware of when they are masking, what purpose the mask is serving, and whether it is helping or costing too much in a particular situation. The goal is not to shame masking, but to help it become a choice rather than an automatic default.

Is ACT helpful for ADHD or autism?

ACT can be helpful for neurodivergent clients when it is adapted thoughtfully. It may support emotional regulation, self-acceptance, values-based action, burnout recovery, masking awareness, executive functioning, and a more compassionate understanding of neurodivergent needs.

Do you use ACT with children and teens?

Yes. ACT-informed therapy can be adapted for children and teens using developmentally appropriate language, visuals, metaphors, body-based awareness, caregiver support, and practical skills tied to real-life situations.

Do you provide ACT therapy near Jeffersontown, Middletown, or East Louisville?

Yes. Closer Horizons provides Acceptance and Commitment Therapy in Louisville, KY and serves clients from nearby areas including Jefferson County, Jeffersontown, Middletown, East Louisville, Oldham County, and surrounding communities.

Related Services

If you are looking for additional support, Closer Horizons also provides:

  • Modified CBT therapy in Louisville, KY

  • Anxiety therapy and burnout counseling

  • ADHD counseling in Louisville, KY

  • Autism counseling in Louisville, KY

  • Neurodiversity-affirming therapy

  • Executive functioning support

  • Therapy for children, teens, and adults

  • ADHD evaluations in Louisville, KY

  • Autism evaluations in Louisville, KY

  • Psychoeducational evaluations and learning disability testing

Ready to Get Started?

If you are looking for therapy that helps you or your child move from shame, masking, and self-criticism toward flexibility, self-understanding, and meaningful change, Closer Horizons can help.

Schedule a consultation to learn more about Acceptance and Commitment Therapy in Louisville, KY.