Acceptance and Action Questionnaire-II

The Acceptance and Action Questionnaire-II (AAQ-II) is a validated, widely used clinical measure of experiential avoidance and its conceptual inverse…

Questions: 7
Duration: 3 min
Original title: AAQ-II — Acceptance and Action Questionnaire
Adaptation: Acceptance and Action Questionnaire-II
Authors: Bond, F.W., Hayes, S.C., Baer, R.A., Carpenter, K.M., Guenole, N., Orcutt, H.K., Waltz, T., & Zettle, R.D.
Created: 2011

The Acceptance and Action Questionnaire-II (AAQ-II) is a validated, widely used clinical measure of experiential avoidance and its conceptual inverse, psychological flexibility. Grounded in the Acceptance and Commitment Therapy (ACT) model, this instrument helps clinicians capture a patient’s tendency to rigidly avoid distressing thoughts or feelings, which often maintains long-term suffering. By establishing a reliable baseline, the AAQ-II allows practitioners to track a patient’s progress toward meaningful, values-based living even in the presence of internal discomfort.

Rather than focusing on symptom frequency, this measure targets the core functional processes that drive behavioral constriction. It provides a highly reliable metric to determine whether therapeutic interventions are successfully altering the patient's relationship to their own distress, making it an essential tool for third-wave cognitive behavioral therapies.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

28/ 49

The AAQ-II is a 7-item self-report questionnaire assessing experiential avoidance and psychological inflexibility, central concepts in Acceptance and Commitment Therapy (ACT). A higher score indicates greater psychological inflexibility (difficulty accepting unpleasant thoughts and emotions and acting in alignment with one's values). Suitable for clinical and research use in adults.

7–24

Normative levels of psychological flexibility

25–49

Psychological distress / moderate to severe anxiety

A score of 1 standard deviation above the normative mean indicating psychological distress, and classifying clients as moderate / severe on measures of anxiety.

généraleMixed · General population · Undergraduate student sample and adult employee sample · n = 1016

749

M = 18 ± 6.4

cliniqueMixed · Pathology: substance abuse

749

M = 28.34 ± 9.92

Scoring

Sum, total score from 7 to 49, each item is scored on a 7-point scale (from 1 to 7).

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What the test measures

The AAQ-II assesses how tightly a person is entangled with their internal experiences and how much this struggle restricts their daily life. Instead of measuring symptom severity, it maps the underlying processes that sustain distress.

Experiential avoidance: The degree to which a person tries to alter, suppress, or escape unwanted internal events.
Cognitive entanglement: The extent to which painful thoughts dictate behavior, reflecting a need for defusion techniques.
Behavioral restriction: How much internal distress derails the pursuit of meaningful life goals.
Emotional fear: The active dread of feeling one's own anxiety or sadness, disrupting the natural thought-emotion-behavior loop.

Targeted primarily at adults, this measure is foundational for clinical work centered on moving from a rigid defense to active acceptance.

When and why to use it

Clinicians deploy the AAQ-II to understand the functional impact of a patient's internal control strategies and to guide treatment planning.

Intake baseline: To identify how much a patient's distress is compounded by their active resistance to it.
Monitoring change: To track improvements in flexibility across sessions, ensuring the patient is learning to decouple the automatic jump from emotion to behavior rather than just masking symptoms.
Differential support: To determine if the patient might benefit from targeted interventions mapping onto the ACT hexaflex, such as values clarification or willingness exercises.
Screening and cut-off: To identify clinically significant levels of psychological inflexibility that warrant targeted therapeutic intervention.

Using a validated score offers a quantifiable metric of inflexibility that moves beyond subjective clinical impression, grounding the therapeutic process in measurable behavioral shifts.

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The questions

Below is a list of statements. Please rate each of them by checking the box that best corresponds to what you think about each of these statements. Use the scale below to make your choice.
1. My painful experiences and memories get in the way of me living my life the way I would like to.
This item assesses the extent to which a person feels their past pain actively blocks their ability to pursue meaningful goals.
- Never true
- Very rarely true
- Rarely true
- Sometimes true
- Often true
- Almost always true
- Always true
2. I'm afraid of my feelings.
This statement probes the direct fear of one's own emotional landscape.
- Never true
- Very rarely true
- Rarely true
- Sometimes true
- Often true
- Almost always true
- Always true
3. I'm afraid I won't be able to control my worries and feelings.
This question captures the secondary anxiety generated by the perceived loss of internal emotional control.
- Never true
- Very rarely true
- Rarely true
- Sometimes true
- Often true
- Almost always true
- Always true
4. My painful memories prevent me from living a full life.
This item measures how strongly distressing recollections restrict a patient's present-day flourishing.
- Never true
- Very rarely true
- Rarely true
- Sometimes true
- Often true
- Almost always true
- Always true
5. Emotions are a source of problems in my life.
This statement evaluates the patient's perception that their affective experiences are inherently disruptive to their daily functioning.
- Never true
- Very rarely true
- Rarely true
- Sometimes true
- Often true
- Almost always true
- Always true
6. It seems like most people are handling their lives better than I am.
This question reflects the social comparison and isolation that often accompany severe experiential avoidance.
- Never true
- Very rarely true
- Rarely true
- Sometimes true
- Often true
- Almost always true
- Always true
7. My worries keep me from succeeding.
This final item identifies how much cognitive apprehension interferes with the patient's tangible achievements.
- Never true
- Very rarely true
- Rarely true
- Sometimes true
- Often true
- Almost always true
- Always true