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Editorial Standard — sentenceCompletion session (single-prompt ACT reflection)

Purpose

A sentenceCompletion session presents a single sentence stem that the user completes in their own words. The stem functions as a focused reflective prompt -- an ACT defusion or values-clarification exercise in written form. Unlike chipExercise (multiple-choice, structured output) or reframe (two-field cognitive restructuring), sentenceCompletion is open-ended and qualitative: the output is personal and unstructured. Its therapeutic value is in the act of articulation -- completing a stem about tinnitus's impact, or one's values, or a recent observation makes implicit material explicit.

Sentence stems cover several ACT functions: self-as-context ("I am not my tinnitus because..."), defusion ("When I notice the thought that this is permanent, I also notice..."), values connection ("Something I want to do more of, whatever the sound is doing..."), and progress acknowledgement ("One thing I have handled this week is..."). They can also serve as end-of-session reflection prompts appended to longer sessions.

Voice register

Default register is early habituation -- companion-forward, still, warm. This is the most reflective session type in the app: the user is being invited into a genuinely open space. The intro paragraph should be brief and quiet; it creates the invitation without over-directing.

The stem itself sets the register by its content. A stem about a spike ("In the moment the sound feels unbearable, I notice I...") is more acute. A stem about values ("Something that still matters to me, whatever the sound is doing, is...") is habituation-forward. Match intro tone to stem content.

Closing paragraph (if used) should be quieter and shorter than in other session types. The sentenceCompletion is a reflective ending, not a task with a deliverable. Closing with a simple acknowledgement ("Thank you for taking the time to reflect") is appropriate here in a way it would not be in a chipExercise or reframe session.

Evidence / IP

Grounded in docs/protocols/ACT for Tinnitus.md (ACT hexaflex, defusion, self-as-context, values clarification, Westin) and docs/session-audio-protocols-ip-guide.md (Zetterqvist thesis). Key sources:

  • ACT defusion: one of the six hexaflex processes. Cognitive defusion techniques -- including "I notice I'm having the thought that..." patterns -- are the mechanism behind several sentenceCompletion stems. The Zetterqvist ACT-for-tinnitus thesis (open access; source: docs/session-audio-protocols-ip-guide.md) documents these as freely usable clinical material.
  • Self-as-context: ACT hexaflex process directly implemented by "I am not my tinnitus because..." stems. Distinction between the observing self and the experiencing self; prevents tinnitus-identity consolidation.
  • Values clarification through articulation: the written form of values card-sort. Completing "What matters most to me right now, independent of the sound, is..." operationalises values in language the user has generated themselves, which has higher commitment value than a ranked list.
  • ACT-for-tinnitus evidence: Westin et al. RCT (large effect sizes for tinnitus distress; 18-month superiority over TRT, mediated primarily by tinnitus acceptance). The sentenceCompletion is positioned in the Acceptance and Deepening phase (Weeks 8-10) as well as the transition from cognitive work.

IP: ACT sentence stems based on the hexaflex processes are academic, widely documented, and unprotectable. Specific stem wording is authored by Naluma. Do not reproduce verbatim stems from the Zetterqvist thesis or other copyrighted ACT workbooks -- draw on the concept and write the stem fresh.

Length / reading level

  • Intro paragraph: 1-3 sentences. Brief. Creates invitation, not instruction. States that there is no right or wrong answer, if that is genuinely true for the stem (for defusion and values stems it always is; for progress-acknowledgement stems it usually is).
  • Stem: 8-20 words. Sentence fragment that the user completes. Should begin with a first-person setup ("One thing I...", "When the sound is bad, I notice...", "Something I want to hold onto from this week is..."). The stem should leave genuine space -- avoid stems that have an obvious correct completion ("I feel better when I...").
  • Hint text: 5-12 words if used. A gentle pointer at what kind of response belongs in the field. "Your first honest answer is the right one" or "No need to be eloquent -- just true."
  • Closing paragraph: 0-2 sentences. Optional. When used, simple and quiet. Never celebratory.
  • Reading level: Grade 8 or below for the intro; Grade 6 or below for the stem (the user completes it, so it should be easy to parse quickly).

Editorial-required elements

  1. The stem must leave genuine space. A stem that has an implied correct answer is not a reflective exercise; it is a leading question. "The tinnitus has not stopped me from..." implies a positive answer and may cause users to perform optimism rather than reflect honestly. "One thing tinnitus has changed about how I spend my time is..." leaves genuinely open space.

  2. Intro must name the purpose -- but lightly. The user should know this is a reflective exercise, not a quiz. But the intro should not over-explain the mechanism ("this ACT defusion exercise will help you develop psychological flexibility"). Name the type of reflection; do not deliver a lecture about why it works.

  3. Hint text must not narrow the space. The hint text is optional and, when used, should suggest the type of response (honest, personal, brief) not the content. "e.g. something that made me feel more like myself" works as a hint. "e.g. how you're coping with tinnitus" fails because it limits the response to the tinnitus-coping frame.

  4. Progress-acknowledgement stems need grounding. "One thing I handled this week is..." must be positioned at a programme point where the user actually has something to acknowledge. In Week 1, this stem would be premature. The editorial review should flag sentenceCompletion sessions where the stem's emotional premise does not match the programme week.

  5. Closing must match the register of the stem. A defusion stem about a spike is not closed with "great work this week." An end-of-week reflection stem can close with quiet acknowledgement. Read the stem and the closing together before publishing.

  6. Obeys ai-patterns-en.md. All copy must obey ai-patterns-en.md. The closing paragraph is at risk for "you've got this" and similar banned constructions -- review it specifically.

Examples

Good -- ACT self-as-context stem:

Intro: "Tinnitus can start to feel like it defines what is and isn't possible. Take a moment with this."

Stem: "One thing tinnitus cannot change about who I am is..."

Hint: "There are no right answers -- your first thought is worth writing."

Why this works: the intro validates the experience (tinnitus-as-defining is real for many users) without endorsing it as permanent, the stem uses "cannot change" to assert continuity of self (self-as-context mechanism), the hint reduces performance pressure. Roughly 30 words total. No wellness clichés.

Bad -- progress-acknowledgement stem:

❌ Intro: "You've been working so hard on your wellness journey, and it's time to celebrate how far you've come!"

❌ Stem: "I've been feeling so much better since I started managing my tinnitus because..."

Why it fails: "wellness journey" and "managing your tinnitus" are banned under ai-patterns-en.md (Naluma-voice additions). The intro is toxic positivity ("celebrate how far you've come"). The stem has an implied correct answer ("feeling better") and will cause users to perform optimism rather than reflect honestly -- a user in a difficult week cannot complete this stem genuinely.