Given its intensity—smaller caseloads, 24-7 open-ended commitment, and ongoing fidelity monitoring—implementing ACT may seem daunting and close to an all-or-nothing proposition (3). This leads to a second question: how does ACT fit the varying needs of mental health clients? Its effectiveness is well-established for clients with more severe disabilities (3); however, ACT seems less equipped to serve clients whose needs are episodic or sporadic (4) and those who are well on their way to mental health recovery (5). ACT's step-down capacity—that is, the ability of ACT teams to provide a less intensive approach, linking clients to specific services as needed—has received some attention but remains poorly understood and operationalized (5). To make matters more complicated, ACT sometimes needs to be stepped up—that is, expanded to address comorbid problems such as poor health and substance abuse. ACT has been described as a suitable platform to deliver other evidence-based practices, such as integrated dual disorders treatment (6), although such practices require that traditional ACT services be repurposed. For now, the ways in which “ACT step-down” or “ACT step-up” affects fidelity—and, more important, client outcomes—remain to be seen.