Author: Todd Schmenk, LMHC | RIACT.org
Abstract:
This paper introduces Version 15 of the Functional Process Note (FPN), developed through Rhode Island ACT (RIACT.org) as a clinical, supervisory, and pedagogical tool aligned with Functional Contextualism (FC) and Relational Frame Theory (RFT). Initially designed to capture the nuances of ACT-consistent in-session work, this evolution—now titled the AIC-Flex Note—serves a dual purpose: to document what ACT clinicians actually do in session and to guide supervisees toward deeper, process-based fluency. By embedding psychological flexibility metrics, real-time contextual analysis, and ACT-consistent process markers, this note format creates transparency, accountability, and a developmental roadmap for ACT practitioners. This version is now actively used in RIACT's residency training program and has become a cornerstone in how we cultivate and evaluate clinical competence in contextual behavioral practice.
Introduction
Since its inception, Acceptance and Commitment Therapy (ACT) has emphasized behavior-in-context over diagnosis, processes over protocols, and function over form. However, many clinical documentation systems remain misaligned with these principles—favoring symptom tracking, diagnostic labeling, or rigid CBT-style formulations. At RIACT.org, we have spent the past five years developing and refining a progress note format that more accurately reflects the moment-to-moment stance and interventions of an ACT clinician.
The current result—Version 15 of the Functional Process Note—now titled the ACT-In-Context Flex Note (AIC-Flex), represents our most mature and flexible iteration. Developed inside a live training context (our ACT Residency Program), this version integrates insights from over a dozen prior templates and supervisor feedback loops.
This note represents the natural evolution of the original Process-Based Progress Note introduced to the ACBS community, which can be found here: https://contextualscience.org/node/49924. While that original version provided a crucial foundation for aligning documentation with ACT principles, Version 15 expands the scope, deepens the functionality, and increases adaptability for use in diverse formats, including brief consults, group therapy, and longitudinal training contexts.
There is also a newer version, simply called the Functional Progress note (FPN), currently in the final stages of development and testing. Once this has been completed, it will be published here as well.
Context of Development
The AIC-Flex Note was designed with three core goals:
- Supervision Support: To help supervisors and ACT trainers more clearly identify where a clinician is developmentally in terms of ACT process fluency.
- Clinical Integrity: To help ACT clinicians track their moment-to-moment work in-session with clarity, especially across the six core processes of psychological flexibility.
- Training Through Use: To enable supervisees to learn by doing—using the structure of the note to deepen their understanding of FC, RFT, and ACT-based intervention in practice.
This structure emerged from a need to unify idiographic fidelity with pragmatic usefulness. It has been stress-tested across brief consults, long-form therapy sessions, and group supervision debriefs.
Structural Overview
The AIC-Flex Note includes six core sections:
- Presenting Concern – Captures the client’s language and identifies interference in life domains (Love, Work, Play, Health). Emphasizes language context and situational cues.
- Context & Emerging Cues – Prompts clinicians to identify session context, triggering events, and domain-specific shifts. This supports both situational analysis and historical trajectory mapping (Time, Trigger, Trajectory).
- Functional Analysis – Anchored in FC and RFT, this section surfaces the behavioral function, private experiences (thoughts, emotions, memories), and the inflexibility processes at play. This strengthens the clinician’s ability to analyze not just what happened, but why it happened in that moment.
- Intervention & EMR (Evoke, Model, Reinforce) – Documents not just the tools used (e.g., defusion, metaphor, mindfulness), but also the process-level work: what was evoked, how the therapist modeled flexibility, and how movement was shaped.
- Tracking & Plan – Introduces numerical tracking for psychological flexibility (0–10) and life functionality (0–10). This allows practitioners to track change across time and sessions in a client-centered, idiographic way.
- Clinical Reflection – Offers a reflective space for therapists to examine their own stance, note supervision needs, and highlight areas of process growth.
Training Implications
One of the most exciting outcomes of Version 15 is its utility as a training accelerant. Rather than learning FC or RFT solely through academic texts, supervisees are now learning it in real-time through documentation. As they complete notes, they:
- Practice identifying functions of behavior, not just topographies.
- Develop fluency in mapping ACT processes to session moments.
- Build awareness of their own stance, language, and effectiveness.
Supervisors are now able to scan notes and quickly spot:
- Whether the clinician is over-relying on technique rather than stance.
- Which processes are being over- or under-utilized.
- What phase of ACT development the clinician is currently working through.
This note has become a live developmental mirror.
Measuring ACT Processes in Session
Most progress notes do not provide a mechanism for tracking how much flexibility is increasing. The AIC-Flex Note explicitly includes a place for numerical estimates (0–10) across:
- Psychological Flexibility – A gestalt or direct client-reported measure of openness, presence, and movement.
- Functionality – How well the client is showing up in valued domains.
These markers allow trainers, clinicians, and even clients to start tracking movement in the six core processes and their associated life outcomes.
Conclusion
The AIC-Flex Note (Version 15) represents a major step toward embedding FC and RFT into the daily workflow of ACT practitioners. It is not just a documentation tool, but a process-based intervention in itself: shaping the clinician, supporting fidelity, and revealing development in real-time.
We offer this template and conceptual model to the ACBS community as both an open-source tool and a training aid. Feedback, refinements, and collaborations are welcome as we continue to track, teach, and evolve what it truly means to practice ACT-in-Context.
For access to the template, fillable PDFs, training materials, or to collaborate on adaptations, visit www.RIACT.org or contact Todd Schmenk at [email protected].