By Todd Schmenk
A System on the Brink
Every industry eventually reaches a breaking point where old structures can no longer contain new possibilities. Taxis operated reliably—until Uber decentralized transportation. Landlines dominated communication—until mobile networks made connectivity fluid, portable, and personal.
The mental health system is standing on that same precipice today.
Clinicians are leaving agencies in record numbers. Waitlists are months long. Compliance demands and reimbursement models have warped therapy into paperwork. Yet beneath this dysfunction, a powerful new alignment is forming—between technology, modular collective structures, and the scientific backbone of Functional Contextualism (FC), Relational Frame Theory (RFT), and Process-Based Therapy (PBT).
Together, these forces are creating an inflection point that may soon redefine how mental health care (if not healthcare in general) is delivered, organized, and sustained.
From Agencies to Ecosystems
Traditional mental health agencies are built on a 20th-century logic: control the clinicians, standardize the product, and measure success by throughput. This model worked when access and oversight were the biggest problems. Now, it is precisely what prevents innovation.
Yet, a new organizational form is emerging, the modular collective. Instead of a rigid hierarchy, these systems operate as interconnected nodes: independent clinicians sharing a unified mission, infrastructure, and philosophy. Think of it as a therapy ecosystem rather than a company.
Each clinician functions as a contextually adaptive unit—autonomous yet linked through shared technology, supervision, and values. Digital platforms (Slack, SimplePractice, Notion, AI documentation tools) make this collaboration seamless. The collective becomes a self-organizing, living network, much like a neural system that strengthens pathways through ongoing interaction.
Functional Contextualism: The Operating System of Change
Functional Contextualism provides the philosophical engine for this new model. It asks one essential question: What works, in this context, to move us toward our chosen values?
Where agencies cling to static rules, FC insists on adaptability. Systems, like behaviors, must be analyzed for workability. A billing structure, supervision protocol, or outreach model isn’t right or wrong—it’s simply more or less effective in producing the desired outcomes.
When applied to organizational design, FC transforms leadership into an ongoing experiment: observe what functions, modify what doesn’t, and track the reinforcing contingencies that sustain collective vitality. This allows the organization itself to become a living contextual process, not a static entity.
Relational Frame Theory: A Network Science for Networks
Relational Frame Theory extends this logic to human meaning-making. RFT tells us that behavior is shaped not just by direct reinforcement, but by how we relate things in language—by the networks of meaning we build over time.
This principle scales beautifully to organizations. In a modular collective, coherence arises not from control, but from shared relational framing—common language, shared principles, mutual reinforcement.
When every member orbits around the same organizing relations (“flexibility over rigidity,” “function over form,” “values over compliance”), the collective self-organizes. Communication, decision-making, and cultural identity flow naturally from those relational frames.
RIACT.org embodies this. The language of ACT, FC, and RFT doesn’t just describe therapy, it structures the entire organization. Members speak in terms of “workability,” “context,” and “flexibility,” forming a living demonstration of RFT’s premise: shared relations generate shared action.
Process-Based Therapy: The Functional Framework for Practice
PBT moves beyond the era of alphabet therapies—CBT, DBT, ACT, IFS—by asking a more fundamental question: Which processes drive change, and for whom, under what conditions? (Think Reimagining ACT)
The modular collective mirrors that inquiry at a systemic level. Instead of insisting on one “best model,” the collective integrates diverse clinicians, each addressing processes like psychological flexibility, emotional regulation, perspective-taking, and social connection.
Just as PBT tailors treatment to the individual, the collective tailors structure to each clinician—creating a system that is idiographic, data-informed, and continuously evolving.
RIACT.org exemplifies this process-based design: it’s a network that adapts in real time to the needs of its members and clients. Supervision, education, documentation (like the AIC-Flex Note), and even community engagement are modular—each serving a functional role within a broader ecosystem of growth and feedback.
RIACT.org: A Living Case Study in Systemic Flexibility
What’s happening at RIACT.org in Rhode Island isn’t theoretical—it’s already happening.
Born from the dissatisfaction with rigid agency models, RIACT has grown into a collective of independent clinicians, residents, and interns operating under a shared contextual framework. It combines technology, peer-based supervision, and functional philosophy to provide a “teaching hospital” for contextual behavioral science.
RIACT’s structure:
- Residency and Supervision Programs: Function like medical residencies, offering structured training grounded in ACT, FC, and PBT principles.
- Collaborative Infrastructure: Shared billing, marketing, and digital communication tools create efficiency without hierarchy.
- Contextual Data Systems: The AIC-Flex Note format integrates process-based tracking with contextual reflection, turning documentation into a live feedback system.
- Education and Dissemination: Podcasts, trainings, and workshops extend the model’s reach, while reinforcing the community’s shared language and mission.
In just a few years, this network has expanded rapidly, attracting clinicians who want autonomy without isolation, and structure without bureaucracy. Its growth signals what’s possible when philosophical coherence, technological tools, and functional design come together. It started in 202 with 2. Became more formal in 2022 with six and last year there were about a dozen involved. This year, there are 50+ members, associates, affiliates and 263 basic members..
Technology as the Accelerant
Technology is the force that transforms theory into movement. With AI-supported note systems, outcome dashboards, and communication hubs, collectives like RIACT can scale while maintaining intimacy and quality.
The integration of automation, analytics, and adaptive platforms frees clinicians from administrative drag, allowing attention to return to process and presence. These same tools make supervision more dynamic, feedback more immediate, and training more experiential—creating an ever-learning system.
The Disruption Has Already Begun
What Uber did to taxis and what smartphones did to telecommunication, RIACT and similar collectives are poised to do to mental health agencies. I want you to have access to this and help shape how it unfolds. As contextual behavioral science merges with modular infrastructure, a new paradigm is taking shape—one that replaces compliance with collaboration, efficiency with adaptability, and hierarchy with functional coherence.
Legacy agencies, designed for volume and control, will either evolve or evaporate. The clinicians and collectives that thrive will be those that think contextually, act flexibly, and organize functionally. This isn’t merely the future—it’s already unfolding in Rhode Island (and perhaps elsewhere), one context at a time.
The Future Is Functional
The convergence of FC, RFT, and PBT with modular technology represents not just a theoretical advance—it’s a movement toward systemic flexibility.
The next decade will belong to collectives like RIACT.org: organizations that act like living systems, learn from their environment, and continuously adapt to promote the well-being of both clients and clinicians. The mental health field is about to experience its Uber moment. Those grounded in context, process, and collaboration won’t just survive it—they’ll define it.
An Invitation to Join
Maybe you’ve already begun to build something like this on your own—if so, let’s connect and learn from each other. Maybe this is all new to you, and you’re curious about how it works—we’d be happy to share more and show you what’s possible. Or maybe you’re barely hanging on inside a system that’s burning you out, and you’re looking for a way out.
We’re here to help.
Visit RIACT.org, reach out, and see how we’re creating a better, more functional way to do this work—together.
We are RIACTing the best ways we know how—functionally and relationally. Join in the movement.
Please NOTE: If there is enough interest in this, I will add the guide for "Building a Functional Collective" here so that the community can use the document to form their own version of this group. In the meantime, you can also just send me a message and I will send you what I have to [email protected]
Thanks!