How to Write an ACT-in-Context (AIC) Note
A Process-Based, Functionally Grounded Clinical Note Format for Modern Therapists
Why Use the AIC Note Format?
The ACT-in-Context (AIC) note is a structured, practical tool designed to capture clinical work through the lens of Functional Contextualism (FC) and Relational Frame Theory (RFT). It helps clinicians identify, document, and respond to functional patterns of behavior using ACT's psychological flexibility model.
Enhanced SOAP Note
A clinically evolved version of the traditional SOAP note with the precision of a behavioral progress note and the depth of a process-based intervention model.
Functional Analysis
Infuses behavioral analysis while anchoring observations in client context and highlighting relational networks and language patterns.
Process Awareness
Organizes therapeutic work through the six psychological flexibility processes, promoting both clinical accountability and process awareness.
Step-by-Step: Writing the AIC Note
Gather Information
Collect client data and session observations
Structure Note
Organize into AIC format sections
Apply ACT Lens
Analyze through psychological flexibility model
Track Progress
Document interventions and outcomes
1. Presenting Problem
This section blends the client's internal narrative (subjective) with observable signs (objective), equivalent to the Subjective and Objective components of a SOAP note.
Functioning Update
Summary of how the client has been functioning since the last session
Practice Completion
Note any assigned practice completion and emotional tone upon arrival
Client's Language
Include the client's own phrasing of the problem
Severity Rating
Rate distress on a 0–10 scale to provide a behavioral anchor
2. Context: The Four Life Quadrants
This section tracks stability, shifts, or environmental events that influence session themes—paralleling the "O" (Objective) section in SOAP with a richer contextual frame based on Functional Relevance.
LOVE
Relationships, connections, supports
WORK
Employment, productivity, education
PLAY
Recreation, creativity, joy
HEALTH
Physical/mental health, routines, risk behaviors
3. Functional Analysis
This is the heart of the note from a behavioral and contextual lens, equivalent to the Assessment in SOAP and the ABCs in a Behavioral Note. It identifies why patterns persist and how they function in the client's life.
Triggering Contexts
Identify antecedents
Behavioral Responses
Note emotional and behavioral reactions
Avoided Experiences
Recognize covert behaviors
Consequences
Document reinforcement patterns
4. Psychological Inflexibility Patterns
Identify the most dominant ACT processes interfering with psychological flexibility in your client's presentation. This helps target interventions more precisely.
The Yearning
What meaningful experience is the client longing for?
Inflexibility Processes
Patterns that block psychological flexibility
Core Processes
Cognitive Fusion, Experiential Avoidance, Present Moment Disconnection, Values Confusion
5. Intervention
This section blends behavioral data and subjective response—restructuring the "S" and "A" from SOAP through Functional Contextualism. It clearly describes your therapeutic approach and client response.
Intervention Applied
Model used, exercises introduced, metaphors applied
Client Response
How the client engaged with the intervention
Functional Shifts
Changes in emotional tone, posture, insight, or behavior
Integration
How the client incorporated the learning
6. Experiment Assigned
Assign a between-session activity, framed as an experiment—not homework. This approach promotes generalization, pattern disruption, and self-reflection in the client's natural environment.
Specific
Clear instructions with concrete steps
Observable
Can be tracked and reported on
Process-Linked
Connected to flexibility processes (e.g., defusion, acceptance)
Keep experiments manageable and directly related to the session's focus. Frame them as curious explorations rather than tasks to complete or fail.
7. Plan
Summarize the direction for upcoming sessions, equivalent to the Plan section in SOAP notes but with a process-based focus that guides your therapeutic intention.
1
Flexibility Focus
Which psychological flexibility processes you'll target next
2
Functional Shift
The clinical function you're trying to change
3
Guiding Intention
Your therapeutic aim (e.g., increase willingness, strengthen values clarity)
8. CPAT Rating (0–10)
The Clinical Process Awareness Tracker (CPAT) adds a layer of process tracking not found in SOAP or standard behavioral notes. This numerical rating helps evaluate session quality and track progress over time.
Use the CPAT to help both supervisor and clinician quickly assess session depth and direction, providing a visual representation of therapeutic progress. Be sure to look up CBAT and CPAT articles on https://rhodeislandactcom.substack.com/
Summary: Building on SOAP and Behavioral Notes
The AIC note format integrates the best elements of existing clinical documentation approaches while enhancing them with process-based tracking.
Final Thought
The AIC note supports both clinical rigor and therapeutic intuition. It keeps you grounded in what matters—what the client is doing, why they're doing it, and how you can respond effectively in a way that promotes sustainable, values-aligned change.
By integrating functional analysis with process-based therapy, the AIC note format transforms documentation from a bureaucratic requirement into a powerful clinical tool that enhances your therapeutic effectiveness.